Weight loss injections and vision problems

👀 In a recent news article, Robbie Williams has opened up on the effects of the weight loss injections he's having. 

💉 While noting the benefits they've had on his weight and mental health, he's also admitted to have been unfortunate enough to experience one of their rare side effects, namely vision problems.

🚨 These drugs are GLP-1RAs, of which the most well known are semaglutide (marketed under the brand names Ozempic and Wegovy) and tirzepatide (Mounjaro). 

☝🏼 Though rare, these problems can occur with these drugs and patients on them are encouraged to promptly contact their health care provider if they notice any changes in their eyesight.

Sleeping habits

💤 Do you put off sleeping in order to get some 'me time ' at the end of the day or maybe watch another episode of your favourite series?

☝🏼 You could be doing 'Bedtime procrastination'.

Most of the time this is unintentional. 

However getting enough sleep is essential....7-9 hours is the recommended amount. 

🫩 Not getting enough sleep can have the same effect as being drunk. 

💡 Getting enough sleep is essential for a healthy body and mind!

Melatonin

Melatonin is a common supplement used by persons suffering from insomnia. 🛌🏼

The effects of this substance on patients' health were studied and the findings are quite interesting.

👉🏼 Melatonin users were found to have a higher incidence of new onset heart failure.

👉🏼They were also at increased risk of hospitalisation for heart failure.

👉🏼 Mortality risk was also increased.

☝🏼The study had certain limitations such as relying on electronic health record and claims data, the results are yet to be peer reviewed, cohort members were all insomnia sufferers - so difficult to extrapolate results beyond this group, and the mechanism of 'harm' has not been established.

Link to more information here.

☕ Coffee: The Good, The Bad, and The Buzz

🚀 The Health Benefits of Coffee

1. Boosts Energy and Focus

Coffee’s caffeine blocks adenosine, a chemical that makes you feel tired.

💡 Result: More alertness, sharper focus, and a productivity boost—perfect for long workdays or early mornings.

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2. Packed with Antioxidants

Coffee is rich in antioxidants that fight inflammation and cell damage.

🌱 Fun fact: It’s one of the biggest antioxidant sources in the modern diet, beating out even fruits in some cases.

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3. May Protect Against Disease

Moderate coffee drinkers (2–4 cups a day) have a lower risk of:

Type 2 diabetes

Parkinson’s and Alzheimer’s

Liver diseases (like cirrhosis and fatty liver)

🩺 Studies suggest coffee supports heart and brain health when consumed in moderation.

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4. Improves Physical Performance

Caffeine raises adrenaline levels and mobilizes body fat for energy.

🏃‍♀️ Why it matters: Coffee can make workouts feel easier and more effective—hence the pre-gym espresso trend.

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5. Enhances Mood and Mental Health

Regular, moderate caffeine intake is linked to lower risks of depression and improved mood.

❤️ A mindful cup can be a genuine mental boost in your day.

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⚠️ The Harmful Effects of Too Much Coffee

1. Anxiety and Sleep Issues

Overdoing caffeine can overstimulate your nervous system, causing:

Jitters

Racing thoughts

Restless sleep

🕐 Pro tip: Avoid coffee within 6 hours of bedtime.

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2. Stomach Sensitivity

Coffee increases stomach acid, which can lead to heartburn or nausea.

☕ Try cold brew or low-acid blends if you’re sensitive.

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3. Dependence and Withdrawal

Skip your usual cup and you might face:

Headaches

Fatigue

Irritability

⚡ Taper slowly rather than quitting suddenly.

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4. Bone Health and Nutrient Loss

Excessive caffeine (over 4–5 cups daily) can interfere slightly with calcium absorption.

🥛 Pair coffee with calcium-rich foods or fortified plant milks to stay balanced.

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5. Sugar and Calorie Overload

Fancy café drinks can pack hundreds of calories.

🍩 Stick to black coffee, plant-based milk, or natural flavorings like cinnamon.

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☯️ Finding Your Healthy Coffee Balance

Here’s how to keep your relationship with coffee healthy:

☕ Drink: 1–3 cups per day (max ~400 mg caffeine)

🤰 Pregnant: Limit to 200 mg/day

💧 Hydrate: Match each cup with a glass of water

🍃 Choose wisely: Go for clean, minimally processed coffee

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💬 Bottom Line

Coffee is neither hero nor villain—it’s all about how you use it.

Enjoyed mindfully, it supports energy, focus, and longevity.

Overdone, it fuels stress and sleepless nights.

☕ Sip smart, stay balanced, and enjoy every cup.

Hot Car Deaths: How to Keep Children Safe from Heatstroke in Vehicles

Most parents believe they could never forget their child in a car. But research shows that hot car deaths can happen to anyone — even the most loving, attentive caregivers. In the United States, dozens of children die each year from heatstroke in vehicles. While the number of cases in Europe is lower, the same risks exist, especially as summers grow hotter and cars heat up faster than many people realize.

How Children Get Trapped in Hot Cars

Most cases of child heatstroke in vehicles happen when a caregiver unintentionally leaves a child in the back seat, often after a change in routine or a moment of distraction. In other cases, toddlers climb into parked cars on their own and become trapped. It’s rarely about negligence — it’s about how human memory and stress can work against us in everyday life.

Why Children Are So Vulnerable

A child’s body heats up three to five times faster than an adult’s. Even when it feels comfortable outside — around 20°C (68°F) — the temperature inside a parked car can climb to dangerous levels in just minutes. Within a short time, the heat can overwhelm a young child’s ability to cool down, leading to potentially fatal heatstroke.

Simple Steps to Prevent Hot Car Tragedies

Experts recommend a mix of awareness, daily habits, and new car safety technologies for children:

Always check the back seat. Before locking up, do a quick “look before you lock.”

Lock your car when parked at home. This stops children from climbing inside.

Use reminders. Place a bag, phone, or shoe in the back seat so you’ll always look before leaving the car.

Use or support new vehicle safety systems. Many newer cars have rear-seat reminders or child detection alerts that notify drivers if someone might still be in the car.

Why Awareness Matters in Europe

While pediatric vehicular heatstroke is more common in the U.S., the same risk factors — busy lives, stress, and higher temperatures — apply across Europe. Public health experts say awareness campaigns, along with new vehicle safety standards, could save lives. Teachers, health professionals, and caregivers all play a role in spreading one simple message:

👉 Check the back seat, every time.

No one plans to forget their child — and that’s exactly why prevention is so important. A quick glance before locking the car can make all the difference.

When Can You Drive or Return to Work After Groin Hernia Surgery? | Recovery Guide

If you’ve recently had a groin (inguinal) hernia repair, you’re probably eager to get back to your usual routine. Recovery varies from person to person, but most people can resume normal activities within days — depending on comfort, job type, and the kind of surgery performed.

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🚗 When Can You Drive Again?

You can usually start driving a few days after surgery, once your pain is controlled and you can move comfortably enough to perform an emergency stop.

Laparoscopic (keyhole or TEP) repair: Often safe to drive within 2 days

Open (Lichtenstein) repair: Driving ability may be affected for up to 2 weeks

Studies show that brake reaction times are slower for about two weeks after open repairs, so it’s best not to rush.

✅ Pro tip: Don’t drive if you’re still on prescription painkillers or can’t twist and brake quickly without discomfort.

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💼 Returning to Work

Your return-to-work timing depends on how physical your job is:

Office or light-duty work: Usually within 1–2 weeks

Strenuous or manual jobs: Typically 2–4 weeks

Most people take around a week off, but some need longer. Pain, fatigue, and wound healing are the main limiting factors. Importantly, research shows that an early return to work doesn’t increase the risk of recurrence, as long as you feel ready.

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💡 Key Takeaways

Driving: Safe once you’re pain-free and mobile (2 days–2 weeks)

Work: Light jobs in 1–2 weeks; heavy jobs in 2–4 weeks

Listen to your body: Comfort, confidence, and safety come first

Check with your surgeon: Everyone heals differently

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Bottom line:

Most people are back to driving and working within a couple of weeks after hernia surgery. Follow your body’s cues, stay active within reason, and don’t hesitate to ask your surgeon for tailored advice — recovery is personal, but short and successful for most patients.

What You Need to Know About Frozen Shoulder: Causes, Symptoms, and Treatment

Have you noticed your shoulder becoming stiff and painful, making it hard to lift your arm or reach behind your back? You might be dealing with frozen shoulder, also known as adhesive capsulitis. This common condition can make even simple tasks—like brushing your hair or reaching for a cupboard—feel impossible.

What Is Frozen Shoulder?

Frozen shoulder happens when the tissue around your shoulder joint (called the joint capsule) becomes thick, tight, and inflamed. Over time, this restricts movement and leads to ongoing pain.

It often develops gradually and can affect one or both shoulders. Although anyone can get frozen shoulder, it’s more common in people between 40 and 60 years old, and in those with diabetes or thyroid problems.

The Three Stages of Frozen Shoulder

1. Freezing stage – Shoulder pain slowly increases, and movement becomes limited.

2. Frozen stage – Pain may ease, but stiffness remains and everyday movement feels restricted.

3. Thawing stage – The shoulder slowly regains its normal range of motion.

These stages can take anywhere from 12 to 24 months to fully pass.

How Is Frozen Shoulder Treated?

Most people recover without surgery, though it can take time. Treatment focuses on reducing pain and restoring mobility. Common approaches include:

Physiotherapy: Stretching and strengthening exercises to restore movement.

Pain relief: Over-the-counter medication or prescription medication to reduce inflammation.

Heat therapy: Applying warmth to relax muscles and ease stiffness.

If symptoms persist, your doctor might suggest referral to an orthopaedic specialist.

Can You Prevent Frozen Shoulder?

You can lower your risk by keeping your shoulders moving—especially after an injury or surgery. Gentle range-of-motion exercises and regular stretching help maintain flexibility and prevent stiffness.

The Bottom Line

While frozen shoulder can be frustrating and slow to heal, the good news is that most people make a full recovery with the right treatment and patience. If shoulder pain or stiffness is affecting your daily life, don’t ignore it—talk to your GP or physiotherapist for guidance.

The Hidden Dangers of Trans Fats — And How to Avoid Them

Not all fats are created equal. Some are good for your body, like the healthy fats in nuts, avocados, and olive oil. But there’s one type of fat that health experts agree we should avoid as much as possible: trans fats.

Why Are Trans Fats Harmful?

Trans fats are made when liquid oils are turned into solid fats to make foods last longer on the shelf. You’ll often find them in:

Packaged snacks (cookies, crackers, cakes)

Fried fast foods

Margarine and shortening

The problem is, trans fats raise your “bad” cholesterol (LDL) while lowering your “good” cholesterol (HDL). This double hit makes them especially dangerous for your heart, increasing the risk of heart disease and stroke.

How to Spot and Avoid Trans Fats

Food companies have gotten better at reducing trans fats, but they can still sneak into your diet. Here’s how to protect yourself:

1. Read labels carefully – Look for “partially hydrogenated oils” on ingredient lists. That’s code for trans fats.

2. Limit fried and packaged foods – These are the most common culprits.

3. Cook more at home – Using fresh ingredients gives you control over what goes into your meals.

4. Choose healthier fats – Swap butter or shortening for olive oil, nut butters, or avocado.

The Bottom Line

Trans fats offer no health benefits — only risks. By choosing whole foods and checking labels, you can keep your heart healthier and your body stronger. Small changes, like cooking with healthier oils or skipping that box of processed snacks, add up over time.

What To Do If You or Someone You Know Gets Bitten by a Dog

Dog bites can be frightening, painful, and sometimes serious. Even the friendliest dogs may bite if they feel scared, startled, or protective. Knowing what to do right after a bite can make a big difference in preventing infection and complications.

Step 1: Stay Calm and Safe

Move away from the dog to prevent further injury. If the dog is unfamiliar, try to remember what it looks like, as this may help later with identifying vaccination history.

Step 2: Wash the Wound Thoroughly

Clean the bite immediately with plenty of running water and mild soap. This is the most important step in reducing infection risk. Allow the wound to bleed slightly if it’s small—it helps flush out germs.

Step 3: Control Bleeding

If the bite is bleeding heavily, apply gentle but firm pressure with a clean cloth or bandage until it slows down.

Step 4: Apply Basic Care

After cleaning, cover the wound with a sterile bandage. Avoid putting ointments or creams until a healthcare provider has assessed it.

Step 5: Seek Medical Advice

Always seek medical attention for dog bites, especially if:

The bite is deep, large, or near the face, hands, or joints.

The dog is unknown or not up to date on vaccines.

The person bitten has diabetes, a weakened immune system, or poor circulation.

A doctor may recommend a tetanus booster, antibiotics, or (rarely) rabies shots depending on the situation.

Step 6: Report the Incident

Local animal control or health authorities may need to know about the bite, particularly if the dog is a stray or its vaccination status is unclear. This helps protect others in your community.

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Key takeaway: Wash the wound well, control bleeding, and always seek medical advice. Quick action keeps small bites from becoming bigger problems.

False positives?

A study yet to be formally published and which is gaining media attention is posing an interesting question. Could it be that the PCR test currently in use to detect COVID-19 is picking up dead virus particles? This would result in patients being labelled positive when in fact they have recovered. It would explain observed instances when persons who have recovered clinically from the virus continue being flagged as still having it. Another issue that is raised by the yet to be peer-reviewed study is whether COVID-19 test results should continue being issued as simple positive or negative rather than using a cut-off point to determine active infection.

More reporting on

https://www.msn.com/en-gb/news/uknews/covid-tests-may-be-picking-up-traces-of-dead-virus/ar-BB18JutX

https://www.bbc.com/news/health-54000629

Update on COVID-19 vaccine

Astrazeneca is currently working on a vaccine against COVID-19 and has reported on early findings of tests carried out in human volunteers.

Published in The Lancet of 20th July, the paper gives details of results of a study carried out on 1077 volunteers who were either given the COVID-19 or a meningitis vaccine.

The researchers found that the COVID-19 vaccine was generally well tolerated with causation of mild side effects which were easily controlled by paracetamol. 

The vaccine gave promising results in that it elicited a response from the subjects' immune system of antibody and cellular type.

Currently there are 160 vaccines undergoing research in a global effort to combat the devastating coronavirus pandemic.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31604-4/fulltext

Here we go again

In my previous post I had hinted at an end to restrictions caused by the pandemic. Unfortunately events are showing otherwise. In retrospect I realise that I was being overly optimistic about a resolution to the COVID-19 problem. Which is not to say that things won't sort themselves out....just that we might have to wait a little longer.

All this roller-coaster of events puts strain on the psyche...especially on the brains of young children and adults who are growing up in a rapidly changing and sometimes scary world.

For this reason I suggest that you go through the following article I came across online. Especially if you have young children at home and are finding it challenging to keep them as happy as possible. Worth reading! 

https://www.unicef.org/coronavirus/how-protect-your-familys-mental-health-face-coronavirus-disease-covid-19

Post-COVID world

As we start moving towards some semblance of normality after the havoc of COVID-19 we must ensure that the gains made are not lost. For this end we must continue observing basic public health precautions.

One way to do this is by imparting information in an easily digestible manner to mass audiences such as with the use of posters or fliers. 

The link below directs to a website with a mini-trove of free posters to print out and display in public places. Check it out! 

https://www.websiteplanet.com/blog/free-printable-posters-covid-19/

Should I disinfect my groceries to prevent getting Coronavirus?

These days one of the things most people are concerned about is keeping an adequate food supply at home. Is there a risk of getting Coronavirus from grocery items? In theory if someone sneezes onto a food item and you pick it up and eat it then yes there is a risk...so how does one protect oneself?

According to the article in the link below the most practical way is to rinse objects you may be concerned about with warm water.

Keep in mind that use of disinfectant chemicals on food items is not recommended as this carries risks of it's own...the chemicals are often hazardous in themselves. For example bleach is irritant to the lungs and the last thing you want in this pandemic is a compromised lung.

More information in the link below. 

https://www.insider.com/how-to-safely-clean-your-produce-to-prevent-coronavirus-2020-3

There's also this article which has answers to a series of questions about grocery shopping. 

UPDATE. The Lancet published this paper about the survival of SARS-CoV-2. Of note is the prolonged survival at a temperature of 4 degrees Celsius which is the temperature of most refrigerators. Hence it is important to clean groceries such as fresh milk cartons before putting them in the fridge. 

UPDATE 2. Whilst going through my Facebook timeline I came across an article from Reader's Digest that is on the subject at hand. Though adding nothing new it is written in a matter of fact style, with lots of common sense that will surely appeal to those wishing to inform themselves without the burden of lots of technicalities. Read it here.

COVID-19 resources

Here are some useful resources for 

information on COVID-19

Johns Hopkins Coronavirus map

World Health Organisation advisory

World Health Organisation Q&A

Centers for Disease Control and Prevention COVID-19 page

Worldometer Coronavirus live statistics

NHS UK COVID-19 page

Malta Health Ministry COVID-19 page

European Centre for Disease Control and Prevention COVID-19 page

Burnout at work

Everyone experiences stress at work...otherwise it wouldn't be work! However continuous unrelenting stress is harmful to the individual. Oftentimes the problem for the worker is recognizing there is one, because unless this happens corrective actions will be difficult go implement.

The following are 20 warning signs that the stress levels at work have become toxic and some serious thought should be put towards remedying the situation. 

Courtesy of https://amp-businessinsider-com.cdn.ampproject.org/c/s/amp.businessinsider.com/20-ways-to-avoid-getting-burned-out-at-work-2015-9

Taking blood pressure medicines at night saves lives

High blood pressure or hypertension is a very common condition. It is an important risk factor for heart disease and stroke. Treatment for it exists and involves taking tablets on a daily basis usually for the rest of one's life. 

Some blood pressure tablets come with a recommendation to take at night because of the possibility of causing dizziness. Other tablets can cause the patient to use the bathroom more frequently and so patients ask the doctor to take them at times when this would cause least inconvenience. 

A new study just published followed up a large number of patients in Spain to study if taking blood pressure medications at night has any effect on health. It emerged that it has. Taking blood pressure tablets in the night time reduces the risk of dying from heart attack, stroke or heart failure. 

https://www.webmd.com/hypertension-high-blood-pressure/news/20191023/bedtime-may-be-best-time-for-blood-pressure-meds

The ECG

While on LinkedIn I came across some useful information about the ECG. The ECG has long been used as one of the first investigations when checking the health of the patient's heart. It remains a reliable, if interpreted well, companion in the doctor's search for answers.

So the following picture illustrates what normality should look like.

Being familiar with the normal is the first step for every doctor. Deviations from these patterns then need to be assessed and investigated. 

In the next picture we become aware of the most important abnormalities in the ECG....these changes should not be missed.

Red eye clinic

Once I came across the term 'red eye clinic'. My mind immediately went to an ophthalmic clinic - dealing with eye problems. The writer was actually referring to out of hours clinics that offer doctor services when most clinics would be closed. Hence 'red eye' - referring to the tired clinician suffering from lack of sleep.

These clinics are particularly stressful because they tend to present problems which could be dealt with in other scenarios, like for example the three month old painful knee coming in for a check up at 4am. Hence the challenge is to educate the patient in a diplomatic way to seek the appropriate avenue of assistance.

Alternatively they present acute problems of a very serious nature, like trauma or heart problems, where timely and effective medical assistance is of utmost importance.

And last but not least - the doctor. He or she has to struggle with the natural urge to sleep at the hours usually dedicated to this activity whilst keeping an alert mind to deal with the issues at hand. Coffee is often the answer!

Barts MedSoc end of year reflections

Last week saw the end of my first experience as a GP tutor to Barts Malta first year medical students. The MedSoc programme, as it is called, is a series of twelve themed days from October till May dealing with a range of topics from the GP perspective. Topics dealt with included chronic pain, diabetes and pregnancy amongst others.

I was on a learning curve. Organising visits to associations, agencies, old people's homes and patients' residences as well as preparing tutorials and practical sessions....the work was intensive. Seeing my students motivated and eager to learn made it all worthwhile.

So this week it was with a bit of a heavy heart that I met Upe, Hish, Lexie and Casey for the last time. Knowing however that the experiences shared will stay with us for a long time...