Tanzania 1000Tshs | Kenya 50Kshs| Uganda 2000Ushs WHITE COATS | A JAMSA PUBLICATION | JULY 2013
WHITE COATS
July 2013 | Ramadhan 1436 AH | Issue 14 - Making Health a Priority
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From the Desk
Editorial Dear readers,
Salaams, and Ramadhan Mubarak! We are excited to present you with another issue of White Coats! We are super proud to announce that we have printed 500 copies of this issue, making it accessible to 500+ readers! We have been trying to continue the great work that the previous editors have done, and take the magazine to even greater heights! Through this magazine, we look forward to smarter, responsible, and healthier living practices in the community. We would like to extend our deepest gratitude to the sponsors who advertised in this issue, Br. Sameer Kermalli for his very talented work in the design and layout, and our dear White Coats team who worked hard to find sponsors and help us make this issue possible. Last but not the least, thanks to all who volunteered to write articles! Without you all, this issue would not have been possible!
WHITE COATS Issue No. 13 Ramadhan 1436 A.H July 2013 A publication of JAMSA Editorial Team Editors: Zohra Damji Shaneabbas Jaffer
In this issue, we present you with six themes: JAMSA – Who We Are?, Health in the Holy Month, Modern Medicine, Our Health – Our Choices!, Daily Dilemmas, and Kid’s Corner. In this issue, we have tried to reiterate that a healthier community starts with you. There is no doubt that individual health habits and personal choices affect health outcomes, both individually and for the community at large. It is about time we advocate for healthy living as individuals and as a community too.
Members Maisam Dossa Fatema Meghji Hasnein Rashid Zainab Meghji Zahra Meghji Sakina Khatau
We have come up with several articles, including early diagnosis of hearing loss in children, preparing for medical emergencies, as well as the value of prevention. Other interesting topics include the role of maggots and thymol in health. We hope you will put into practice, all this knowledge, after you have finished reading the magazine.
Design and Layout Sameer Kermalli
Lastly, we have created an online poll pertaining to health and lifestyle (see: how healthy are we?). Please do take your time to answer, anonymously and honestly, 5 multiple choice questions. This will take no more than 5 minutes of your time. Insha’Allah we will post the results in the next issue. Remember, there is no right or wrong answer in this poll, and every question you answer is a 100%. Lastly, we wish you a happy reading (and happy fasting too)!
Zohra Damji and Shaneabbas Jaffer
For Letters to the Editor, Comments, Article References, Suggestions and Reviews, please send us an email on
White Coats is a non-profit magazine and printing costs are financed through advertising.
jamsaawhitecoats@gmail.com WHITE COATS | A JAMSA PUBLICATION | JULY 2013
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Contents
What is inside
an overview Editorial........................................................................ 1 Jamsa - Our Past............................................................4 Jamsa - Present.............................................................5
10
Jamsa - Future...............................................................6 Fasting Healthy..............................................................9
FIRST AID
First Aid.......................................................................10 Obesity........................................................................12
14
PREVENTION
Prevention...................................................................14 Exercise.......................................................................15 Imaging.......................................................................17 Margarine....................................................................18
MARGARINE
18
OCD.............................................................................19 Maggots......................................................................21 Occupational Therapy...................................................23 Hairloss.......................................................................24 Hiccups.......................................................................32 Diabetic Diet.................................................................33
24
HAIRLOSS
Tibb al Aimma..............................................................34 Water Therapy..............................................................35 Breast Cancer...............................................................36 Phobias.......................................................................37 Grandmas Closet..........................................................38
37
FEAR
Silent World.................................................................39 Trivia...........................................................................40
SARFARAZALI CHAGANI sarfarazali@haadigroup.com Tel: +255 686 889 988
JAMSA Our Past
Photograph by Sameer Kermalli
Back when we started, as it is now, being in medical school was a proud moment for any student. As a medical student, most people in the community knew you, and everyone called you “Doctor.” When people got sick, your number was the first one they dialed. But a question that some students asked themselves was: “How much do we really give back to our community as medical professionals?” Most of us just graduate from medical school and get busy with our jobs, only to bump into someone when he or she turns up at the hospital – or when someone we know is sick at night. Clearly, our duty towards the community was not done! This group of pro-active students got together and decided to form an association through which they desired to achieve their goal – to give back to the community. Another purpose of creating JAMSA was to provide a platform from within, whereby members would get to interact with one another and assist each other in the process of becoming better medical personnel. After a meeting between medical students (Dr. Aliasgher Esmail, Dr. Fatema Thawer, and Dr. Imran Hassam) and doctors (Dr. Mahmood Hameer and Dr. Jaffer Dharsee), the foundations of our association were laid. With a consensus between them they decided to name the group after the 6th Holy Imam (as). Shortly after, Dr. Fatema Thawer and Dr. Aliasgher Esmaill compiled our constitution, and we were ready to go! Thus, JAMSA started in 1999 - 2000, with a few members under the leadership of Dr. Mubarak Janmohammed and the patronage of Dr. Muhsin Sheriff. Packed with enthusiasm, they plunged towards their first event which was AIDS Awareness Day. Since AIDS was a new disease then, the community was very interested and wanted to know more about it. After this overwhelmingly positive
response, the members were determined to achieve even more. That year they organized many more events including awareness programmes on breast cancer, diet, and ophthalmic diseases. For their own improvement they organized quite a few events, one of them being a session on ECG interpretation by Dr. Hameer. With the seeds sown, this plant grew with remarkable vigour. Initially the group was limited to students from Muhimbili University of Health and Allied Sciences (MUHAS), but as time passed, the group was expanded to include students from other universities, both within the region and throughout Tanzania. JAMSA developed further to involve other allied heath schools within these universities such as the schools of Pharmacy, Dentistry, Physiotherapy, Occupational Therapy and Radiography. With each passing year, the number of students kept on increasing and currently JAMSA has a total of 60 members. The upcoming committees had similar great ideas, one of them being the publication of “White Coats.” The first editor of “White Coats” was Dr. Imran Hassam. Through this magazine, JAMSA hopes to increase general knowledge about healthy and unhealthy practices prevalent in the community, and thus empower people to make wellinformed choices regarding their own health and the health of the community at large. This year’s committee aspires to continue the great work of the previous committees. We intend to raise the bar for JAMSA in terms of health awareness and community involvement, and in order to achieve this, we need your continued support. By: Shaneabbas Jaffer.
JAMSA Our Present To date, Our group constitutes students from Muhimbili University of Health and Allied Sciences (MUHAS), Kilimanjaro Christian Medical College (KCMC) and Hubert Kairuki Memorial University (HKMU). Currently, we have 60 members, 11 of whom are graduating this year. Many more of them will be Doctors, Nurses, Dentists, Pharmacists and Radiologists in the near future Inshallah! We are thankful and proud to have Dr. Kamaal Sheriff as the Patron of JAMSAA, who spares time from his busy schedules to constantly guide us. JAMSAA aims at creating a platform from which students in the medical field can be identified and health issues can be discussed and made aware to the community at large. Recently, JAMSAA members have participated in a number of community based activities channeled through the external committee such as: • A visit to the orphanage Dar-ul-muslimeen Orphanage in Morogoro. • Volunteering in the Lindi eye camp organized by Bilal Muslim Mission Tanzania • Volunteering at the Mini-screening held at the mosque held in the Holy month of Ramadhan. • Volunteer in different activities at EHCHC like cancer campaigns and stock taking • Participate in health related talk shows organized by IBNtv • Volunteer at the Blood donation day in the month of Muharram • Provide basic health education to community members e.g. visiting the Al-Muntazir schools and Madrassah to talk about health issues. • Participate in programmes organized by Jamaat and EEC regarding Career guidance.
JAMSAA is a network whereby medical students from different fields get together to create a healthier society. Through the internal committee we organized different activities and courses for ourselves this year, including: • A Session on Full Blood Picture interpretation by Dr. Sibtain Moledina • A Stress- counseling session by Sis. Zinat Fazal who works with the United Nations. • Basic Life support training offered by professional trainers from the American Heart Association • Fiqh sessions discussing Rules of Jurisprudence pertaining to medical practice with Sheikh Safdar Razi • A talk on the health benefits of natural foods( honey,almond, date and raisin) • Day-outs and meetings for JAMSAA members, whereby we get together to interact and plan future activities. We would like to thank the Jamaat, for accepting and supporting our activities, and hope for the same support in our future endeavors. We express our gratitude to community members, be it in the form of readers or viewers, who have encouraged us and strengthened our motives. We will fail in our duty if we do not appreciate our members without whom JAMSA would not have been what it is today! Finally, “Elimu ni ufunguo wa Maisha”, therefore we would like to welcome more students who are interested in the medical field. Feel free to contact us at jamsaa.team@ gmail.com if you need advice or if you have any questions. By: Muhammad & Zahra Mohamedhussein
WHITE COATS | A JAMSA PUBLICATION | JULY 2013
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Our Future
Into the Jungle
heros!
Here are a few words (and smiles) from our recent graduates, and we wish them all the very best in their future endeavours! Amira N. Baliram classmates, your roommate, your friends, your teacher, Course: your family. A big thank you to all those who helped me Doctor of Medicine (M.D.) cross that finish line. Hubert Kairuki Memorial University (HKMU) Muhammad S. Message: Mohamedhussein Once upon a time I walked Course: into HKMU as a mere high Doctor of Medicine (M.D.), school graduate with a Muhimbili University of dream trying to grasp Health and Allied Sciences a little bit of knowledge (MUHAS) before I entered the real world. What I didn’t know was that I would gain more than a little bit of knowledge. I would Message: gain moral, values and compassion, which made me the I love the sight of gushing person I am today. For all the times I spent walking the blood, broken bones, halls of my university building and the hospital, taking tests crying babies, cutting live and sweating over my grades, I have to admit that now people open and individuals screaming in pain. My clients in the end I realize it was all worth it. I learned to strive for include people in the two extremes of life and anybody in success. To be all I can be. I started as a follower and I am the middle. My ultimate goal is to heal, even if that means ending as a leader. I have to communicate with the deaf and dumb or make the mentally challenged understand. I sacrifice my sleep If it weren’t for my family I may not have been the person so that the mother of sick child can sleep, I starve myself I am today. I am grateful to the Almighty for giving me to save the only bread earner in a family so his children do the strength and I am sincerely thankful to everyone out not go hungry. In the end, I have no heart to feel others’ there who supported me, as each of them have played an pain but still have to console the families of the deceased invaluable role in making my dream come true. and the afflicted. I am glad to be one step closer to my dream, but the journey still continues. Mohamed Ramzan N. Sachedina Course: Doctor of Medicine (M.D.), Hubert Kairuki Memorial University (HKMU) Message: Finally a nobleman! These 5 years have been like a rollercoaster of up and downs. At times you feel like your heart will come out through your mouth like just before receiving your results. Or that feeling of throwing up -watching 3 liters of blood gush out from a human, and the pumping of adrenaline through your veins -all nighter before exams, doing a CPR. But the most exciting feeling is when you come to the finish line, You made it! You conquered it! You’re alive! All through that ride, it was you going through all those weird experiences, but it always helped when the passenger next to you held your hand, making you feel that you were not alone. It could be your parents, your best friend, your
Yes, I am a Doctor and I sure love my job.. Mujtaba Ratansi Course: Bachelor of Pharmacy, Muhimbili University of Health and Allied Sciences (MUHAS) Message: Salaams My name is Mujtaba Murtaza Ratansi and I am proud to be one of the Graduates of 2013. I am very thankful to Almighty God, to have achieved my Bachelor of Pharmacy Degree in Muhimbili University of Health and Allied Sciences. Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs. From my experience, Pharmacy is a very interesting and challenging course with variety of fields of practice and specialization including Hospital Pharmacy, Industrial Pharmacy, Community Pharmacy, Pharmaceutical Management, Quality Control and Quality Assurance, etc and each of the options would be the right one. When I started my 1st year back in 2009, I wondered how
would this four years pass but now I see it as a blink of an eye but the wonderful memories and people I met along the way will always remain for life. The daily routine was lectures, study, exams, relax and enjoy (especially holidays). This is not the end rather a beginning of a new journey where one goes out to apply the knowledge in the real world. Finally I would like to thank my parents who always encouraged and supported me in any situation during these years and also not to forget my relatives and friends who also helped me in one way or the other. I would like to end with a hadith from the Holy Prophet: “Seek Knowledge from the Cradle to the Grave” Nazeem S. Suleiman Course: Doctor of Medicine (M.D.), Kilimanjaro Christian Medical College (KCMC)
and understand fully’’
Message: ‘’You will remember some of what you hear, much of what you read, more of what you see, and almost of what you experience
Neelam A. Ismail Course: Doctor of Medicine (M.D.), Hubert Kairuki Memorial University (HKMU) Message: A 5 year long journey that was once simply a dream has come to an end. The friends I’ve made and the eye opening experiences I’ve been though and skills I’ve learnt from learning how to hook up IVs, to vaccinating newborns, to mending broken bones and assisting in surgeries, to helping women give birth and hearing a baby’s first cry, to dropping off the social grid, staying up all night studying gigabytes worth of material and to the very unfashionable permanent undereye dark circles, it has all been worth it and is now over before I know it. I wouldn’t have reached this far without the blessings of Allah the Almighty who lead me one step closer to observe His best creation. Without forgetting the never-ending support from my family who encouraged me all the way and were there for my highs and lows and also reassuring me when I’d diagnose myself with multiple rare incurable diseases I’d only read about in textbooks. To my juniors: Study hard, but do not forget to enjoy the ride! To the future: I’m here to serve, let my destiny guide me (inshAllah towards pediatrics or surgery – another 4 grueling years).
Sadiqa Sheriff-Manji Course: Diagnostic Radiography, Muhimbili University of Health and Allied Sciences (MUHAS) Message: “Failures are often the results of timidity and fears; disappointments are the results of bashfulness; hours of leisure pass away like summer-clouds, therefore, do not waste opportunity of doing good.” - Imam Ali (a.s) Let’s all make the most of the opportunities we get in this life and do something worthy so that we can help our Imam (A.T.F). Sajida Dhalla Course: Doctor of Medicine (M.D.), Muhimbili University of Health and Allied Sciences (MUHAS) Message: Five years are over?? I can’t believe it!!My roller coaster ride at medical school has almost come to an end. But is it really the end? No it’s just the beginning of my medical career. I thank the Almighty Allah for giving me the strength to reach this level and of course it would not have been possible without the support of my lovely parents and sisters. I also thank my teachers and not forgetting my friends who made this journey a fun-filled one J To my Juniors-Hard work is the stairs and lift is luck, though the lift may break down the stairs will always get u to the top..so keep going and never lose hope.. Sakina M. Khatau Course: BSc in Environmental Health Sciences, Muhimbili University of Health and Allied Sciences Message: Environmental science is an apparently unheard of field in our community and many people questioned my decision to study it. But Allhamdullilah, as we approach graduation, I can look back on three wonderful years filled with learning and discovery. It’s definitely a field I would encourage all science students to consider!
WHITE COATS | A JAMSA PUBLICATION | JULY 2013
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Salma Lalji Course: Occupational Therapy, Kilimanjaro Christian Medical College (KCMC) Message: Life has its ups and downs. Here is a quote that I came across while reading sometime back, and it has stuck with me, “The only disability in life is a bad attitude.” - Scott Hamilton. Being in a medical field has made me appreciate life in a way I never would have otherwise, anything worth working for needs passion and a lot of patience, so my only advice, if you have found something that makes you get up everyday – go for it! Siddika Dewji Course: Doctor of Medicine (M.D.), Muhimbili University of Health and Allied Sciences (MUHAS) Message: The journey of five years has come to an end. A journey that was all awesome, stressful, and mesmerizing to be able to be so close to witness the beauty of God, his miracles and his signs. Medicine is a very satisfying field because you get an opportunity to make a difference, to touch a life, to make a sick child smile, to give hope to a dying patient and to be an intercession between your patient and God. I would like to take this opportunity to thank the Almighty Allah for this wonderful opportunity as “Service to humanity is service to God” and also would like to thank my family and friends for their support through out my studies. I would also like to take this opportunity to encourage our community members to engage into medical field. Asantenisana!!! Zahra Nagri Mohamedhussein Course: Doctor of Medicine (M.D.), Muhimbili University of Health and Allied Sciences (MUHAS) Message: Words cannot express fully how it feels to graduate as a doctor after 5 long years of unending stress and sleepless nights.. All I can say is Alhamdulillah! I thank Allah (swt) for inspiring me and enabling me to take up this noble profession. I would not be what I am today without my
family, therefore I would like to appreciate my parents, my husband and my in-laws for their constant motivation and support every step of the way. Finally, I pray for the success of all my colleagues, those who are already in the medical field and those who will soon be, so that together we can build a healthier community and lay grounds for the arrival of our beloved 12th Imam (atfs). A few interesting quotes that I’d like to share.. “The only equipments lacking in the most modern hospital may be somebody to meet you at the entrance with a handshake or somebody to attend to you with a smile..” ~ Martin H. Fischer “In nothing do men more nearly approach God, than in giving health to other men” ~ Marcus Cicero “You may be able to pay a doctor for his efforts, but you will forever remain in debt of his Kindness” ~ Seneca
MEDICAL JOKES Mr. Right Mary was shortsighted , to vain to wear glasses was determined to get married. She finally found herself a husband, and went off on a honeymoon with him. When Mary returned her mother gave a shriek , dashed to the telephone and rang up an oculist. “Doctor”, she gasped , “ You’ve got to come over here right away. It’s an emergency. My daughter Mary has always refused to wear glasses and now she is back from her honeymoon and...” “Madam ,” interrupted the doctor, “please control yourself. Ask your daughter to come and see me .No matter how bad her eyes are , it can’t be that much of an emergency.” “Oh, no ! “ said the mother. “Well , this fellow she’s got with isn’t the same one she went on the honeymoon with!” Chronic Laziness The man told his doctor that he wasn’t able to do all the things around the house that he used to do. When the examination was complete, he said, “Now, Doc, I can take it. Tell me in plain English what is wrong with me?” “Well, in plain English,” the doctor replied, “you’re just lazy.” “Okay,” said the man. “Now give me the medical term so I can tell my wife.” New Disease Discovered Medical researchers have discovered a new disease that has no symptoms. It is impossible to detect, and there is no known cure. Fortunately no cases have been reported thus far.
Fasting Healthy
Natural Medicines
what we should be doing
Fasting is not a license to eat whatever you want after it’s dark! Despite what you may think, fasting could expand your waistline. When your body feels hunger it automatically stores fat, and then eating late at night when you’re hungry can encourage you to eat more than you need while the body is in a resting state when it will store rather than burn accumulated calories. For a healthy Ramadan; Consider the following: Divide your food into three meals. Saher is the morning meal when the fast starts; iftar is the evening snack when the fast is broken and then dinner. Include complex carbohydrate foods rich in fibre, such as those found in grains and seeds. For example, whole wheat roti, brown rice, daal, beans, bajara, bran, fruits and vegetables should be eaten, particularly during saher. Fiber-rich foods help increase the feeling of fullness, promote good blood glucose levels and help with regularity. Fasting during the day can also increase stomach acid content and cause feelings of pain or discomfort. High-fiber foods during dinner can help neutralize this acid and alleviate pain. (Remember to increase fluids with fiber intake to prevent excessive gas). During iftar, dates and juice are traditionally consumed. Include three dates and 4 oz (120 mL) of juice to help normalize possible low sugar (hypoglycemia) and provide the much needed “instant” energy along with hydration. Bake or grill foods instead of frying them, and if frying, decrease the amount of oil used. Try and measure the oil in spoonfuls instead of just pouring it from the bottle.
Avoid: Fried and fatty foods such as french fries, sweets, fried samosa, pakoras, parathas, greasy curries and biriyani. High-fat foods are high in calories and are nutrient deficient which will lead to an imbalanced diet, thereby increasing sluggishness and fatigue during Ramadan. Salt and salted food, such as achars pickles, papadums, sauces, nuts, chips and olives. Dehydration is a risk due to limited fluid intake during the day, and high salt foods can further increase this risk by drawing fluids out of your body. Foods containing too much sugar such as sweet glucose energy drinks and mithai. These are sources of empty calories with very little nutritional value. While they may provide you with instant energy, they will not sustain you through the day and night. Overeating especially at saher can cause further metabolic imbalance, like highs and lows in your blood sugar and dehydration. Too much tea or caffeine at saher. Both of these are diuretics when consumed in large quantities and the body can lose valuable minerals, salts and fluids that you need during the day. Sleeping immediately after iftar and saher meals, since your body will require time to digest the food. Wait for 2–3 hrs before sleeping By: Sayyeda Somaiya
Choose lower fat and lean cuts of meat. Skin chicken and remove any visible fat before cooking. Eat slowly and chew food well. Because you have not eaten all day, there will be a tendency to want to eat a large quantity of food quickly. Remember that it takes 20 minutes for your stomach to tell your brain that you are full — put small portions on your plate first. Walking in the evening for at least 30 minutes is an ideal routine activity. Walking will not only help your metabolism, but also help your mind stay clear. However, if you’ve eaten a big meal, blood needs to move to your digestive system rather than to your muscles, so a brisk walk straight after a heavy meal is not a good idea. Wait 1-2 hours after your meal before engaging in any strenuous activity. Best to keep your meals light. Drink as much fluid (preferably water) as possible. It is advisable to consume at least 8-12 cups between iftar and bedtime so that your body may adjust fluid levels in time for the next day.
WHITE COATS | A JAMSA PUBLICATION | JULY 2013
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First Aid save a life
Faster the Better
By:Mohammed Mohammedhussein
We have all come across the concept of First Aid. This is the initial treatment or assistance given to someone who is injured or suddenly ill. The outcome of emergencies is determined by how it is taken care of in it’s initial stages, and hence it is every one’s duty to have at least some knowledge of how to do so. Of course, a few paragraphs cannot do justice to this practice, but it can definitely stimulate you to read more and if possible to get formal training on First Aid. Some conditions are quite common and we may have been there when people are suffering from them, but didn’t know what to do. Perhaps if we knew how to handle such patients, in their first few moments, some lives might have been saved. This article will shed some light on the First Aid management of unconscious patients, heart attacks, seizures (convulsions) and burns. A few basic things to remember before giving First Aid: • Personal safety first - do not attempt heroic rescues in hazardous circumstances. If you put yourself at risk, you are unlikely to help others effectively. • Assess the situation quickly and CALMLY - take deep, slow breaths, and you will remember first-aid procedures better! • Make the area around safe - neutralize the conditions that gave rise to the incident if possible for instance put out a fire or turn off an engine. • Call for help - other people can help but beware of and clear by-standers who are there for a show! The approach to an unconscious patient is extremely important. The first few steps involve assessing the
situation and checking if the person responds to your voice or gentle stimulation. If not, check the airway and ensure that the individual is breathing. The most common cause of obstruction of airway is rolling back of the tongue. To counteract that, perform head tilt, chin lift and jaw thrust. Remove foreign objects from the mouth if visible. Recent findings have discouraged mouth to mouth resuscitation due to spread of various infections. If available, use bag and mask when there are no signs of spontaneous breathing. Once airway is clear and breathing is achieved, blood circulation should be checked. Palms should be felt for warmth and pulse felt. When there are signs of poor blood circulation, immediately commence cardio-pulmonary resuscitation (CPR). Alternate 15 chest compressions with 2 rescue breaths with bag and mask. As soon as there is spontaneous breathing and circulation, put the patient in a neutral position (recovery position). Heart attack (myocardial infarction in medical terms) is a result of inadequate blood supply to the muscles responsible for the pumping action of the heart (myocardium). This can be due to myriad of conditions including, fat clogging in the coronary blood vessels (by a process called atherosclerosis) and abnormal aggregation of platelets in the blood vessels (formation of a thrombus). How do we know if someone is having a heart attack? Symptoms may include sudden sharp chest pain which may radiate to the arms, breathlessness, indigestion-like discomfort in the upper abdomen, sudden collapse and profuse sweating. What is our role? Identify, make the person comfortable by helping the patient (if not collapsed) in a half-sitting position and give one tablet of aspirin to be chewed slowly. Aerosols of nitroglycerin can be applied beneath the tongue and can
be life saving. Definitive treatment can then be sought by taking the person to a hospital. Seizures are due to abnormal activity of neurons in the brain. Severe cases may even result into sudden loss of consciousness. What can you do to help? Try to ease the fall, clear airway (refer to management of unconscious patient), and protect head. DO NOT put anything (such as keys) in the mouth as this will result into infection, injuries, and bleeding. Once the seizures have stopped, place the person in recovery position. In children, a common cause of convulsions is febrile seizures (due to high fever) and hence if this is suspected, sponge with tepid water starting from head to toe. Seek medical attention in an appropriate institution after person is stable. Burns are very common especially in toddlers and young children. Misconceptions about treating burns are also very prevalent. After identifying a burn-patient, pour cold water on the burn for at least 10 minutes. Carefully remove any clothing from the burnt area before it starts to swell, however do not forcefully remove any clothing that is stuck to the burn. Do NOT apply petrol, kerosene or toothpaste as this is known to worsen the burn. Honey may be applied if available, for it prevents further infection. Do not burst
any blisters and take the person to a nearby hospital so that appropriate treatment can be given. Burn injuries are serious, and ensure the person is hydrated and free from bacterial contamination. First Aid can be life saving and leads to better outcomes if provided correctly, and hence adequate knowledge and skills are of utmost importance for every individual. No one knows when a medical emergency may arise, but if you are capable and can take control of the situation you can save a life. Happy life-saving! Editor’s Note: It pays to have first aid skills because you can’t learn it in an emergency! Other useful skills include handling common injuries and wounds and Heimlich maneuver (used for choking). While tending to a person, always look for clues that may provide information about the person’s medical condition, such as diabetic bracelet. Additionally, it is important to have a first aid kit (along with a guide) at home, office, and in the car. You never know when you might need it! Preparedness is a good thing!
In order to know how aware our community is with regards to issues in health and medicine, we decided to create a poll of only 5 multiple choice questions related to health practices. Insha’Allah, we will display the summary of the responses in the next edition of White Coats. We would be very grateful if you could take 5 minutes or less of your time to answer the questions. The link to the Poll is: http://www.surveymonkey.com/s/XR22BSB. Alternately, you can find this link on our facebook page – “JAMSA”. Finally, please remember, we want honest answers. In other words, no Googling. Remember, there is no right or wrong answer. The responses will remain anonymous. We just want to know how much the community knows! Just take the survey for the fun of it, and choose what you feel, think or know is the best answer!
WHITE COATS | A JAMSA PUBLICATION | JULY 2013
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Obesity binge eating In today’s changing times, health and health issues, attract greater attention than they used to earlier. Obesity is one among the many health problems affecting a large proportion of the general population. Accumulation of excessive body fat is known as obesity. It is mainly caused when the intake of calories exceed the expended ones. In simple words, when one tends to eat more than his body requires, the extra fat starts depositing in the body tissues giving rise to obesity. Junk food is usually the main culprit. People are considered obese when their body mass
index (BMI), a measurement obtained by dividing a person’s weight in kilograms by the square of the person’s height in meters, exceeds 30 kg/m2. Obesity is not only considered as a major health problem, but also a debilitating disease. Initially there are no presenting symptoms as such except the ever increasing body weight. Later on, shortness of breath, fatigue, oversweating and lethargy present as the chief complaints of the patient. Obesity can lead to Hypertension, Diabetes, Joint problems other conditions. The quality of life deteriorates and the loss of self-esteem due to poor body shape can lead to depression, eating disorders and crash diets. However most of the times, the person does not pay much attention towards these changes in the body and ignores them only to run and seek the physician’s help after serious manifestation of the disease occurs. It has been noted that most of the obesity related medical complications resolve on their own when the patient starts losing weight. The modern day sedentary life style leaves less time to
Planning to Stroke
work out and hence the lack of exercise is also a major contributing factor. Physical exercise is compulsory as it helps us to burn out the excess calories we have consumed. If right eating is accompanied with physical work out, it provides the perfect way to lose weight and stay healthy. The quality of the food must be checked and altered. Avoiding red meat, oily food, extra fats in form of ghee, butter etc. can dramatically help to reduce the weight. Healthy eating habits and an active life style should be adopted by individuals of all age groups and gender, to prevent obesity.
Do diets work? The answer is yes. But for many it’s only temporary. The problem is that people eventually go off the diet, because they get fed up of the diet and eat all things they have been deprived of. Most people gain the weight back and more. Due to the previous food restrictions in the diet, their body’s metabolism slows down. Their body thinks it’s experiencing a famine; it is in a starvation alert mode and trying to store every extra calorie that it can find. The outcome of it all is that they gain weight with a vengeance, faster than ever before. Regaining weight at the end of a diet can be discouraging and unhealthy. To lose weight and keep it off, you will need to break out of the dietary patterns you have made for yourself and create a plan that offers a lasting change. The only reliable way to do this is to make a permanent tireproof plan that involves a healthier diet and more exercise that conveniently fit into your style of life. By: Amira Baliram
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Prevention
Safer than Sorry
better than cure?
By: Aliasgar B. Khaki It is the aim of every country, to engage its people in personal health and well being which has an effect on increasing the number of years of quality life by prolonging life and preventing illness. Many health associations are trying to focus more on wellness and prevention rather than focusing solely on the cure of illness. This is because if a medical condition is controlled in its beginning stages then it does not prevail and many associated ills such as financial pressures are also averted. “But if I am feeling okay then I’m doing good so why should I worry, if something goes wrong then will refer to my doctor”? Ever have that question pop in your head? Lets first start by defining what is meant by prevention. It means to stop something bad from happening rather than dealing with it after it has happened. So is prevention actually necessary? Can’t we just make do with treating the problem after it has appeared? To put things into perspective, let us consider a situation in which a person doesn’t monitor his diet well and consumes a lot of oily and greasy foods (sambusa, kabab…) then he ends up having a high cholesterol level which then leads to a heart attack. Well, what will he say then, “I wish I had monitored my diet”? Consider all the pain that he would have to go through, the drugs that he might have to consume for the rest of his life and their side effects and not forgetting the thousands of dollars he would have to spend on medical treatment. If only he would have checked his cholesterol level and weight and maintained a balanced diet probably all of this wouldn’t have happened. From this example, we all get to learn that the benefit of early screening and treating outweigh the harms of waiting for the consequences. This urges us to consider undergoing medical check ups
regularly. This means we should go for a medical check up if not every 6 months then at least once a year (referring more to adults and those at risk). However, remember getting too many unnecessary medical checkups is not a good thing. So, if prevention is better than cure, do we abandon curative services? Not really, instead we need to maintain a balance between the two. The reason behind this is quite obvious. There is a problem we as humans have, many of us always tend to act irrationally even if we are informed and educated about the consequences of some of our actions. We can’t find the time to exercise daily, can’t afford the expense of vital vegetables and fruits even though we know their importance in our daily lives, or even can’t stop smoking even though we know its harmful effects. And sometimes there are many factors that are beyond our control such as accidents or inherited disease where prevention can play a role in early diagnosis but may not prevent the disease on taking its effect. Prevention is quite essential in its place as is treatment and the only way out is to continue with both the services but have prevention as the forefront followed by treatment. “Prevention is one weapon in combating the battle towards a disease–free world, treatment is another”. Therefore, prevention has numerous benefits and it should be regarded as a priority in our lives. If our community and the people around us have ample knowledge on preventative measures and health education we will be able to avoid many pandemics that affect thousands of lives across the globe, as well as save money. These diseases not only affect the individual but the families and society as a whole, and at times it becomes a life-bearing burden. Prevention contributes by enabling people to find information to make more informed choices on lifestyles and to live a better if not a happier life.
Greater Achievements
Exercise a Fulfilled Dream
By: Mehdiya S. Manji
Do you want to feel better, have more energy and perhaps even live longer? Look no further than exercise. The health benefits of regular exercise and physical activity are hard to ignore. Exercise is free, easy to undertake, and has an immediate effect. Our bodies were meant to move - they actually crave for exercise. But one big QUESTION we all have is how to exercise the right way. Most of us do it in two ways, either “the stop-start routine” or “doing too much too soon”. The stop-start routine is not only ineffective but can actually harm you. As for the other method, we tend to do in the spur of the moment and tend to think of it as - the more, the better, while in reality we are not doing that much good. Both of these are incorrect methods of exercising.
before, 10 minutes would make a good start! FLEXIBILITY TRAINING: Also known as stretching, flexibility training helps keep your joints flexible and reduce your chance of getting injured during other activities. Gentle stretching before aerobic training for at least 15 minutes will be useful. Stretch your arm and shoulder muscles, neck, back, legs and feet. Many people forget to stretch or make excuse that they don’t have time. Flexibility is important, so make time for it! Stretching can be done every day, but stick to a minimum of three times per week in order to reap benefits.
Being consistent is the key to achieving the desired results. This can be done by making work out a part of your everyday life. Here are a few tips on what you should include in your exercise schedule:
STRENGTH: Also referred to as Resistance Training. These exercises make your muscles stronger. Even small increases in strength can make a big difference in your ability to stay independent and carry out everyday activities, such as climbing stairs and carrying groceries. Examples of resistance training include lifting weights and using a resistance band.
AEROBIC EXERCISE: Also called endurance, it aims at increasing your cardiovascular endurance (i.e. stamina). Some of the examples include cycling, swimming, hiking, running, walking, skipping and playing tennis or soccer. This exercise should be done on a daily basis (if not possible, then at least 5 times a week) for at least 30 minutes. If you wish to begin, having not done much regular exercise
Of all the different ways to improve your physical and mental health, exercise is one of the easiest, safest, and most effective methods. Regular exercise can go a long way to help ease depression, boost energy and mood, and relieve stress among its other benefits. Remember, you’ll only benefit as much as you are willing to put in. Plan it well so you don’t face problems with continuity or overworking
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yourself. All these demand a high degree of self discipline and determination - it is your call!
Editor’s Note: With current technology and gadgets we have, exercise has never been easier than before! There are many fitness-related applications (including Runtastic) that you can download from Android Market or Play store. Such applications help keep track of your exercise activity, include a few workout routines, and even tell you how many calories you have burned! They are simple, easy to use, and make exercise more fun!
MEDICAL TRIVIA ANSWERS
THIS WAY UP
Answers: 1. C 2. The skin 3.The Pancreas 4.Melanin 5. Louis Pasteur 6. Plasmodium Species 7. Iron 8.Small Pox 9. Sunshine 10. Penicillin 11.No (Fear of Bathing) 12. Yes 13. No (Contact with rhinnovirus gives you the cold) 14.Yes 15. No (This is a common myth).
Seeing Inside
Medical Imaging seeing inside easier
By: Zameena Kassam “Every year, more than 300 million xrays, CT scans, MRI’s and other medical imaging exams are performed in the United States, and seven out of 10 people undergo some radiological procedure.” As we witness and enjoy the advancement in technology when it comes to our gadgets, such has been the joy to the medical field in the introduction and rapid ascend of the medical imaging techniques. In an ideal world, diagnosis, treatment and cure would be possible without having to cut open a patient’s body. And the existence of medical imaging technology has allowed this to happen in our real world where a doctor would otherwise have to do the cutting procedure repeatedly. What is Medical Imaging? Medical imaging encompasses different imaging modalities and processes (x-rays, ultrasound, CT scan, MRI etc.) to image the human body for diagnostic as well as therapeutic purposes (e.g. radiotherapy). Therefore, it plays a very essential role in the improvement of public health in all population groups. Furthermore, medical imaging is also justified in cases where the course of a diagnosed disease requires follow up thus aiding further diagnosis as to what the patients condition is.
of applications, or the size of the screen. Rather it’s more about the accuracy and sensitivity these modalities provide in diagnosing a medical condition at the earliest. It has reached to that level to present images as you would view a structure face on- 3D imaging. Who is involved in medical imaging? The field of medical imaging is very complex and requires supplementary activities of medical imaging technologists, radiologists, physicists and biomedical engineers. Who is a Medical Imaging Technologist? A professional who performs imaging examinations to assist in the diagnosis of illness and treatment of patients. They may be responsible for managing and maintaining the radiographic equipment, patient preparation and aiding procedures, recordkeeping, scheduling and other responsibilities within the department. It includes both radiography and sonography experts who have been addressed as the radiologists right-hand. This is due to the combined efforts of these two professions involved in producing a radiograph of diagnostic quality and provide with it accurate analysis respectively.
How it works?
Should you pursue a career in medical imaging technology?
Radiations from the electromagnetic spectrum aid in obtaining information from a patients body and the sensitivity of this information sometimes leaves one astounded. As a student of medical imaging technology, my definition for advancement in technology now takes an entire different perspective. It’s no more about the progress
Statistics show a faster than average employment growth in this field and it furthermore provides opportunities for advancement. It enables you to help others as patient care being the primary responsibility of the personnel. It is an interesting field indeed giving you a deeper insight and a whole new perspective.
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Margarine
You are what you eat
banning it
By: Mohamed Ramzan Sachedina It came as surprise to me as one of my friends’s stated that most margarine brands available in Tanzania are banned in the western world. The question that followed was why? Every time you buy packaged food try to look at the ingredients section. You will find so many types of oils and fats; saturated, mono-unsaturated, poly-unsaturated etc. However be very wary of the content Trans Fat. You should always try to keep your saturated oils at a low, but a big NO for trans fats. Trans fatty acids are the worst kind of fats, even worse than saturated fats. By an industrial process called partial hydrogenation, perfectly good oils like soybean and palm oil are converted into perfectly bad oil. The oil now becomes more solid, provides longer shelf life (baked products) and provides longer fry- time for cooking oils (best for kaangiaing chips); all good qualities in some ways, but this comes at a very very steep cost. Kwanini?.. Kwasababu the oil now contains trans fats. Partially hydrogenated oils are commonly found in processed foods like commercial baked products such as cookies, cakes and crackers, margarines, and even in bread. They are also used as cooking oils (called “liquid shortening”) for frying in restaurants. So why are we scared of trans fats? Trans fats cause significant and serious lowering of HDL (good) cholesterol and a significant and serious increase in LDL (bad) cholesterol; make the arteries more rigid; cause major clogging of arteries; cause insulin resistance; cause or contribute to type 2 diabetes; and cause or contribute to other serious health problems like Alzheimer’s disease,
prostate cancer, obesity, liver dysfunction, infertility in women and depression. However one key point as explained by Canadian Professor S. Meralli, Trans fats once ingested cannot be broken down by the body and so move on to the heart and blood vessels where they cause detrimental effects including cardiac arrest. The New England Journal of Medicine scientific review team commented; “from a nutritional standpoint, the consumption of trans fatty acids results in considerable potential harm but no apparent benefit.” The American Heart Association in 2006 recommended a daily intake limited to 15 grams of saturated fats compared to 2.5 grams of trans fats. So here are a few tips to avoid eating bad fats;
• Don’t eat any product which has the words “partially hydrogenated” or “shortening” in the ingredients list.
• If the label says zero trans fats, don’t believe it. If the • • • •
words “partially hydrogenated” or “shortening” are in the ingredients list, it DOES contain trans fat. Check the label. Keep saturated fat intake low too. This is very important. Remember that polyunsaturated fat and monounsaturated fats are good fats. If a product is “cholesterol fee,” that doesn’t mean that it won’t raise your bad cholesterol. If the product itself contains no cholesterol but it does contain trans fat or saturated fat, it will raise your bad cholesterol.
Early to bed, early to rise… that and avoiding bad foods, makes a man healthy, wealthy and wise.
Magirini ... which means lies in Swahili is actually derived from the alternate of butter
OCD
Always on the Edge
obsessive-compulsive disorder
It’s normal, at times to go back and double check that the heater is switched off or the iron is unplugged or your car door is locked. But if this happens excessively and causes your brain to get stuck on a certain thought or urge that you cannot break free, then you might be suffering from an obsessive-compulsive disorder!!
Obsessive thoughts include:
• Fear of being contaminated by dirt, germs or contact with others.
• Order and symmetry (intense stress when objects aren’t arranged orderly and perfectly).
• Doubts if you’ve locked the door or turned off the stove
By: Fatema M. Meghji
What is OCD? OCD is a disorder of brain and behaviour. It is an anxiety disorder in which one has unwanted, disturbing and repeated thoughts, ideas or feelings (obsessions) and behaviours that he/she engages in to counteract, neutralize and make their obsessions go away (compulsions). For instance; you may check the stove 20 times to make sure that it is turned off or wash your hands until they are scrubbed raw or drive around for hours to make sure that the bump you heard while driving wasn’t a person you hit. What causes OCD? There are several theories about the causes of OCD but none have been confirmed. Some studies have shown OCD to be an inherited disorder. Other studies show that there are brain abnormalities and insufficient serotonin (one of the brain’s chemical messengers) in people suffering from OCD.
and the like.
• Thoughts that you have hurt someone in a traffic accident.
• Fear of losing or not having things you might need. • Violent thoughts and images. • Superstitions (excessive attention to something considered lucky or unlucky).
Complusive behaviours include: • Spending a lot of time washing and cleaning. • Ordering and arranging things every now and then. • Excessive double checking of stoves, heaters, iron, doors and the like. • Repeatedly checking on loved ones to make sure they are safe. • Repeating certain words or doing senseless things to reduce anxiety.
However, OCD affects both children and adults.
How to manage OCD? People with symptoms are referred to specialist OCD multidisciplinary teams that offer age-appropriate help.
What are the signs and symptoms? These are the obsessions and compulsions.
For Adults; first line therapies are: Cognitive Behavioural Therapy (CBT). WHITE COATS | A JAMSA PUBLICATION | JULY 2013
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Medications usually antidepressants (e.g SSRI’s - selective serotonin reuptake inhibitors). CBT may use cognitive therapy (CT) that aims to change a person’s response to his/her own obsessions. It teaches them effective ways of responding to their obsessive thoughts without resorting to the compulsive behavior. CBT also includes exposure and response prevention (ERP) that involves repeated exposure to the source of your obsessions and then you are asked to refrain from the compulsive behaviour. By doing this repeatedly, you gradually get rid of your anxiety. Medications (SSRIs) are given in severe OCD, even if the patient is not depressed. They may take up to 12 weeks to work in controlling the symptoms so they have to be taken daily and not stopped abruptly as symptoms may return and become even worse.
ANCHOR CLEARING & FORWARDING
For Children: Beneficial treatment with CBT (including ERP) can be provided. It often involves the family, guardians or caretakers and is adapted to suit the developmental age of the child. Some tips on self-help: • Refocus your attention while suffering from an obsessive thought. • Write your obsessions and worries on a piece of paper (It does help to a certain extent). • Practice relaxation techniques such as meditation, yoga, deep breathing and other stress relief techniques. • Stay closer to family and friends. • Eat healthy, exercise regularly and get enough sleep. • Do not drink alcohol and avoid nicotine because they increase anxiety.
Zanaki Street, P.O. Box 2951 Dar es Salaam, Tanzania Tel: +255 22 2111808 | +255 713 465 046 Email: anchorcf@gmail.com
Maggots? wound management Numerous studies have been carried out all proving the beneficial use of maggot therapy (white larvae of the housefly) especially as an adjuvant in surgical debridement of open wounds. Sometime last year during my surgical rotation, I came across a patient in the wound section of the surgical ward. I was greeted with a putrid smell; there was a new admission with a massive bandage around his leg. On opening it up a most unexpected sight lay before me, Hundreds of maggots all busy squirming around in a big wound going about their business not giving us a care in the world. The patient was a long time diabetic who had developed a sore on his foot, which progressed to a chronic ulcer that had invaded most of the foot area leaving the tissues and muscles non-viable and oozing pus. That patient would have needed an amputation, but due to the maggot therapy his foot was saved. I had read about maggot therapy in textbooks, seen it on the net, heard about the success rate but never expected to see it in action! Placing maggots onto your skin, in an open wound might sound crazy, but maggots have actually been proven useful to patients by helping to rid open sores of dead flesh and lowering the risk of infection. This therapy can be
used to treat diabetic wounds (most common), traumatic or postsurgical wounds, pressure ulcers, neuropathic foot ulcers and venous stasis ulcers. Use of maggots to cure wounds dates back to the 1500s in military history where battlefield surgeons for centuries used maggots to close wounds sustained by soldiers. It however was replaced by the discovery of penicillin in 1940s and was put on the shelf. In the recent years the therapeutic benefits of maggot therapy have been “rediscovered” due to antibiotic-resistant bacteria which created a new demand for alternative treatments. This therapy is now an FDA approved treatment. What maggots do is feed on necrotic (dead) tissue while leaving the living tissue unharmed. They secrete
Little Surgeons
an antibiotic that has an action against many bacteria including the resistant ones. They also produce proteolytic enzymes, which are capable of digesting bacteria. The mechanical feeding of the maggots and the reduction of necrotic tissue changes the wound’s environment from an acid to a more alkaline pH, which assists in stimulating healthy granulated tissue (sign of healing). That’s 4 actions in one! Antibiotics on the other hand either kill the bacteria (bactericidal) or stop reproduction and growth of the bacteria (bacteriostatic). They are not specific to damaged cells so they may harm living cells, have many side effects, and they do not remove the dead tissues either. Removal and cutting off the dead tissue is done manually by surgeons in a procedure called debridement. Bacteria have now become resistant to a number of antibiotics making the prescription and dispensing of antibacterials redundant. There is a strain of bacteria known as MRSA (methicillin resistant staphylococcus aureus) bacteria that is resistant to almost all antibiotics, but maggot therapy has proved to be beneficial. Since these bacteria are found on the skin, open wounds have a high risk of getting infected by them.
Maggot therapy is an efficient, low cost alternative method to cleanse and promote the healing of chronic soft tissue wounds before they progress to a stage where amputation is the only alternative. Many studies have established that pre-amputation maggot therapy is reported to save 40– 50% of limbs, usually with complete wound healing. You decide, white slimy crawling creatures on your chronic wound with healing powers or popping pills with their side effects and surgical debridement (with anesthesia of course) or maybe a combination of the two? “Maggots are the world’s smallest surgeons. Much cheaper and work 24 hours a day” – Professor Boulton By: Neelam A. Ismail
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Leisurely Health
Occupational Therapydisability is not inability What is Occupational Therapy? Occupational Therapy is the treatment of physical, mental, and social problems using purposeful activities in order to help people reach their maximum level of function and independence. The ability and right to participate in activities of daily life (ADL) is the key focus of occupational therapy. Studies have demonstrated that engagement in occupation is correlated with health, cognitive functioning, and subjective well-being. What are the different disabilities seen by an Occupational Therapist? • COGNITIVE IMPAIRMENT - Mental illnesses (psychiatric), learning disability or intellectual impairment, mental retardation, attention deficit, and autism. • PHYSICAL IMPAIRMENT - Paraplegia, stroke, head injuries, amputations, burns, muscular disorders/ diseases, cerebral palsy, Down’s syndrome, developmental or congenital defects, and speech and language defects. • SENSORY DEFICITS - Nerve injuries, visual impairment/blindness, and hearing impairment.
Somebody asked me: “You’re an Occupational Therapist. How much do you make?” I replied: “HOW MUCH DO I MAKE?” … I can make holding your hand seem like the most important thing in the world when you’re scared... I can make you equipment so that you can walk when you can’t... I can help you to retain your strength after an accident... I can relieve your pain when your pills can’t… I can give you hope when you have lost one…. I can make you get up from a wheel chair… I can keep you fit, healthy, and strong... I work all day to make my patients live... I will drop everything and run to make sure you never fall!!! I make my family wait for dinner until I know your family member is taken care of... I make myself skip lunch so that I can make sure that everything I did for you today was correct... I work weekends and holidays because people don’t just get sick on Monday… Today, I might make your life complete... How much do I make? All I know is, I make a DIFFERENCE
What are the areas that an Occupational Therapist works in? • Acute care • Long term care • Home care • Outpatients • Community rehabilitation • Physical rehabilitation • Mental health • Paediatrics ( Children and /or adolescents) • Geriatrics (Older adults)
By: Salma Lalji
Occupational Therapists normally consider treating a person holistically, and also look at the individual’s occupation (roles, habits, activities, tasks etc.), and the environment in which he or she does those occupations. ‘’When you focus on someone’s disability you’ll overlook their abilities, beauty and uniqueness....’’ Yvonne Pierre.
PROFESSIONAL CREATIVE
GRAPHIC DESIGNS
Call: +255 787 212 256 or e-mail : sameer.kermalli@gmail.com
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Hairloss
Brains and its intricacies
a balding issue By: Fatema Mohammed Versi
Got a lot of hair fall? Losing too much hair? Here’s a natural, chemical free, and effective solution to all your problems!!! Like they say, The beauty of a woman lies in her hair, therefore it is very important that a person maintains their hair well, not just to look beautiful but also to lead a healthy, stress free life. Hair is made up of a protein called keratin that is produced in hair follicles in the outer layer of skin. As follicles produce new hair cells, old cells are being pushed out through the surface of the skin at the rate of about six inches a year. The hair you can see is actually a string of dead keratin cells. The average adult head has about 100,000 to 150,000 hairs and loses up to 100 of them a day; so finding a few stray hairs on your hairbrush is not necessarily a cause for an alarm. However, if a person tends to lose a lot more hair then this, it could be a cause of concern, and therefore the necessary actions should be taken to control it. Hair loss is not just a question of concern to women, but also to men and children. So what are the causes of hair loss?!? • Stress • Poor diet(nutritional deficiencies) • Dandruff • Thyroid imbalance • Medications such as allopurinol and warfarin • Severe infections and chronic illness • Radiation therapy for cancer treatment • Use of chemicals such as bleaches,hair colours and overstyling. • Genetic factors • Too much exposure of hair to the sun • Hormonal imbalances • Aging
The following measures can be taken to treat this problem and prevent further loses:• Avoid the application of chemicals (i.e hair colour) and the excess use of straightners, curlers and blow dryers. • Avoid too much exposure of your hair to the sun • Oil your hair regularly. • Avoid use of too many hair products. • Follow a healthy lifestyle - Eat fruits,vegetables and a protein rich diet. • Avoid stress and practice of meditation to reduce it. • Regular washing of hair with a good quality and mild shampoo. • Get a good head massage occasionally.This will stimulate your circulation and keep hair follicles active. Editor’s Note: Did you know, half of all men in begin losing their hair around the age of 50. This loss of hair is called “androgenic alopecia”. It is hereditary and often associated with increased levels of testosterone – which is why women hardly have to worry about growing bald!
Pl aza Limited
BOOK YOUR SPACE NOW Contact us at: Jangid Plaza Ltd. P.O.Box 22028, Dar Es Salaam, Tanzania. Sales Hotline: +255 784 737705, 0786 224822, 0776 786300 Email: shafiqali@jangidplaza.com
24 Hour Security
CCTV cameras and access control, monitored from central security room
Fully Controllable Air Conditioning in Each Floor
High Speed Internet access capability
Four (4) High Speed Lifts and Two (2) Escalators on Ground Floor for Shopping Center
Luxurious Interior Design of Ground Floor Lobby Using Marble and Granite
120 Covered Parking Spaces on Basement Levels
Designated visitors parking
Drop off Area at Building Entrance
Features: Electronic access cards for secured parking and tenants areas
Eight Floors of A-Class office Space, Offices ranging from 109m² to over 1800m²
Retail outlets on the ground and mezzanine floor
Amenities: Location: Main Road Ally Hassan Mwinyi Road and Junction of Protea Apartments (Little Theater)
Jangid Plaza epitomizes the style and status of business in the most prestigious location in Dar Es Salaam with its elegant design and prominent position to the Oysterbay Area. Businesses gain maximum exposure through its strategic location on Ally Hassan Mwinyi Road and its close proximity to the commercial hub of Dar Es Salaam a prime location for world-class companies and brands.
I was “hick“ saying ...
Hiccups unstoppable What Are Hiccups? The word ‘hiccup’ was derived from the actual ‘hic!’ sound, followed by the release of air. Hiccups (or, medically, synchronous diaphragmatic flutter (SDF), or singultus) are a completely normal but involuntary reaction of the body, specifically the diaphragm. The actual act of hiccupping is the involuntary contraction of your diaphragm. When hiccupping, your diaphragm contracts, which causes you to inhale suddenly and unexpectedly. Often, only one side of your diaphragm is affected. In up to 80% of the time, it is the left diaphragm. This same involuntary contraction (spasm) causes your glottis - more commonly known as your vocal chords - to clamp shut. So, just as you start to inhale and pull in air, the air is blocked. This sudden inhalation and blocking of air causes you to feel that bump in your throat and produces the hiccupping sound. Hiccups are not usually serious and in most cases they only last for a few minutes. What Causes Hiccups? The phrenic nerve is a nerve that extends from the throat region of the spine down through the diaphragm. These nerves (the body has a right and left phrenic nerve) are responsible for some sensation in the chest but, much more importantly, are the brain’s main connection to the diaphragm and are responsible for telling the diaphragm when to contract and relax. Without the phrenic nerves, we would not be able to breathe. Irritation to the phrenic nerve can cause it to tell the diaphragm to contract when it’s not meant to, leading to hiccups. Other causes are:
• • • • • • • • • • • • • • • • • • •
Drinking carbonated beverages Drinking alcohol Eating particularly dry foods Eating spicy foods Eating too fast An overly full stomach Air trapped in the stomach Prolonged laughter Sudden changes in temperature Excitement, stress, heightened emotions Excessive Smoking Acid Reflux Irritation of the phrenic nerve Irritation of the vagus nerve Side effect of various medicines Metabolic disorders Nervous system disorders Hyperglycemia Chemotherapy Brain Tumor
How To Get Rid Of Hiccups? I personally drink a full glass of water at a go and it works all the time. Other remedies are; Sweeten the hiccups. Have a teaspoonful of sugar, and if you can, place the sugar on the back of the tongue, where “sour” is tasted. This way, the sugar overload will pack the most punch. Get Scared Silly Having someone surprise you can overwhelm the vagus nerve and put an end to hiccups. Pull on Your Tongue It may sound strange and immature, but sticking and pulling out your tongue may stop hiccups. Did You Know?
• Within 35 milliseconds the glottis closes off the windpipe, producing the famous “hic” noise.
• Fetus also gets hiccups as hiccups strengthen the diaphragm and prepare the baby for breathing.
• The record for the longest hiccupping in world
• • •
Guinness record is held by a pig farmer named Charles Osborne. He began hiccupping in 1922 and continued until 1990 that is 69 years. He was unable to find a cure but led a normal life, marrying twice and fathering eight children. Hiccups in Indian and Arabic culture are said to occur when the person experiencing hiccups is being thought of by someone close. It generally occurs at a frequency of four to sixty per minute. Hiccups that occur for extended periods of time (days to years) are extremely rare and are known as chronic hiccupping. By: Alina Murji
Editor’s Note : Even though only three are mentioned, there are many more ways to stop hiccups. Most of the time, hiccups will go away on their own. However, if they last for more than two days, consult a doctor, and s/he may prescribe medicines or other form of therapy to stop chronic hiccups.
Diseases Overview
Dieting the diabetic way
So you visit your doctor for a prescription for flu or malaria, and after a couple of lab tests, you come to know that you’re diabetic. You’ll probably first go into a state of panic and fury wondering why the doctor had to be so nosy to check your sugar levels, but then it hits you. You now have to live with it! You get back home to plan out your meals, and these are the instructions you give to your wife, or for that matter, the home ‘master-chef’: “From now on my food will all be boiled, and my tea sugar–free, and so that I don’t get tempted, there will be no soda and ice-cream in the house.” What is Diabetes? Diabetes is a condition in which there is little or no insulin to control what your body should do with all the food that it receives. In other cases, diabetes is due to insulin resistance. Every meal that you take is similar to unloading
The focus is to avoid loading your body quickly – simple sugars and fats are absorbed too quickly for your struggling insulin levels to deal with them, so you need to avoid having these on a regular basis. This means avoid the daily sodas, fries and fruits that rush sugars in – bananas, pineapples, watermelons etc. Fresh juices and carbohydrate friendly fruits such as apples, avocado, papaya, strawberries, blackberries and the list goes on. The tougher to digest the better – if you have lunch at 1 p.m. and at 4 p.m. you’re hungry again, you’re having foods that are absorbed too quickly, and your gut wants more – avoid the polished rice and breads – chapattis, naans, parathas, mandazis. If you eat it, burn it – whenever you enjoy a delicious meal, remember that you are taking more than you’ll burn by sitting at your office desk. Cycling, swimming and walking are all great options, provided that you sustain the workout for at least 30 minutes. Do what you can – the diet control should not be a three month activity. This is a lifelong adaptation, so don’t stop everything that you’re used to. Less fat = lose weight – obesity is not only likely to cause diabetes but it also makes it more difficult to control diabetes. Low fat diets have been the backbone of the diabetic diet for years.
a large container of goods at your shop – if you don’t have a good manager, your shop ends up looking like it just came through an earthquake. Similarly, if you don’t have enough insulin, your body misuses all the nutrients it receives, and this causes trouble!!! This eventually means the same concept as giving tuitions to a struggling form 1 student – you start with grade 4 topics and work your way up as he/she is able to cope with the load. Here we will discuss a few basic concepts that will help plan your diet. All energy sources are affected – diabetes was initially thought as only a sugar disease, and many still picture it that way. But this is not true – you have to control your carbohydrates, fats, and proteins. A heavy load of proteins stresses your body to produce insulin in the same way that carbs do. So keep the “sumni sumni” in check.
Smells fishy? – Fish oils have great advantages in protecting the heart and blood vessels, and that’s what causes the damage in diabetics. These can also be found in fish oil preparations. One such widely available one is produced by Seven Seas Ltd. All in all, diabetes is a lifestyle disease and controlling it needs a lifestyle modification. There is no single change that will shoot your blood sugar levels down. Having said that, diabetes is preventable and we should try avoiding risk factors such as obesity, hypertension, and low physical activity. So let us not look at this at a treatment guideline but as a guide to improve on what we are doing.
By: Dr Sadiq Dawood
WHITE COATS | A JAMSA PUBLICATION | JULY 2013
27
Tibb-al-A’imma the medicine of the Imams (AS) Adapted from Tibb-al-A’imma (by Abdallah, Abu atab and Abdallah, Husayn) What is an illness? Why do we get ill? These questions, and several more regarding disease and distress, cannot be answered simply in scientific and measured values, as illness is a multi-dimensional incidence. It consists of the stereotypical physical realm, as well as psychological and spiritual facets. The immaculate imams of the holy household were the masters of the great religion of Islam, along with that, the forefront in every field; including medicine and healing. The ‘Tibb-al-A’imma’, a collection of ahadith from them, highlights their infinite acquaintance in all matters relating to well-being, health-promotion, treatment and cure of ailments. This volume of therapeutic wonders is a testament to their comprehension and vast array of both natural and spiritual healing. It describes cures to heal the soul of its piercing pains and medications for other diseases of the body. Imam Amir al-Mu’mineen (a.s) advised his son Imam Hassan-al-Mujtaba (a.s) regarding health promotion: “If you practice these measures, you will not require medicine:
• • • •
Do not eat unless you are hungry Cease eating while you still have a desire to eat Chew your food well Relieve yourself after awakening from sleep.”
He also added that “there is no healthiness with gluttony”. This statement reiterates the divine view of “eating and drinking but not being prodigal” (Quran, 7:31), that synopsises medicine. Furthermore, Imam Ja’far-As-Sadiq (a.s) asserted “If people eat moderately their bodies will be healthy.” In the same light, Imam Musa-al-Kadhim (a.s) added “abstaining from certain foods (al-lahmiyya) is the chief medication. The abdomen (al-maida) is the house of illness. Accustom [the body] to what you are used to.” It is known that one is what they eat, thus, having a balanced diet (what the body truly needs, and is accustomed to) is unquestionably a mainstay of health. It is also reported from Hussain ibn Ali (a.s) that, during illness, one should “abstain from dates.” and one should “cure themselves with apples and water.” The eight Imam, Ali ar-Ridha (a.s) recommended “avoiding medications as long as the body can bear the illness. Only when it cannot bear the illness, take medications.” The
Islamic Medicine
By: Faisal Hooda Imam’s wisdom in this proclamation is contemporarily exemplified by the simple fact that excess and unnecessary usage of drugs can have long-lasting harmful side effects on the body’s daily mechanisms. Similarly, due to drug misuse and abuse, the medical world today is facing a prime predicament concerning increasing pathogenic drug resistance. Other fundamental principles for achieving vigour, according to the A’imma, include the requirement for rest and calm after suffering from an illness; accustoming the body to routine; understanding the body’s natural constituents and elements, and their balance within the body. Furthermore the spiritual side of any illness can’t be denied, as during our daily trials and difficulties, we experience severe anxiety and displeasure. Many a time, we also feel anxious, sorrowful, agitated, lonely and fearful for no obvious reason. Regarding falling ill and its causes, Amir al-Mu’mineen (a.s) opined to his son Hussain (a.s), “Don’t be distressed, O’ Abu Abdallah, for there is not one of our Shia afflicted with pain, but that is for a sin committed previously by him, and the pain is purification for him.” Muhammad al-Baqir (a.s.) adds, that as long someone is ill, there is not even “a single sin recorded against them.” As for the consequences of illness, Ja’far as-Sadiq (a.s) avows from his grandfather Ali ibn Hussain (a.s), who narrates from the Holy Prophet that “One night’s fever expiates one year of sins.” Physical, psychological and spiritual aspects of medicine have profound influences in the treating of several internal and mental illnesses. Accordingly, healing of the soul may be achieved by seeking healing in the verses of the holy Qur’an, praying with humility, invocations and supplications. The Tibb-al-A’imma is thus practical advice for healing through use of foods mentioned in the holy Qur’an and traditions of the Ahlulbayt.
Designers Note : This article has names of Imams and also translated verses from the Holy Qur’an. It is advicable to hence use prescibed methods when discarding this magazine, specifically for this article. Thank you
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Water Therapy
Natural Remedies
everything is water
By: Sajida Dhalla
Feeling tired? Stressed? Constipated? Looking for an easy way to lose weight? Don’t worry, here is a very simple way to get the best relief.
Whenever we think about good health, the very first thing is that comes into our mind is exercise and diet, but what may be the most important factor to the health of both our mind and body is the amount of water that we drink. What is water therapy? Water therapy is the natural treatment for controlling diseases and keeping the body hydrated by the use of water. How to practice water therapy? Every morning as soon as you get out of bed, before brushing your teeth, drink as least 4 glasses of water, take short breaks in between and after that avoid eating anything for an hour. As we know the body gets dehydrated during the night so taking water early morning helps to boost metabolism and drinking water on an empty stomach helps to purify the colon, making it easier to absorb nutrients.
Editor’s Note: Water is very important for rehydrating our body. For those who do not prefer drinking plain water, they may find Gatorade more appealing, and may use it as a substitute for water. However, there is no ideal substitute for water, and drinking plain water is the best. The next closest thing you can do is add sugar free flavoring to the water. Diluting your Gatorade with water is better than having it in the original form. Fresh fruits are better than fruit juices, due to less sugar content. For those who drink Gatorade, remember to drink no more than 1 bottle per day as too much electrolytes are not good for the body. Moderation is the key!
Water therapy is easy and offers wonderful benefits. Water has the ability to cleanse our body of toxins and unwanted waste through urine and sweat. Among other benefits, healthy water consumption can also help maintain the body’s temperature and a healthy glowing skin. Water therapy has no side effects at all, but remember too much of anything can be bad! So maintain a balance and enjoy the goodness of this wonder drink and trust me you will never actually believe this until you start practicing. DRINK WATER AND STAY ACTIVE & HEALTHY! WHITE COATS | A JAMSA PUBLICATION | JULY 2013
29
Breast Cancer
The Real Deal
hereditary?
Breast cancer is the most common cancer affecting women worldwide. Like other cancers, breast cancer is also caused by an abnormal multiplication of cells, this time in the breast tissue. These cells may originate from the inner lining of milk ducts or the lobules that supply the ducts with milk. While the overwhelming majority of cases occur in women, breast cancer can also occur in males. The abnormal multiplication which occurs in the breast tissue is the consequence of an interaction between defective genes in our body and certain environmental factors. Although a single cause of breast cancer has not been established, multiple risk factors have been implicated. The primary risk factors are female gender and age. Breast cancer is strongly related to age with only 5% of all breast cancers occurring in women under 40 years old. Other potential risk factors include; lack of childbearing, NOT breastfeeding, and long-term use of oral contraceptives. Active cigarette smoking, as well as passive smoking (being exposed to cigarette smoke) has shown to increase the risk of breast cancer. High fat diet, alcohol consumption, and obesity may also play a role in developing breast cancer. Breast cancer also has a genetic component, and the likelihood of developing it increases when there is a history of breast cancer in the family. Generally, in those patients with a first degree relative with the disease, the risk of breast cancer between the age of 40 and 50 is twice that of the general population. The first noticeable symptom of b r e a s t cancer is typically a lump that feels different from the rest of the breast tissue, and it is usually painless. More than 80% of breast cancer cases are discovered when the woman feels a lump. The earliest breast cancers are detected by mammogram. Lumps in the armpits can also indicate breast cancer (due to the presence of lymph nodes). Indications of breast cancer other than a lump may include thickening of skin, one breast becoming larger or lower, a nipple changing position or shape or becoming inverted, skin puckering or dimpling, a rash on or around a nipple, discharge from nipple/s, constant pain in part of the breast or armpit, and swelling beneath the armpit or around the collarbone. Diagnosis of breast cancer is confirmed on the basis of a biopsy. A small part of the breast tissue/lump is excised and taken for microscopic analysis (for evidence of precancerous or cancerous cells). A breast ultrasound or a mammography may show signs of a cancerous process, and can therefore be used for screening purposes. However, a biopsy is warranted for definitive diagnosis.
The management of breast cancer depends on various factors, including the stage of the cancer. Breast cancer is usually treated with surgery, and then possibly with chemotherapy or radiation, or both. A multidisciplinary approach is preferable. Stage 0 is a pre-cancerous stage or marker condition. Stages 1–3 are when the cancer is within the breast tissue or spread to nearby lymph nodes. Stage 4 is ‘metastatic’ cancer, meaning that the cancer has spread to distant organs in the body. This stage has the least favorable outcome. Standard surgeries include: Mastectomy: Removal of the whole breast. Quadrantectomy: Removal of one quarter of the breast. Lumpectomy: Removal of a small part of the breast. Radiotherapy is given after surgery to the region of the tumor bed and regional lymph nodes, to destroy microscopic tumor cells that may have escaped surgery. Breast cancer can also be managed by medication. There are two types: Hormonal therapy - Breast cancer is a hormonedependant tumor, that is, some breast cancers require the estrogen hormone to continue growing. This is why certain conditions, such as first period at a very early age and first pregnancy at a late age have been shown to increase the risk of developing breast cancer. Therefore, hormonal therapy involves drugs that either inhibit the production of estrogen in the body, or drugs that block the estrogen receptors in the body. Chemotherapeutic drugs destroy the fastgrowing cancerous cells. They are given in combinations, usually for 3–6 months. Predominately used for stage 2–4 disease, being particularly beneficial in estrogen receptor-negative (ER-) disease. Women may reduce their risk of breast cancer by maintaining a healthy weight, being physically active, and breastfeeding their children. These modifications might prevent about 38% of breast cancers in some countries. The benefits with moderate exercise such as brisk walking are seen at all age groups including postmenopausal women.
By: Zahra Nagri
Phobia
Scareddd ...
fears ...
By: Fatema Alimohammed take action in different ways, for example through spoken word, poetry, creative writing, etc. Sometimes it may seem impossible; but trust me, nothing is. And if you really want to achieve victory over your fear, you will build that courage needed. Most people may suffer from very complicated phobias such as mean classmates, people who bully, exams, being afraid of voicing opinions in public, making new friends, applying for a post at an institution etc. Such phobias have to be tackled in steps, and so you may have to plan out how you will work your way through. Sometimes willpower is not enough and you may end up taking drastic action in your motivation to get rid of your phobia. Remember, every fear has a solution, and no matter how complicated it may seem, you HAVE to work your way through it. Have you ever felt helpless in the face of your constant phobia of things that don’t even really matter to others? Rest assured you are not alone in your misery. The majority of the world’s population suffers from some phobia or the other, unfortunately exacerbating the pain that people may already have. In most cases, phobia is related to an event that occurred sometime during a delicate phase in your life. It is very likely that this phase is childhood. A video called ‘The Stir’ by Julie Evans showed the effects of bullying on the rest of a child’s life. Although I find it my duty to warn you on the harsh content of the video, it is a must-watch. It is only after I had watched this eye-opener, did I truly fathom the delicate nature of young age to external factors such as bullying. However, the effects of phobias acquired during these tender times can definitely be overcome. Getting over something you fear implies being more powerful than the fear itself. You may reach a point whereby you are about to fight your phobia, and suddenly you lose all that initiative you had in the first place. During these times, you should remind yourself that the Almighty is the most powerful entity; and so the number one rule is to always remember that the only fear one should have is the fear of God. Once you have mastered this and engraved it into every phobia you have, the rest falls into place. Personally, I have fears that I find really difficult to overcome; but what I have learnt in the process of working my way through each one of them is the importance of developing the courage and will-power to face your phobias and say, ‘Hey, I can do this.’ Different people find motivation to
Some people say that being cool and indifferent means walking through life with your arms crossed in front of your chest, always taking a defensive stance and waiting to protect yourself when troubles come. But I believe that life should be walked through with arms outstretched, looking for challenges and having no fear anymore because you have already faced what’s out there. And so, the last rule of overcoming your phobias is getting out there and facing them. In fighting my fears I find pleasure, because with every victory comes relief. You may fear public speaking or diving into a swimming pool; but once you muster the courage to go out there and do it, you will never fear again. Where there is a will, there is a way...so what are you waiting for??? Get out there and fix your phobia!!
Editor’s Note: It is usually a good idea to be open and proactive about your fears. Do share them with others, so that they may give you tips on how to handle, or even get rid of them. You may be surprised to find out how many people share the same phobia as you. Talking with a person who has successfully overcome a phobia that you currently have is another good idea. One good tip is facing a little dose of your phobia at the beginning, then gradually increasing the dose, till you overcome it! Lastly, searching on the Internet about your phobia may be a worthwhile thing to do, and you will find various ways of tackling it.
WHITE COATS | A JAMSA PUBLICATION | JULY 2013
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Old School Pharmaceuticals
Grandma’s Closeta home remedy that does it all Have you ever complained to your grandmother that you had a tummy ache? If you have, chances are she had some seeds she asked you to chew or she told you to drink a funny tasting solution called ‘arakh saathar’. Arakh saathar is known as ‘Thymol’ in English, because it was derived originally from the plant Thyme. It is also found in various seeds such as ‘suwa’ and ‘ajma’. These are the seeds your grandma asks you to chew on to relieve tummy aches. So, does thymol actually work? What does it do? Can it be used for things other than tummy aches? Read on to be wowed by how much medicine your Grandma knows! Thymol kills bacteria. And if your tummy hurts because of food poisoning, the thymol will help your body get rid of the infection faster than it would on it’s own. This property of thymol can be put to other uses as well. Research has shown, in fact, that thymol even kills bacteria that are resistant to antibiotics from the pharmacy. You can use thymol as: • A mouthwash to stay free of bad breath, or to help with your sore throat when you have tonsillitis. • An antiseptic, before you bandage up, to clean cuts and scrapes that you fear might get infected. • Toner for facial skin (after diluting) to clear up acne and prevent breakouts. Thymol prevents spasms. Thymol has been shown to prevent spasms of smooth muscles, which is another cause of tummy aches. It has also demonstrated these muscle relaxing properties on muscles of the airways, which may be an indication that it may work to relieve bronchospasms in asthmatic patients, but the jury’s still out on that one. Thymol helps with coughs. In addition to it’s antibacterial properties, thymol works as a mucus clearing agent. This means if you have an
annoying productive cough, you can use thymol to soothe it. Grandma might have told you vapor from ground ajma gets rid of these. She would recommend rubbing a mixture of ground ajma and onion on your chest before sleeping. You just shower it off in the morning and voila, the cough gets better. Thymol kills fungi. Those with fungal infections of the nail and/or skin can soak the affected parts in thymol solution once a day for a few weeks to clear these up. Skin infections clear up faster than nail infections, which need to be treated until the affected nail grows out. Thymol prevents mutations and thus, cancers. Research on the subject indicates that thymol somehow prevents mutations in cells exposed to mutagenic influences such as radioactivity. This may not treat a cancer that has already grown, but it may prevent new cancers from developing. Thymol kills pests. This isn’t something most of us will use it for, but thymol may be used a pesticide on farms to stop pests from destroying crops. And a bonus? Thymol is readily biodegradable so it’s environment friendly. A word of caution before you rush for the thymol, though. Thymol is usually sold as white crystals which are an extremely concentrated form. Just melting it by heating or using it undiluted may cause chemical burns. Thymol is best used diluted. Simply throw some crystals into a bottle full of water and use the solution as desired. The crystals will not dissolve completely, since they’re only partially soluble in water. You can keep topping up with water as you use the solution, until all crystals are dissolved. Then you can get more and start over. If all that sounds confusing, ask your grandma. She knows how it’s done!
By: Dr. Fatimah Zahra Karim
Silent World
Stapes
children and hearing loss
By: Fayaz M A Jaffer
Whilst universal hearing screening for newborns in developed countries has helped to identify 80 to 90 percent of children with hearing issues quickly and accurately shortly after birth, sadly in most of the developing world including Tanzania, this practice is not common. This is due to lack of screening tools and expertise at the health centers and hospitals. Early identification of hearing loss and intervention is the only way to ensure best possible outcomes for language development. It is therefore important to identify the signs that may suggest a possible hearing loss in a child as quickly as possible, so that steps such as testing, treatment and management can be taken. Infants and Toddlers The most important clue that indicates a possible hearing loss in a very young child is a delay or absence of speech development. Watching critical development milestones helps to identify any hearing impairment that may exist. Early detection of hearing loss and treatment can help a child develop speech and language at a rate comparable to children with normal hearing. The following are indicative milestone guidelines, and as always, any concern should be discussed with a pediatrician. By 3 months: The baby should be able to recognize your voice, make cooing noises and gets startled by sudden, loud noises. By 6 months: The baby should be recognizing speech
sounds and familiar voices, turn head towards interesting sounds, play with own voice and laughs. The baby uses his/her voice to indicate pleasure and discomfort and has speechlike conversation with caregivers. By 9 months: The baby should understand simple words like “Mommy,” “Daddy,” “no,” “bye-bye” and his or her own name. By 10 months: The baby’s babbling should sound speechlike, with strings of single syllables (“da-da-da”). By 12 months: One or more real, recognizable, spoken words emerge. By 18 months: The toddler should understand simple phrases and be able to retrieve familiar object and point to body parts on command (without gestures). The toddler should have spoken 20 to 50 words and short phrases and is learning new words every week. By 24 months: The toddler’s spoken vocabulary should be about 200 to 300 words and simple sentences can be spoken. The child should also be able to sit and listen while being read to. Older Children Identification of mild hearing loss in older children who have developed speech skills is more difficult. This is because they may have developed speech unconsciously by means of coping techniques to compensate for their hearing loss.
WHITE COATS | A JAMSA PUBLICATION | JULY 2013
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Some of the signs to watch for in older children are:
• The child seems to hear fine some of the time and • • • • •
• • • •
then not respond at other times. The child wants the TV volume louder than other members of the family. The child asks “what?” or says “huh?” more often than he or she used to. The child moves one ear forward when listening, or complains that he or she can only hear out of his “good ear”. The child’s academic performance deteriorates or the teacher notes that he or she does not seem to hear or respond in class. The child says that he or she didn’t hear you. There may be an assumption that the child is not paying attention when in fact there may be an unidentified hearing loss. It seems as though the child is just not paying attention. The child starts to speak more loudly than previously. The child looks intensely when spoken to. He or she may be depending on visual clues. Sometimes it is just a feeling that a parent has.
Acquired hearing loss that appears months or years after birth and has many possible causes, otitis media and meningitis to name a few. Most hearing loss in children without obvious risk factors (e.g. premature birth) has a genetic cause. It is advisable to escalate any concerns to the pediatrician who can then refer the child to an audiologist for a complete hearing evaluation. References Jenkins, B. (2012) 10 Clues - Your child has hearing loss. Hearing Health, Iss. Fall 2012 p.12,13. Fayaz M A Jaffer Hearing Instrument Specialist (HIS)
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Trivia
i know ...
1. Orange juice has a lot of which vitamin? 2. The Largest Organ in the human body is? 3. Insulin is secreted by? 4. The pigment that gives color to the skin is? 5. Rabies vaccine was invented by? 6. Malaria is caused by? 7. Hemoglobin in blood contains which element? 8. Which is the only infectious disease that has been eradicated from this world? 9. What is the main source of vitamin D? 10. What did Sir Alexander Flemming discover? YES/NO 11. Ablutophobia is the fear of abrasions. 12. Women are more prone to get Osteoporosis. 13. Cold Weather Can Give You a Cold. 14. Trypanophobia is the fear of Injections. 15. Shaving your head will stop hair loss and help hair to grow back thicker. (Answers on a random page in this magazine)
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