Head injuries

Today the news sites reported the sad loss of Australian cricketer Phillip Hughes following a head injury during a match. He was 25 years old.

I frequently encounter patients suffering from head injury, mostly involving minor wounds of an accidental nature. The relatives and friends are often anxious, one might say justly since a head injury can have serious consequences.

The link below has some helpful tips on how to recognize the more serious injuries and what to do.

http://www.nlm.nih.gov/medlineplus/ency/article/000028.htm

Wellcome Image Awards | Breast cancer treatment

Breast cancer therapy in (really) close up...

Wellcome Image Awards | Breast cancer treatment

Shift work bad for the brain

Heart attacks, obesity, stroke...and the list has just been increased by one. A recent study has found that shift work can also lead to cognitive decline. Thankfully it seems to be reversible within five years.

http://www.bbc.com/news/health-29879521

Sex: myths and facts

It is remarkable how many misconceptions exist about sex. The page below lists some of the commoner ones...as well as several important-to-know facts.

http://www.ashasexualhealth.org/stdsstis/myths-and-facts/

5 tips for discussing Ebola with children

When talking to children about this disease:

1. Stick to the facts
2. Reassure them they are safe
3. Explain to them the difference between where you live and Africa
4. Reinforce the need to look after their health including the importance of hand hygiene
5. Take the opportunity to teach them some facts on geography, biology, and science

More in the following link

http://www.washingtonpost.com/news/parenting/wp/2014/10/07/5-tips-for-talking-to-your-kids-about-ebola/

Ebola outbreak status

Ebola infections are currently predominantly in Africa. The link below illustrates this.


http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html

The digital chaperone

A chaperone is a person, apart from the doctor and the patient, present during the medical consultation whose role is to ensure propriety on the part of the doctor and the patient. Such a person is typically enrolled during consultations entailing sensitive and/or intimate examination (of for example the breast).

Dr Paul E. Shannon muses in his blog whether the time has come to introduce some sort of digital chaperone.

http://beyondclinical.wordpress.com/2013/07/26/the-digital-chaperone/

He links his concept to Google glass, through the following blog post.

http://geekdoctor.blogspot.com.au/2013/07/the-healthcare-it-applications-of.html?utm_source=twitterfeed&utm_medium=twitter

Antibiotics: to prescribe or not to prescribe?

A survey carried out in the UK sheds light on doctors' prescribing habits.

http://www.express.co.uk/news/uk/501185/Half-GPs-admit-dishing-out-useless-antibiotics-pushy-patients-off-back

A case of severe peanut allergy

http://www.standard.co.uk/news/london/little-girl-4-stops-breathing-on-stansted-flight-after-selfish-passenger-opens-packet-of-nuts-despite-three-warnings-9667938.html

Four tips for coping with depression

Some quick advice on how to help yourself if you think you are suffering from depression.

-Be more active.
-Face your fears.
-Avoid too much alcohol.
-Develop a routine.

More information in the link below.

http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/dealing-with-depression.aspx

Acne

Is there a reason for acne? Does it have a purpose? More in the link below...

https://testtube.com/dnews/why-do-we-get-acne/?utm_source=FB&utm_medium=DNews&utm_campaign=DNewsSocial

Ibuprofen side effect

https://testtube.com/dnews/an-unexpected-side-effect-of-ibuprofen/?utm_source=FB&utm_medium=DNews&utm_campaign=DNewsSocial

The Ebola virus

http://www.who.int/mediacentre/factsheets/fs103/en/

Shot at!

Yesterday evening somebody decided to play around with an airgun in the vicinity of Gzira Health Centre. A couple of shots rang out...then a bang and the noise of a ricochet. One pellet entered through an open window, hitting a cupboard door, passing within a whisker from my face before tumbling harmlessly on the floor. I shudder to think what would have happened had the trajectory been slightly different....

Kif inħarsu saħħitna fis-sajf

Sajf tipiku Malti huwa kkaratterizzat minn temperaturi għoljin u umdità qawwija fl-arja. Filwaqt li għat-turisti li jiġu jżuruna dawn il-kundizzjonijiet huma ideali, mhux daqstant għal min irid jagħmel tliet xhur jgħix ġo fihom. L-iktar esposti għall-effetti kiefra tas-sħana huma t-tfal żgħar, l-anzjani u l-morda.

Ir-raġġi tax-xemx għandhom effetti fuq il-ġilda tal-bniedem. Dawn narawhom meta din tismar, jew inkella tiħmar wara ħin twil fix-xemx. Filwaqt li suntan tista' tkun sabiħa u attraenti, wieħed irid iżomm f'moħħu li r-raġġi tax-xemx jistgħu jikkawżaw kanċer tal-ġilda. Għalhekk wieħed għandu jieħu l-prekawzjonijiet neċessarji li huma:

• tiġi evitata x-xemx bejn il-ħdax ta' filgħodu u t-tlieta ta' wara nofsinhar
• jintlibes kappell
• jintlibes nuċċali tax-xemx
• jintlibsu ħwejjeġ ċari u mhux issikkati
• tintuża krema kontra r-raġġi tax-xemx (sunblock) li tkun adattata għall-ġilda tal-individwu (ġilda ċara teħtieġ protezzjoni iktar qawwija).

Is-sajf ipoġġina f'temperaturi għoljin li l-ġisem tagħna jirrispondi għalihom billi jipproduċi l-għaraq. L-għaraq jgħin biex it-temperatura tal-ġisem tibqa' kostanti. Dan it-telf ta' likwidi jrid ipatti għalih ix-xorb ta' likwidi. L-aħjar li jinxtorob hu ilma frisk (mhux kiesaħ) f'ammont ta' madwar żewġ litri fil-ġurnata. Jekk dan ma jsirx il-persuna tista’ tiġi dehydrated, tinżlilha l-pressjoni u saħansitra jħossha ħażin.

Riskju ieħor assoċjat ma’ nuqqas ta’ xorb ta’ likwidi fis-sajf hu dak ta’ ġebla fil-kliewi. Dan għaliex f’sitwazzjoni fejn il-ġisem ikun nieqes mill-fluwidi, dawn jittieħdu mill-urina li b’hekk issir iktar konċentrata. Urina kkonċentrata tagħmilha faċli li titrabba l-ġebla fil-kliewi.

It-temperaturi għoljin tas-sajf ikollhom effett ukoll fuq il-moħħ. Bosta nies ikunu irritabbli jew apatiċi f'dan l-istaġun, probabbilment minħabba nuqqas ta' rqad, jew irqad ħażin. Ġranet twal u sħan inaqqsu mill-irqad. Fil-ġranet tas-sajf wieħed għandu jnaqqas l-impenji ta' xogħol, jew jekk dan mhux possibli, jiżgura li l-mistrieħ tiegħu jieħdu.

Biex jiffriskaw xi ftit bosta nies jerħulha lejn il-bajjiet. Hemm diversi prekawzjonijiet li wieħed jagħmel tajjeb li jieħu qabel din l-attività pjaċevoli. Dawn jinkludu:

• Jagħżel bajjiet fejn l-ilma jkun nadif. Portijiet u marinas għandhom tendenza jkollhom ilma baħar imniġġeż biż-żjut u ħmieġ ieħor tad-dgħajjes. Għawm f’ilma mniġġeż jista’ jwassal għal infezzjonijiet fil-ġilda.
• Ma jkunx prużuntuż. Mhux kulħadd għandu l-istess abbiltajiet fiżiċi, għalhekk għawwiema mhux esperti għandhom jevitaw bajjiet fejn l-ilma huwa fond jew imqalleb.
• Ma jimxix ħafi lanqas fuq il-bajja. Bosta huma dawk li jweġġgħu saqajhom għax jaqtgħuha ma’ xi biċċa ħġieġa mkissra, jirfsu fuq ġamar jikwi, jew jitniggżu b’siringi mormija.

Attività li dejjem qed iżżid fil-popolarità hija l-għads. Huwa importanti li wieħed jagħmel eżami mediku qabel wieħed jibda dan il-passatemp. Dan hu tajjeb għaliex hemm diversi kundizzjonijiet mediċi li jekk wieħed ikun ibati bihom aħjar ma jogħdosx, bħal pereżempju l-ażżma mhux kontrollata. Kif ukoll wieħed irid jieħu ħsieb li jekk ikun ma jiflaħx jaħsibha darbtejn qabel jinżel jogħdos, għax ċertu mard bħal sinusite jiggrava bit-tibdil fil-pressjoni tal-ilma.

La qed insemmi l-għawm u l-baħar ma nistax ma nitkellimx dwar il-bram.

F'dawn l-aħħar snin, malli jersaq is-sajf u jibda l-istaġun tal-għawm, dlonk tibda l-problema tal-bram. Donnu minn xi snin ’l hawn dawn żdiedu, bil-konsegwenza li qed itellfu l-gost ta' għawma li tiffriska u ttaffi mis-sħana tas-sajf.

L-ewwel ħaġa li wieħed għandu jagħmel biex ma jingidimx hu li jiżgura ruħu li jmur jgħum f’bajjiet li ma fihomx bram. Wieħed jista’ jikkonsulta ma’ siti meteoroloġiċi jew rapport tat-temp biex jara d-direzzjoni tar-riħ. Jekk ir-riħ ikun jitfa’ ’l ġewwa r-riskju li jkun hemm il-bram jiżdied. Illum hawn ukoll siti fuq l-internet li jagħtuk mappa, aġġornata kuljum,  ta’ fejn qiegħdin il-bram. Titwila lejn il-baħar qabel wieħed jinżel hija wkoll importanti.

Il-konsegwenzi lokalizzati ta' gidma ta' brama huma uġigħ li jiżdied fuq medda ta' għaxar minuti, ħmura, ħakk, nefħa, bżieżaq li jistgħu jkunu mimlija b'likwidu ċar jew materja, u ulċeri. Rarament il-gidma jista' jkollha wkoll konsegwenzi serji u ġenerali bħal żieda fil-produzzjoni tar-riq, disturbi gastrointestinali, spażmu muskolari, disturbi respiratorji u problemi kardjovaskolari.

Il-kura ta' gidma ta' brama għandha tibda billi l-parti tal-ġisem affettwata tinżamm ma tiċċaqlaqx u wara jiġi applikat il-ħall (dan biex ma jibqgħux ħerġin iktar labar mit-tentakolu). Għandhom jiġu evitati ilma ħelu, alkoħol, ammonja, u bleach għax dawn jistimulaw it-tentakoli biex jisparaw iktar labar.

Li jmiss hu li jitneħħew xi tentakoli li jkun għad baqa’ mal-ġisem. Dan għandu jsir b'kura, preferibbilment bl-użu ta' ingwanti u pinzetta. Wieħed għandu joqgħod attent li t-tentakoli jiġu merfugħa 'l fuq u mhux mimsuħa. Huwa wkoll siewi li l-parti tal-ġisem affettwata tiġi mqaxxra minn xi suf jew xagħar.

Il-pass li jmiss hu li jsir kuntatt ma' tabib biex dan jagħti parir dwar xi ingwenti jew pilloli li jistgħu jkunu ta' fejda.

Il-ġilda tal-bniedem tista’ tiġi attakkata wkoll minn insetti, li fis-sajf il-maġġoranza tagħhom ikunu nemus, żnażan, u naħal. Gidma ġġib magħha nefħa, ħmura u ħakk. Inqas spiss gidma tista’ tikkawża infezzjoni. L-aħjar prevenzjoni huwa l-ilbies li però fis-sajf bilfors ikun imqaċċat. Għall-ġewwa d-dar wieħed jista’ juża insect screens mat-twieqi u bibien jew xi attrezzatura li tarmi kimika fl-arja li tgerrex jew toqtol l-insetti. Jeżistu wkoll diversi ingwenti għal fuq il-ġilda li jgerrxu l-insetti.

Qabel nagħlaq, kelmtejn fuq l-ikel. Is-sħana tas-sajf tagħmilha iktar faċli biex il-mikrobi jimmultiplikaw u għalhekk wieħed għandu jaħsel idejh ta’ spiss, jaħsel frott u ħaxix qabel jieklu, u jiżgura li laħmijiet u ħut ikunu imsajrin sew. Dan sabiex tiġi evitata gastrointerite li hija kkaratterizzata minn deni, dardir, remettar, dijarrea u uġigħ fl-istonku.

An autistic child

The other day a mother brought her five year old daughter to the clinic.

"Doctor, my daughter has a sore throat, I'd like you to check her out please"

As I was about to get up to examine the girl...

"Please note that she's autistic...examination might be tricky."

As two nurses and the mother struggled to hold the child down I glanced at the the mother. Her expression spoke of the endless sleepless nights, of the worry for the child's health.

Autism is a huge challenge for the child, and more so for the parents and carers. Though the cause is as yet not precisely identified, research is ongoing as this article in National Geographic shows.

http://phenomena.nationalgeographic.com/2014/05/21/the-roots-of-autism-are-in-the-skin/?utm_source=Twitter&utm_medium=Social&utm_content=link_tw20140526ph-autism&utm_campaign=Content&sf3050086=1

Edit (September 2019): A reader of this blog recently brought to my attention the relation between people with ASD and the internet. In today's world the web is ubiquitous and naturally everyone has some form of interaction with it...including persons diagnosed with ASD. The following are some guidelines to help those with this condition navigate safely this sea of information. Thank you Mariya Klorova.

Internet safety for people with ASD

The dangers of (too much) tea

While sipping my afternoon cuppa I chanced upon an article on Pubmed...a case of tea overdose.

A lady was complaining of loss of appetite and weight loss to her doctors. They could not find a cause for her symptoms and in the end suggested she cut down on her two litre per day tea consumption. Her symptoms improved and she regained the lost weight.

The readers with a medical background might be interested to know that the only laboratory abnormality was an elevated CA 19.9.

Original article here.

This has nothing to do with medicine...

Recently I unearthed a box of my old toy cars. These were promptly confiscated by my elder son. One of them is the one in the picture shown.

Since I never recall seeing anything like it on the roads, I did some research. It's called the Vauxhall Guildsman and the story behind it is in the link below.

http://www.breithaupts.com/totc597.htm

Gluten sensitivity

Gluten sensitivity is a condition where patients experience gastrointestinal upset in response to exposure to gluten in food.

Now researchers seem to be doubting its very existence after carrying out further studies. More details in the link below.

http://www.businessinsider.com/gluten-sensitivity-and-study-replication-2014-5

More on electronic cigarettes

Recently I posted on electronic cigarettes, link here.

A letter in the New England Journal of Medicine provides further insight. Its gist is that nicotine is highly poisonous, and since e-cigarettes contain nicotine in solution they can be a cause of serious poisoning.

http://www.nejm.org/doi/full/10.1056/NEJMc1403843

Does size matter?

A recent study suggests that it does.

Watch video here http://dne.ws/RlF1rf

For those interested to read the original research paper please click the link below.

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0095298

Electronic cigarettes

The jury's still out on these. What's sure is that they're very popular. This is how they work.

http://www.popsci.com/article/technology/how-it-works-electronic-cigarette?src=SOC&dom=fb

Ten types of patient

During my work I come across many people, with different personalities. These in turn affect the way they present their problems to me. I came across this article which describes the various types encountered in the clinic.

Read it here.

How Facebook might have saved a little girl's eyesight

A mother posted a photograph of her daughter to Facebook. Some users highlighted to her that one of the girl's eyes looked funny. The mother, after a visit to the doctor, was told her offspring had Coats' disease. Full story here.

This disease is a rare disorder that affects the blood vessels at the back of the eye and can cause blindness.

More on Coats' disease in this link.

Diabetes: Prevention of bruising at injection sites

Some useful information for diabetics on insulin.

http://www.informationaboutdiabetes.com/articles/lifestyle-tips/how-to-stop-bruising-at-injection-sites

Mosquitoes

It's interesting to note, now that warmer months are slowly approaching, how mosquitoes seem to select their targets.

http://www.businessinsider.com/skin-bacteria-attracts-mosquito-bites-2014-3

Preventing HIV transmission - new developments

A recent study has suggested that a gel can be used by the female to prevent HIV transmission after sexual intercourse.

More details in this link

Bringing people back to life

I read an article about CPR (cardiopulmonary resuscitation) which puts to rest a couple of myths, and more importantly tells the reader how to be useful in an emergency.

Read it here

Contact lens for diabetics

Google is working on a contact lens that can measure glucose levels in tears. Readings apparently can be taken as often as once per second.

Full story here

Winter blues

SAD is not a myth. It is a mental disorder that is incompletely understood and also something that is complicated by questions about the role of evolutionary biology.


In order to meet the qualifications for a SAD diagnosis, according to the Mayo Clinic, an individual must be show the following:

• depression and other symptoms for a minimum of two consecutive years during the same season.
• depression-free periods following episodes of depression
• unexplained behavior and mood changes.

Read more: Seasonal affective disorder: who suffers what's the best treatment | TIME.com http://healthland.time.com/2014/01/10/can-winter-really-make-you-sick-the-truth-about-seasonal-affective-disorder/#ixzz2q1IXd3yu

Promising cancer research

Cancer-killing "sticky balls" can destroy tumour cells in the blood and may prevent cancers spreading, early research suggests.

Scientists at Cornell University, in the US, have designed nanoparticles that stay in the bloodstream and kill migrating cancer cells on contact.

Full BBC article here