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WHITE COATS JUNE 2012 | ISSUE 12 | Making Health a Community Priority DIABETES
And Diet Control
And its Reasons
Use, Abuse and Overuse
Thinking and Speaking
The Long term Life Savers
Losing out on Bone
Parents and Children
SUNDAYLESS LIFE Of a Medical Student
The Golden Liquid
EDITORIAL Dear Reader, Salaam. It gives us great pleasure to present to you yet another copy of White Coats. This magazine is an annual publication of the Jaffery Medical Studentsâ€™ Association (JAMSA). Every year we try to cover the topics that will be of great benefit to the Jamaat. We are thankful to all the advertisers and donors for helping us in material and time for which without this issue in your hands would not have been as awesome as you will soon find out. Special thanks go out to Br. Sameer Kermalii for designing this yearsâ€™ edition pro bono. Also not forgetting all authors from within JAMSA and outside. This year we have tried to cover topics that will be of much help to would be parents, as we have covered issues regarding vaccination, child nutrition, and childhood diseases. We have also given brief descriptions on different careers in health care; this will help both students and parents to choose a suitable profession to pursue.
WHITE COATS ISSUE No. 12. Shabaan 1434 A.H / June 2012 A publication of JAMSA EDITORIAL TEAM; EDITORS Neelam Ismail Mohamed Ramzan N. Sachedina MEMBERS Faisal Hooda Ahmed Chagani Sajida Dhallah Fatma Alloo Sakina Sikiladha
DESIGN Sameer Kermalli PRINTED BY DTP
Not forgetting those people who just want to fill up their brains with more knowledge, for them a number of good articles to read.
Happy reading! Neelam Ismail and Mohammed Ramzan Sachedina
For Letters to the Editor, Comments, Suggestions and Reviews, please send us an email
White Coats is a non-profit magazine and printing costs are financed through advertising.
email@example.com WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
CONTENTS Opening Your Eyes To The New World
Editorial....................................3 Mamas Corner Prenatal Bonding......................5 Psychology Language = Thought................6
Islamic Perspective Environment and Health...........8
The Islamic Way Teeb al Islamiyya....................23 Brain Conditions Schizophrenia.........................25 Boneafied Osteoporosis..........................26
Most Common Common Cold........................10
Seeing Is Believing Optometry...............................28 I Cried More Reasons to....................29
5 Gruelling Years Life of a Medical Student........30
Trivia Tidbits Human Body Facts.................14
What we Know Noise Induced Deafness........31
Heartache Infective Endocarditis.............15
21st Century 3D Bones Prints.....................32
Like Love Chicken Pox and Measles......16
Becoming Someone Doctors and How....................33
Gods Gift Honey.....................................17
Graduating White Coats ........34
The Only Set Teething Problems..................18
Trouble Totos Child Nutrition.........................35
Teaching Doctors Bugando Teaching University.19
Silent Demon Diabetes.................................36
Catching it Fast Congenital Rubella.................21
Hypochondriac Overdosing on Antibiotics.......37
To Be What to Be Radiology...............................22
Makers Breakers Pharmacists............................38
MAMAS CORNER PRENATAL BONDING … Baby & Beyond By Laila Hassan Dhalla The wonderment of becoming pregnant and creating a family is a profound, exciting and sensitive time in a woman’s life. Pregnancy may hold challenges as well as a wide array of emotions from sadness and frustration to complete joy for both the mother-to-be and her “little one”. Having a baby changes your life. We often tend to talk about sleep deprivation phase, the diapers and the late nights but that does not give you even a glimpse into the earth shattering joy that the baby can bring in your life. WHAT IS PRENATAL BONDING ? It’s the unique personal relationship linking a mother and her fetus, it is the communication with which the mother and her baby embark on that forms the baby’s personality. It begins as early as the time of conception and lasts throughout a child’s life. The birth of the baby may be the culmination of all the efforts and time throughout pregnancy but the prenatal period is as essential as it is. Apart from the fact that this is the time where all vital organs are formed (organogenesis), the prenatal stage is a phase where maternal and fetal bonding can embark on and how are baby will come to experience the world during and after birth; but also because the habits we set in pregnancy and prepregnancy are the ones that are going to act as our natural crutch through parenthood.
Three aspects of prenatal bonding are : creating a peaceful home within ourselves, creating the relationship and taking care of ourselves are all vital to bringing joy to our own lives and the lives of our little ones; these are the crutches that we want to lean on and gain strength from! It is never too late and never too early to start developing these qualities within ourselves, for us our babies and family Did you know that your baby can hear you at the 25th week of gestation. Within the uterus the mother’s voice comes with much greater intensity that the fetus gets used to this voice so much and several experiments have shown us that the newborn is able to distinguish the mother’s voice from that of a strange voice, just as it is able to distinguish the mother’s scents. They are also capable of responding to love, and they are aware of how you feel about them. It gives your baby a greater opportunity to be healthy and happy months
before they are even born. Developing a prenatal bond will occur through conversations with your baby that contribute to feelings of love and this translates into over-all well-being. When parents express love to their unborn baby, they are providing their baby with a warm, safe and nurturing place. This warm and safe place tells your unborn baby that they can trust you, and the world that awaits them. PROMOTE PRENATAL BONDING Feeling a fetal movement or a kick may indicate interaction and a possible response from your child. In return, hold your tummy and make some acknowledgements like saying “Mommy is right here.” Before you retire or sleep at night, make sure to involve your child in your daily reflection such as recalling the activities of the day, the person you may have the chance to talk with, and the things you have been up to and so forth. Also let paternal bonding set in, Let dad talk to his child and share wonderful thoughts about the outside world also encourage siblings to be part of the bonding too. Maximize the time you have with your child. Start fetomaternal bonding in the earliest time you could ever do. Make the bond as extra special as expected and you won’t regret taking those efforts.
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
PSYCHOLOGY LANGUAGE=THOUGHT How Language Affects Thought By Mohamed Ramzan N. Sachedina
Ask yourself the question, which cognitive faculty would you most hate to lose? Sight? Hearing? Many a times we forget about language. Yet if you lose (or are born without) your sight or hearing, you can still have a wonderfully rich social existence. You can have friends, you can get an education, you can hold a job, you can start a family. But what would your life be like if you had never learned a language (including sign language)? Could you still have friends, get an education, hold a job, start a family? Language is so fundamental to our experience, so deeply a part of being human, that it’s hard to imagine life without it. But are languages merely tools for expressing our thoughts, or do they actually shape our thoughts? Humans communicate with one another using a dazzling array of languages, each differing from the next in innumerable ways. Do the languages we speak shape the way we see the world, the way we think, and the way we live our lives? Do people who speak different languages think differently simply because they speak different languages? Does learning new languages change the way you think? Do polyglots think differently when speaking different languages? Ever hear a native of Bukoba substituting ‘L’ for ‘R’ or even for that fact a Japanese person. So most these people will say ‘Ros Angeres’ or ‘rara sarama’ not because they cannot say the “L” sound, but because they cannot hear the difference. The point is; we are born being able to hear and to say all the sounds of every language but, in true use-it-or-lose-it fashion, unused neurons are gradually pruned away until we can only hear the sounds of our own language(s). Similarly, a non-native English speaker might be unable to distinguish between the spoken phrases “that’s tough” and “that stuff,” although a native speaker will be able to without the help of any context.
Lera Boroditsky (assistant professor of psychology, neuroscience, and symbolic systems at Stanford University) has achieved numerous acclaims for her research in this field. One of her researches led her to a small Aboriginal community in northern Australia. She was attracted there because of the way the locals talk about space. Instead of using words like “right,” “left,” “forward,” and “back,” the locals, like many other Aboriginal groups, use cardinal-direction terms — north, south, east, and west — to define space. This is done at all scales, which means you have to say things like “Move the cup to the north northwest a little bit.” One obvious consequence of speaking such a language is that you have to stay oriented at all times, or else you cannot speak properly. The result is a profound difference in navigational ability and spatial knowledge between speakers of languages that rely primarily on absolute reference frames (like the Aboriginals) and languages that rely on relative reference frames (like English). Simply put, the Aboriginals are much better than English speakers at staying oriented and keeping track of where they are, even in unfamiliar landscapes or inside unfamiliar buildings. What enables them — in fact, forces them — to do this is their language. To test this idea, the subjects were given sets of pictures that showed some kind of temporal progression (e.g., pictures of a man aging, or a banana being eaten). Their job was to arrange the shuffled photos on the ground to show the correct temporal order. Each person was tested in two separate sittings, each time facing in a different cardinal direction. If you ask English speakers to do this, they’ll arrange the cards so that time proceeds from left to right. Hebrew and Arabic speakers will tend to lay out the cards from right to left, showing that writing direction in a language plays a role. So what about the Aboriginals, who don’t use words like “left” and “right”? What will they do?
The Aboriginals did not arrange the cards more often from left to right than from right to left, nor more toward or away from the body. But their arrangements were not random: there was a pattern, just a different one from that of English speakers. Instead of arranging time from left to right, they arranged it from east to west. That is, when they were seated facing south, the cards went left to right. When they faced north, the cards went from right to left. When they faced east, the cards came toward the body and so on. This was true even though we never told any of our subjects which direction they faced. The Aboriginals not only knew that already, but they also spontaneously used this spatial orientation to construct their representations of time. “Maro phone (my phone)”, “Mari gadi (my car)”, think about it, unconsciously we have already assigned gender to these items. Many languages assign genders to words. For example, in Spanish, the word for “key” is feminine, while the German word for” key” is masculine. Gender for the most part is arbitrary and varies from language to language, which allows for some interesting experiments. Lera Boroditsky and colleagues asked Spanish and German speakers to provide descriptive adjectives for different objects. Interestingly, people produced adjectives that were consistent with gender stereotypes. For example, German speakers described keys as hard, heavy, jagged, metal, and useful, while Spanish speakers described them as golden, intricate, little, lovely, and shiny. For the word “bridge,” which is feminine in German and masculine in Spanish, the opposite happened. Germans described bridges as beautiful, elegant, fragile, and peaceful, while Spanish speakers said they were big, dangerous, long, and strong. Apparently even small flukes of grammar,
like the seemingly arbitrary assignment of gender to a noun, can have an effect on people’s ideas of concrete objects in the world. Language is a uniquely human gift, central to our experience of being human. Appreciating its role in constructing our mental lives brings us one step closer to understanding the very nature of humanity.
EDITORS NOTE; Clinical term for L – R interchange in pronouncing is Spoonerism
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Patient: How much to have this tooth pulled? Dentist: 150,000 Shillings Only Patient: 150,000 Shillings for just a few minutes work? Dentist: Well, I can extract it very slowly if you like What’s the difference between a physician, a surgeon, a psychiatrist, a radiologist and a pathologist ? The physician knows everything and does nothing. The surgeon knows nothing and does everything. The psychiatrist knows nothing and does nothing. The radiologist knows the inside story and does nothing. The pathologist knows everything, but always a week too late.
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
ISLAMIC PERSPECTIVE HEALTH And The Environment By Sakina Khatau The air we breathe, the water we drink, the food and we eat, the environments we live and work in, all have the potential to affect our health. The environment influences our health in many ways — through exposures to physical, chemical and biological risk factors, and through related changes in our behaviour in response to those factors. In the Holy Qur’an, Allah says that Man is the best of created beings and is His representative on Earth. Further Allah reminds us of the bounties He has given us; ‘It is He who sends down rain from the sky: From it ye drink and out of it grows the vegetation on which ye feed your cattle. With it He produces for you corn, olives, date palms, grapes and every kind of fruit: Verily it is a sign for those who give thought..’ (16:10-11) But in Islam, every right is balanced by a responsibility, and man is warned, ‘and do no mischief on the earth, after it has been set in order..’(A’araf 7:56) Accordingly, in the Islamic world view the relationship of man with nature should be like that of a just ruler with his subjects. Although the ruler has power over his subjects, his subjects are a trust over which he stands guard, and he is expected to act in a responsible way toward them. The right to harness and use natural resources, which Allah has granted man, invokes a duty on man to conserve them. It follows that man has
no right to cause the degradation of the environment and distort its intrinsic suitability for human life and settlement. Nor has he the right to exploit or use natural resources in such a way as to destroy the purpose for which it was created. Environmental protection and prevention of contamination has been a part of Islam since its inception. The Holy Prophets instructions to his followers when they went to battle included the order ‘not to cut down any trees.’ Also, he prohibited defecation on the edge of a well, river or under a fruit tree, among other similar warnings. Evidence shows that environmental risk factors play a role in more than 80% of the diseases regularly reported by the World Health Organization. Every year, the lives of four million children under 5 years – mostly in developing countries – could be saved by preventing environmental risks such as unsafe water and polluted air. Better environmental management could prevent 40% of deaths from malaria, 41% of deaths from lower respiratory infections, and 94% of deaths from diarrheal disease – three of the world’s biggest childhood killers. In developed countries, healthier environments could significantly reduce the incidence of cancers, cardiovascular diseases, asthma, lower respiratory infections, musculoskeletal diseases and poisonings. Furthermore, environmental factors are playing an increasingly important role in the incidence of cancers - From the womb to old age, people around the world are exposed to countless carcinogens in their food, air, water and consumer goods. For example, benzene, a known cause of human leukaemia, is a common pollutant in vehicle exhaust. Arsenic, linked to skin, liver, bladder and lung cancer, contaminates some drinking water suppliesLarge occurrences of cancers have been documented in areas with water and soil
polluted with toxic chemicals and plants have been known to absorb contaminants from soil and transfer these to humans. All the ecosystems and their different aspects constitute an interlinked and integrated system, existing in a dynamic equilibrium. Disturbing the balance and equilibrium that exists in the natural environment beyond its capacity to recover then leads to the environmental problems that we face today. Global warming, ozone depletion, deforestation, desertification, accumulation of contaminants in soil, plants and organisms, water and air pollution all have direct and indirect impacts on our health and the quality of our lives. In our mindless pursuit of consumerism, greed, waste, neglect and mismanagement of resources we have failed to protect and conserve the very earth that provides us with all that we need, and in the process increased risks to our health. Allah describes mans actions aptly in the Quran; ‘corruption has appeared on the land and sea on account of what the hands of men have wrought....’ (Rum 30:41) ‘When he turns his back, his aim everywhere is to spread mischief through the earth and destroy crops and cattle... .’ (2:205) As Muslims we have been enjoined to avoid waste and greed - indeed, Allah says in the Quran; ‘Lo! the squanderers were ever brothers of the devils, and the devil was ever an ingrate to his Lord’. 17.27 The worth of the natural environment to us cannot be quantified, so in conclusion it would be appropriate to briefly describe how the world of medicine has benefited from the natural environment. For example, one may be surprised to find that maggots and leeches have made resurgence in modern medicine. Leeches provide an anticoagulant, an anaesthetic and some antibiotic properties. “Disinfected” maggots have been used to treat certain types of wound healing. Pit viper and cobra venom can help make anticoagulant and hypertension drugs. The plant kingdom too has paved the way for an extraordinary number of modern drugs. Aspirin, is probably one of our most famous modern drugs, and it has its beginnings from the willow tree. Quinine , a treatment for malaria comes from cinchona trees. There is the antibiotic penicillin from the mould (fungus) penicillium, Digitalis from the foxglove plant and curare (spastic cerebral palsy, tetanus convolutions, surgery aid), among numerous others. Today, important new fronts in medicine are being opened in molecular biology, biomedical engineering, biochemistry, nanotechnology. But at the same time we are losing species to extinction and biodiversity is threatened. Perhaps as such events handicap and delay our abilities to exploit and leverage fully our new technologies, we will begin to realize the true value of the enormous treasures we have failed to appreciate and protect. What is essential is that we appreciate that we depend on the earth for food, water clothing and other needs; protecting and caring for it is not only our designated responsibility from Allah, but also vital if we want to lead healthy lives and benefit from the sustainable use of its vast riches that the Almighty has created for us.
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
MOST COMMON Common Cold Little Virus - Great Discomfort By Mujtaba Rattansi
Common cold is a mixture of symptoms of Upper Respiratory Tract due to Viral Infection. It is also known as cold, acute rhinitis, infectious rhinitis. Common cold should always be differentiated from allergic cold. The common cold generally involves a runny nose, nasal congestion, and sneezing. You may also have a sore throat, cough, headache, or other symptoms. Common cold is usually self limiting i.e. 5-7 days but sometimes can lead to secondary infection (Sinusitis, Otitis media, Bacterial pneumonia, Tonsillitis). Common cold can also trigger asthmatic attack in asthmatics especially in children. Causes, incidence and risk factors: It is caused by a Virus e.g. Rhinovirus, Adenovirus, Coxsackievirus, Influenza virus, Parainfluenza virus. It is called the “common cold” for good reason. You and your children will probably have more colds than any other type of illness. Colds are the most common reason that children miss school and parents miss work. Parents often get colds from their children. A cold virus spreads through tiny, air droplets that are released when the sick person sneezes, coughs, or blows their nose. You can catch a cold if: • A person with a cold sneezes, coughs, or blows their nose near you • You touch your nose, eyes, or mouth after you have touched something contaminated by the virus, such as a toy or doorknob
Some of the risk factors involved are: Age (1-5 years are most affected), Fatigue, Emotional disturbances, Allergic disorders (perfumes, soaps, etc), Environmental (fog, winter, rainy seasons, cigarettes, alcohol).
Symptoms: Typical symptoms of cold include: Nasal congestion/blockage, Runny nose, Cough, Sore throat, sneezing. Depending on the virus responsible for colds other symptoms include: Muscle aches, Fatigue, Headache, Loss of appetite, Hoarseness/no voice, low grade Fever. Treatment: There is no curative measure for common colds but palliation of symptoms (relieving pain or alleviating common cold without dealing with the virus). So treatment is mainly symptomatic, they do not make your cold go away faster, but can help you feel better. Non-drug treatment: Bed rest and use of adequate cover to prevent chilling, Adequate fluid (water) intake to avoid dehydration, Humidification of room air if possible to loosen respiratory secretions (mucous), Eating a well balanced diet, Steam therapy to relieve discomfort, Avoid excessive blowing of the nose to avoid infections such as sinuses, ear infection etc
Drug treatment: Involves treating of symptoms of common colds i.e. nasal congestion, cough etc. • •
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Nasal decongestants - to widen the nasal passage/airways and reduce edema e.g Ephedrine, Phenylephrine Cough remedies - Depending on the cough whether productive cough (use expectorants and mucolytics) or dry cough (use antitussives) Expectorants - increases coughing up and spitting out E.g. Ammonium chloride, Guaifenisin, Menthol etc Mucolytics - reduces mucus viscosity thus increasing flow E.g. Carbocysteine, Mecysteine Antitussives - Depress brain cough center by suppressing nerve receptor in Respiratory tract E.g. Codeine Sore throat remedies - To reduce tickling sensation E.g. Lozenges, Mouthwashes, Gargles, Vicks kingo etc Fever/Pain- Use antipyretics + analgesics E.g. Aspirin, Paracetamol, Ibuprofen etc. Some products available are: Actifed, Actifed plus, Benadryl, Benylin, Deleased, Sudafed etc
Over-the-counter (OTC) cough and cold medicines are not recommended for children under age 6. Talk to your doctor before giving your child any type of overthe-counter or nonprescription cough medicine, even if the label says it is made for children. These medicines likely will not work for children, and may have serious side effects. Note: Antibiotics should not be used to treat a common cold.
EDITORS NOTE: • •
A single cold virus can have 16 million offspring within 24 hours. The velocity of a sneeze is as fast as professional cricket bowler who can ball at about 100 miles (150 km) per hour. If you live in an igloo, what’s the worst thing about global warming?
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
FEATURE Vaccines The Long Term Life Savers
By Dr Shaina Yusuf MMED in Emergency Medicine (MUHAS)
All parents love their kids and want them to be healthy at all times. Vaccines work to protect children from illnesses and death caused by infectious diseases. Vaccines protect children by helping prepare their bodies to fight often serious, and potentially, deadly diseases. We all know prevention is better than cure. Parents usually are resentful for the kids getting pricked, a mother says “… but I got all the shots during pregnancy!” or “ Is it necessary to get the booster doses?”. Many of us do not understand the importance of the vaccines our children under five years of age are scheduled for, they prevent diseases of which most of them are morbid and lethal. If a child is not vaccinated and is exposed to a bug, the child’s body may not be strong enough to fight the disease. Before vaccines, many children died from diseases that vaccines now prevent, such as whooping cough, measles, and polio. Those bugs exist today, but babies are now protected by vaccines, so we do not see these diseases as often. Tanzania is supported by several NGOs to make sure that more than 85% of the population has access to these vaccines under the program formally called Expanded Program on Immunization (EPI) now called Immunization and Vaccination Development Program (IVDP). In Tanzania, the vaccines are readily available FREE OF CHARGE at the clinics where mothers get their follow up checkups for the pregnancy as well for children after they are born. It is a common practice to avoid the booster doses of the vaccines as soon as the toddlers start school. Booster doses are equally important as they effect of the vaccine reduces the next dose of vaccine would give “boost” to the immunity that is already sensitized.
We decided to talk about vaccines for children so as to bring awareness and knowledge of the importance of these vaccines which we seldom finish as per schedule. If the vaccines are given incomplete they may not be protective and a healthy child who would lead a normal healthy life could easily lose life! Vaccines available in Tanzania currently for preventable disease are neonatal Tetanus, Polio, Measles, Diphtheria, Pertussis, Tuberculosis, Influenza and Hepatitis B. Each vaccine can be given in single or combination as per possibility and availability. It cannot be over emphasized by how important it is for the parents to understand the important details about these vaccines, briefly described below for each vaccine: Bacille Calmette-Guerin(BCG) is a vaccine for tuberculosis (TB) disease. BCG is used in many countries with a high prevalence of TB to prevent childhood tuberculous meningitis and miliary disease. Oral Polio Vaccine(OPV) is given orally preventing Polio, an infectious disease caused by a virus that lives in the throat and intestinal tract. It is most often spread through person-to-person contact with the stool of an infected person and may also be spread through oral/nasal secretions. It may lead to paralysis if spinal cord is affected. Diptheria-Pertusis - Tetanus - Haemophilus Influenza (DPT-HB) is combination vaccine for Diptheria, Pertusis, Tetanus and Hepatitis B viral infections. Diphtheria causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death. Pertussis causes coughing spells so bad that it is
hard for infants to eat, drink, or breathe. These can last for weeks. It can lead to pneumonia, seizures, brain damage, and death. Tetanus causes painful tightening of the muscles, usually all over the body. Tetanus can lead to death. Hepatitis B is a viral infection that causes jaundice, liver damage and long term complication of liver cancer. Hepatitis B vaccine is the first and currently the only vaccine against a major human cancer. Hepatitis B was incorporated in 2000 with DPT therefore children born before 2000 are not immunized against it. Hemophilus influenzae Type B vaccine prevents meningitis (an infection of the covering of the brain and spinal cord), pneumonia (lung infection), epiglottitis (a severe throat infection), and other serious infections caused by a type of bacteria called Haemophilus influenzae type b which was introduced in 2009 in Tanzania. Measles vaccines prevent Measles, which is the most deadly of all childhood rash/fever illnesses. The disease spreads very easily, so it is important to protect against infection. These vaccines are what are scheduled vaccines for Tanzania which are readily available in clinics during Mother and Child Health (MCH) clinics. Many of us do not complete the schedule with the booster doses. The chart below shows a simple outline of the vaccine schedule at child’s appropriate age. VACCINE BCG OPV0 DPT-HB + OPV1 DPT -HB+ OPV2 DPT–HB+ OPV3 MEASLES
1987, since it is a cheap way to have so many health benefits for the immunity of the new baby which is in constant battle with new organisms, both good and bad. Of the few health advantages are enhancement of immune system, improves healing and keep up of skin integrity, improve eye sight , prevent vitamin A deficiency respiratory and diarrheal diseases. Vitamin A is usually given at 9, 15, 21, 27, 33, 39, 45, 51 and 52 months of age. The Beaton Report concluded that all-cause mortality among children aged 6–59 months was reduced by 23% through vitamin A supplementation in areas where vitamin A deficiency was a public health problem. We hope this article will give you the background information you need to realize the benefits of the vaccine schedules and the importance of finishing the booster doses for the better health of our children. For more information you can contact the editors for the sources of information or correct medical information you may need for children’s vaccination program. •
http://crisis.med.uoa.gr/downloads/ Day%209/IMMUNIZATION%20 PROGRAMME%20new.ppt
AGE Birth Birth 4 Weeks 8Weeks 12 Weeks
BOOSTER After 4 Weeks After 4 Weeks After 4 Weeks
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After 4 Weeks
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Common side effects after a vaccine shot that can be anticipated are fever, sore arm or area of injection, stuffy nose, mild cough, headache or diarrhea. All these are self limiting effects of the vaccine shots, these effects disappear within few days. Treatment for these are specific for what the symptoms are. Supportive care and monitoring usually is good enough to support the child through it. Vitamin A is not a vaccine but it is usually incorporated into the vaccination programs since
My heartfelt appreciation to Prof. Karim for guiding me to compile this piece for the betterment of the community.
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
TRIVIA TIDBITS Amazing Medical Facts About the Human Body • • • • • • • • •
25 million new cells are being produced each second. That’s a little less than the population of Canada - every second ! A red blood cell can circumnavigate your body in under 20 seconds. Nerve Impulses travel at over 400 km/hr (25 mi/ hr). A sneeze generates a wind of 166 km/hr (100 mi/ hr), and a cough moves out at 100 km/hr (60 mi/ hr). Our heart beats around 100,00 times every day. Our blood is on a 60,000 mile journey. Our eyes can distinguish up to one million colour surfaces and take in more information than the largest telescope known to man. Our lungs inhale over two million litres of air every day, without even thinking. They are large enough to cover a tennis court. When we touch something, we send a message to our brain at 124 miles/hour
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• • • •
We exercise at least 30 muscles when we smile. We are about 70 percent water. We make one litre of saliva a day. Our nose is our personal air-conditioning system: it warms cold air, cools hot air and filters impurities. In one square inch of our hand we have nine feet of blood vessels, 600 pain sensors, 9000 nerve endings, 36 heat sensors and 75 pressure sensors. We have copper, zinc, cobalt, calcium, manganese, phosphates, nickel and silicon in our bodies. A person can expect to breathe in about 40 pounds of dust over his/her lifetime There are more living organisms on the skin of a single human being than there are human beings on the surface of the earth. From the age of thirty, humans gradually begin to shrink in size.
HEARTACHE Infective Endocarditis A Slight Tappet Problem By Fatma Alloo
Infective Endocarditis (IE) is an infection of the inner lining (endocardium) of the heart chambers and valves. The term “Endocarditis” also is used to describe an inflammation of the endocardium due to other conditions. IE mainly affects people who have: • Damaged or artificial (man-made) heart valves • Congenital heart defects (defects present at birth) • Implanted medical devices in the heart or blood vessels People who have normal heart valves also can have IE. Men are affected more commonly than women. It has however been noticed that in patients younger than 35 years, more cases occur in women. IE becomes more common among older people. Cause: IE is usually a result of a blood infection. Bacteria or other infectious substance can enter the bloodstream during certain medical procedures, including dental procedures, and travel to the heart, where it can settle on damaged heart valves. The bacteria can grow and may form infected clots that break off and travel to the brain, lungs, kidneys, or spleen. Symptoms of Endocarditis may develop slowly (subacute) or suddenly (acute). Fever is the classic symptom and may persist for days before any other symptoms appear. Other symptoms may include: • Abnormal urine color • Blood in the urine • Chills • Excessive sweating • Fatigue • Joint pain • Muscle aches and pains • Nail abnormalities • Night sweats (may be severe) • Paleness • Red, painless skin spots on the palms and soles • Shortness of breath with activity • Swelling of feet, legs, abdomen • Weakness & weight loss
Treatment: Long-term, high-dose antibiotic treatment is needed to get rid of the bacteria. Treatment is usually given for 4 - 6 weeks, depending on the specific type of bacteria. Surgery may be needed to replace damaged heart valves.
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
LIKE LOVE Chicken Pox and Measles You only get it once By Aliasgar Bashir Khaki
Chicken pox and measles are two very common viral diseases that take place amongst children. These diseases have common symptoms in the beginning however they differ after a few days. Chicken pox caused due to a viral infection by the virus named varicella (zoster virus), appearing as reddish extremely itchy blisters all over the body. It is a contagious disease that can be acquire by touching the fluids of the blister and also if an infected person coughs or sneezes on you. The infected person is contagious one to two days before the appearance of the blisters until when the blisters have been crusted over. Majority of the cases take place in children under the age of 10; but is more severe in older children and adults.
The symptoms occur 8 -12 days after being exposed to the virus. The symptoms include coughing, fever, red eyes, muscle pain, sore throat and spots in the mouth. 3-5 days later, itchy red rashes occur starting from the head, moving down. These rashes are flat and red in color and may last up to 7 days. The treatment for this is acetaminophen/paracetamol to relieve pain and bed rest as well. The doctor can diagnose it be either looking at the rashes or by taking a blood sample. Vaccinations may prevent both the diseases. But it is also very important to check with your Doctor when symptoms occur. There’s nothing to panic about, remember it’s curable!
Symptoms occur 10 -21 days after being in contact with an infected person. The symptoms preceding the rash and blisters are headache, fever, and stomachache. The blisters start on the face, in the middle of the body and scalp. They then spread in other areas and can also appear in the mouth. The blisters usually don’t leave marks, however may get infected by a bacteria and leave a scar. Normally 500 small poxes occur though out the body. A doctor is able to diagnose chicken pox by looking at the blister and rashes. Treatment for chicken pox is applying ointment over the rashes and pox and also mainly to avoid scratching. Other ways include taking shower with lukewarm water, using slight soap. Avoid extreme heat and humid areas. Antiviral medicines can help but must be taken before the on set of the rashes. Children are usually given a vaccine which prevents chicken pox from taking place; and if it does, it’s minor. Measles is another common disease seen in children. Measles is also contagious and is spread by contact with droplets coming from the mouth, throat and nose by sneezing and coughing; it can also be caused by droplets in the air.
EDITORS NOTE: • Every year there are approximately 5,000- 9,000 hospitalizations and 100 deaths from chickenpox in the United States. Can you imagine the number in Tanzania? • In 2008, there were 164 000 measles deaths globally – nearly 450 deaths every day or 18 deaths every hour.
GODS GIFT Honey Traditional Medicine or Scientific Medicine By Fatimah Zahra Karim
Honey helps soften skin. Being a thick sugary liquid, like glycerin, it helps the skin retain moisture. Applied to the face with a pinch of powdered cinnamon, it works as a natural scrub to exfoliate the skin. Regular use on the face gets rid of pimples and prevents more from popping up later. Sunburn. Honey soothes the pain and helps faster healing Other burns. Same as in a sunburn, it soothes the pain and helps the burn heal faster. The first day I walked into the obstetrics ward, I got to see a very unfortunate patient. She had delivered by caesarian section, and somehow, her surgical wound had become infected. Infected wounds don’t form scar tissue and heal. Any medication given orally or by injection would not reach the infected parts due to poor blood supply. So the doctors cut open the stitches, squeezed out as much pus as they could and then put in something that would fix the infection. This “something” was not a something many of us would expect to see in a hospital. It was, in fact, something you would find in your home, in your kitchen, on your table…something you’d have for breakfast with your toast-honey! Over time, I have seen this repeated for many patients, by different doctors and surgeons, not just for surgical wounds, but also for wounds caused by accidents. Doctors insist, “No, I don’t want povidone iodine on it; put fresh honey on it.” You might think, “Hmm, but what of it? I’m not undergoing surgery anytime soon.” Read on…the following are everyday illnesses that honey helps fix. Colds and sore throats. Granny always told you to take a spoonful of honey when you had a cold as a kid. She had a point. The viscous nature of honey helps soothe a sore throat, and the antibiotic properties help you fight the cold.
Cuts, abrasions and any other breaches in the skin. Here, it acts a dressing that does not get stuck to the wound and is therefore not painful to change. An enzyme in honey slowly releases hydrogen peroxide to prevent infection. The high sugar concentration also sucks the water out of any bacteria that might be nearby, and thus kills them. Athlete’s foot and other fungal infections. (Women may use a warm, diluted solution for yeast infections.) Seemingly paradoxically, it helps with both diarrhea and constipation. A diluted honey solution can be used for red eye and other infections of the eye. And all honey is not the same, some carry out more of one function than another, depending which bee produced it, what flower the bee picked nectar from and what season it was. Research shows that the differences are apparent in the color of the honey. Was I surprised when I found out all this? Not really. After all, The Almighty did say in the Holy Quran, “There comes forth from with it (the bee) a beverage of many colors, in which there is healing for Man; most surely in this, there’s a sign for people who reflect.” ~The Bee (16:69)
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THE ONLY SET Removing Teething Problems By Zahra Habib
Dentistry is special. This is because everyone wants to look good and to have the perfect smile and an attractive face, everyone wants to be able to eat anything they want and to chew well and speak with confidence and to interact well with other people. All these aspects are taken care of by dentistry. The field of dentistry is vast and offers a number of career opportunities. There is the ‘dentist’ who is the holder of the DDS degree (Doctor of Dental Surgery). This individual is a general dentist who does routine procedures like extractions, fillings, root canal treatment, scaling and others. After one attains this degree, a number of specializations are available that one can pursue, for example, there is oral maxillofacial surgery where one performs surgery in the head and neck region, there is an endodontist who specializes in root canal treatments, there is the periodontologist who specializes in gum and periodontal disease, there is a paedodontist who practices dentistry for children, there is a prosthodontist who deals with dentures and crowns and bridges, there is an orthodontist that deals with teeth and jaw alignment and relationships, there is an implantologist who deals with dental implants, which are replacing lost natural teeth with implant teeth, there is the cosmetic surgeon who specializes in aesthetic dentistry intended to approve appearance. A general dentist can also do all these procedures but specialization in any given field allows one to do the more complex procedures in these fields and also provides teaching and research opportunities as well. A dentist’s job is not just confined to the parameters of the clinic; dentistry has evolved dramatically to occupy the bigger picture. Dentists are now policy makers, politicians, researchers, entrepreneurs and clinicians. The scope for dentistry is huge and there are many job opportunities available. Dentists work in clinics, hospitals, offices, NGO’s, in the government and other places. The field of dentistry is vibrant with technological advancement, newer and more efficient equipment together with new discoveries are constantly being made. Today, a dental procedure is more like a trip to the salon with all the modern equipment, kits and of course the final aesthetic end result. The pay is very good, the timings are the usual 9am - 5pm and there are no night shifts. The job is very satisfying when you manage to alleviate pain, salvage a tooth that could be lost or make someone look better than when they walked in. A better appearance means
more self esteem and therefore more confidence. Dental school is between four to six years depending on where you pursue the course. Here, in Tanzania, it is a five year course plus one year of internship. You start with the basic sciences in the first two years and then the clinical rotations begin in the third year. Contrary to what most people think, dental school is quite tough in the sense that there is a lot to cover in a very short time between exams and meeting the clinical criteria. However, the subjects are interesting and so are the procedures and with hard work and effort, one can be assured of a smooth sail. And all this pays off when you are handed your DDS (Doctor of Dental Surgery) degree so the hard work and effort is definitely worth it. There are also allied careers in dentistry that can be pursued. These include dental assistants who assist dentists in various tasks, there are dental hygienists who can provide some basic dental care example oral health education, scaling and polishing and fluoride applications under the supervision of a licensed dentist and dental technicians who do not come into direct contact with patients but they fabricate appliances and prosthesis such as crowns and bridges, dentures and appliances. Allied dental professionals form a very important part of the dental team and career prospects are also very good depending upon where one is planning to work. It is well worth it for prospective dental students, to intern with a dentist to get to know what is involved so that they have an idea of what they are getting into. Dentistry is ever evolving with new advancements and greater opportunities and is ideal for one wishing to pursue a career with maximum benefits and minimum hassle!
EDITORS NOTE: • 50% consider the smile, the first facial feature they notice • People are 7 times more likely to have smile enhancement procedures than facelifts • 80% of the people in a consumer survey were not happy with their smiles
TEACHING DOCS Catholic University of Health and Allied Sciences CUHAS -Bugando
(Formerly Weill Bugando University of Health Sciences) By Faisal Hooda
Located within the second largest city of Tanzania, Mwanza, Bugando University is an institution of higher education in the vital field of health and allied sciences. It is perhaps the finest varsity of its kind in Tanzania; in terms of faculty, organisation, infrastructure and resources as a whole. It is a vibrant and rapidly growing university that strives hard to meet its motto: ‘Discipline, Diligence, and Excellence.’ Bugando University is appropriately situated in the Weill Bugando Medical Centre (WBMC) complex; a major 900-bed referral, consultant and teaching hospital. WBMC serves 6 regions in the Great Lakes expanse (Tabora, Shinyanga, Mwanza, Mara, Kigoma, and Kagera) that collectively account for 50% of the country’s population – translating to approximately 14 million people. These factors, out of several more, implicate an ideal catchment area for clinical exposure of CUHAS-Bugando students.
The current university was initially established as WBUCHS (Weill Bugando University of Health Sciences); as a constituent college of SAUT (St. Augustine University of Tanzania) for eight years (2003-2011) – after which the university college was upgraded to CUHAS(Catholic University of Health and Allied Sciences)-Bugando; a fully-fledged independent university. Bugando University operates in the ‘school’ mode, currently having a total of four: Weill Bugando School of Medicine, School of Pharmacy, Anthony Mayala School of Nursing, and School of Public Health. These schools function in conjunction with the Institute of Allied Health Sciences that offers numerous diploma programmes. CUHAS-Bugando has been granted a certificate of full registration and recognition by the Tanzanian Commission for Universities (TCU), the regulatory body for all Tanzanian institutions of higher education, as of its launching in mid-2011.
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WBUCHS was established primarily under the auspices of the Tanzanian Episcopal Foundation (TEC) and initially funded by Maryknoll Missionaries, of the USA, as well as a host of diverse donors including Clinton Family foundation. CUHAS-Bugando is a joint-venture project of the Catholic Church, Tanzanian Government and Weill Cornell Medical College, New York, USA. Majority of the current CUHAS-Bugando university budget (80% in 2007), though, is contributed by the Touch Foundation, also of the USA. This philanthropic organisation also paid for the construction of the students housing projects on campus and funds its basic maintenance on a regular basis. The university is also sponsored by the Tanzanian government through grants (Ministry of Health and Social Welfare, and Ministry of Education and Vocational Training) and loans (Higher Education Students Loan Board). CUHAS-Bugando offers restricted partial scholarships for needy students through the Bugando Scholarship Fund (BSF). Furthermore, the university maintains close association, affiliation, and collaboration with international universities, including Weill Cornell Medical College (New York, USA); University of Calgary (Calgary, Canada); Northwestern University (Chicago, USA) and Julius-Maximilians Würzburg University (Würzburg, Germany). CUHAS-Bugando even offers prospects, even so limited, for exchange programmes with afore mentioned institutes. In addition, Baylor College of Medicine’s HIV paediatrics clinic at Bugando offers clinical practice for Master of Medicine (MMed) in paediatrics. In the same light, the university has continual national and international visiting lecturers; allowing for further
The university maintains close association, affiliation, and collaboration with international universities, including Weill Cornell Medical College (New York, USA); University of Calgary (Calgary, Canada); Northwestern University (Chicago, USA) and JuliusMaximilians Würzburg University (Würzburg, Germany) integrated international exposure of students at CUHAS-Bugando. Speaking of lecturers, the university has highly qualified, and trained professional personnel specialised in a diversified array of fields – ranging from basic sciences to specialised clinical aspects. The university is well-equipped and up-to-date with services, staff and efficiency. The main highlight is the library on campus – stocking more than 5000 book and journal titles – it also offers free wireless internet for students. University lecture halls are well furnished with good quality seats, screens and arranged in a learning-friendly manner, and the use of electric, electronic media in teaching is increasingly being preferred over more conventional methods. CUHAS-Bugando is situated less than 1.5km from downtown Mwanza, thus allows access to all amenities available around town Personally, I believe that CUHAS-Bugando should be the university of choice for all individuals wishing to join the medical and allied health fields as this is a truly distinctive, unique, and one-of-a-kind institution, located in a city of the same calibre.
CATCHING IT FAST Congenital Rubella Syndrome By Amira Baliram
You’re likely to be confused and overwhelmed— not to mention scared—if your infant has been diagnosed with congenital rubella syndrome. By developing a basic understanding of the condition you can play an active role in helping your child get better. Congenital rubella syndrome is caused by a virus known as a rubivirus. It is the same virus that causes Rubella or commonly known as German measles in adults. If a pregnant woman contracts rubella during her first trimester, there is a high likelihood that she will pass it on to her fetus. Most of these infections results in miscarriages. The virus that causes rubella is spread from person to person when an infected person coughs or sneezes. It is also spread by direct contact with the nasal or throat secretions of an infected person. If a woman gets Rubella during the first three months of pregnancy (first trimester) the fetus can develop congenital Rubella syndrome. Besides congenital rubella syndrome, consequences of a rubella infection during pregnancy include abortions, miscarriages, premature delivery and
EDITORS NOTE: • MMR (measles, mumps, rubella) vaccine in dar costs about 40,000/• Rubella causes 20% of children to be born with congenital deafness and also accounts for 2% of congenital heart defects. stillbirths. Therefore pregnant women who have been exposed to rubella need to seek medical attention immediately. Congenital rubella syndrome is described by numerous birth defects particularly to the brain, heart, eyes and ears. Deafness, cataracts, heart defects, microcephaly, mental retardation, bone alterations and liver and spleen damage are just some of the many severe abnormalities.
Even if a woman who develops rubella has no rubella symptoms her baby can still develop serious congenital rubella syndrome symptoms. Therefore, it is important to determine the rubella immunity status for all women, either before conception or very early stages of pregnancy. Congenital rubella syndrome is a viral infection, hence there is no cure. If your baby is born with congenital rubella syndrome, specific symptoms of the disease can be treated accordingly. It is extremely important to note that the disease can be prevented by the rubella vaccine. Extensive immunization against rubella is crucial to controlling the spread of the disease, thereby preventing birth defects and significant fetal damage caused by congenital rubella syndrome. The vaccine is usually given to children at 9 months of age as part of the scheduled measlesmumps-rubella (MMR) immunization. The rubella vaccine should not be taken by pregnant women or by a woman who may become pregnant within 1 month of receiving the vaccine. If you are thinking about becoming pregnant, make sure that you’re immune to rubella through a blood test or proof of immunization. If you’re not immune, you should receive the vaccine at least 1 month before you become pregnant. As the legendary English proverb goes – ‘prevention is better than cure’, rather in the case of congenital Rubella syndrome, prevention is the only option since there is no cure, therefore better be safe than sorry.
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TO BE WHAT TO BE Radiology By Sakina Ramji
Radiology is the heart of modern medicine which provides the best diagnostic tool to save patients’ lives. It mainly has two branches; Diagnostic and therapeutic. Diagnostic Radiography involves Conventional x-ray, Fluoroscopy, Mammography, Computed Tomography (CT scan), Ultrasound, Magnetic Resonance Imaging (MRI), nuclear medicine and Positron Emission Tomography (PET) while therapeutic Radiography involves treatment using radiation therapy. Science has always been a strong interest of mine, and coming from a small town where medical services have always been a rare luxury; I got compelled to pursue a career in the medical field. During my three years at MUHAS (Muhimbili University), I was exposed to different modalities. Diagnostic Radiography is a compelling profession; I came into the profession almost by accident, but quickly became absorbed by the almost magical powers of Imaging. I would find myself spending my free time in a busy ultrasound room trying to capture any information thrown my way; and so began my journey in specialization.
we are able to show the physician the internal status of the patients and play a major role in diagnosis. In Obstetric Ultrasound; it is mesmerizing to observe the growth of a human being starting from the 6th week of their life and later, be able to see how they grow and form each and every part of their body, for the entire 40 weeks journey. Not only these, but we also deal with different patients having variety of diseases such as HIV, TB and Cancers. This is when I realize how important and essential the health of a human being is. We should thank the Almighty Allah and appreciate every moment of our life. It is very gratifying to be able to help fellow human beings by using diagnostic imaging and particularly ultrasound.
Sonography is the imaging modality that uses frequency of sound waves to produce medical images. My interest was more into this specialty as it is operator dependent, helps to reach diagnosis quickly, and can be used in interventional procedures. What I mostly love is the contact with the patient which comes while scanning him/her. The two other aspects of being a Sonographer grabbed me as tightly; one being the wondrous fascination of seeing what is inside and the other, the artistic satisfaction of capturing the best possible images. Through ultrasound, different diseases can be diagnosed. It can be used for abdominal scans (different organs of the body such as liver, kidneys, spleen), Gynecology (female pelvic organs), obstetrics (pregnancy), small parts (such as breast, thyroid, soft tissues) and vascular scan (different vessels of the body). Through imaging
• You know you are a nurse when you compliment a complete stranger on his veins. • You know you are a nurse when you find yourself betting on someone’s alcohol level.
THE ISLAMIC WAY Teeb Al Islamiyya
Starting Point of Many Discoveries By Lujaina.S.Hasan’Ali In the name of The Almighty, the beneficent the most merciful New discoveries give path for mans intellect to evolve. The clarity of science begins to take shape, magnitude and design in his mind. But does that mean, science only started to exist when man discovered it? The Qur’an states quite the contrary. Science existed long before man knew anything, because He only knows what He is taught; He only sees what He is allowed to discover. (Qur’an 96; 05, “He taught man what He knew not”). Islam is an ancient religion that began with the birth of life on earth. It is also new, in the sense that it was established in the first century (1400 year ago).Thus one can argue that medicine, the art of restoring or preserving health, was an ancient practice, which became a heritage from one prophetic generation to the next. The revolutionary contribution of Islam, to this science, can be witnessed in its scriptures. The sciences revolves around the themes, prevention and cure, as can be obtained from the ahadith, “prevention is better than cure” (Imam.Ali A.S.) and “for every disease there is a cure” (The Holy Prophet S.A.W.W.). Also, we implore The Lord, Allah, by the name “Ya Shaafi!” Meaning, “O healer!” We appeal in Dua’a Kumayl by calling out “O the one whose name is medicine, whose remembrance is cure”. The most important of all in the Holy Qur’an Allah says “And when I am sick, then He restores me to health.” (26:80).This is just an exemplary verse stated here; the deep understanding and reflection of the quraan, has lead to many discoveries in medicine. One such is the discovery of a popular eye drops by Dr. Abdul Basit Muhammad, an Egyptian, who named it “The medicine of the Qur’an”. It was inspired by the prophet Yusuf’s narration in the Qur’an and cured eye cataract by 99% without surgery and no side effects.
prophet Muhammad, upon himself and others. It covers preventive medicine, curative medicine, mental well being, spiritual cures or ruqyah, medical and surgical treatments. Muslims established sufficiently equipped hospitals almost one thousand years before these started to be founded in the western world, as official institutes. Baghdad had 6000 medical students and almost one thousand medical practitioners. One hundred years later, Damascus had a central hospital which jointly supervised a large medical college. As it can be seen, the The methodical translations of thousands of Arabic works, was a prosperous industry which enabled, the transfer of the Islamic medical knowledge to Medieval Europe. These heroes of the medicinal world include; Abu Ali al Husain Ibn Sina who wrote the first description of several drugs & diseases such as meningitis
We also note in the history of Islam, “Tib an Nabawi”, which refers to medical practices by the WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
hospitals are of Islamic creation and after having been extended in the Arab world, were introduced into Europe by the Crusades. It is important to mention the great role of Muslim scientists, in the conservation, consolidation, coordination and development of ideas and knowledge, which ancient civilizations had compiled. To this they added many original and outstanding ideas. The methodic translations of thousands of Arabic works, was a prosperous industry which enabled, the transfer of the Islamic medical knowledge to Medieval Europe. These heroes of the medicinal world include; Abu Ali al Husain Ibn Sina (wrote the first description of several drugs &diseases such as meningitis), Hunain Ibn Ishaq, ( translator of medical works), Muhammad Ibn Zakariyya Ar Razi (identified small pox & its cure and much more) and Ali Ibn al abbas al Majusi. All the “do’s” and “don’ts” in Islam are integrated to the well being of mankind. One such is, “Don’t make an eye contact with a non-mahram”. The medicinal explanation to this, as documented in the article “The Poisoned Arrow”, is that the gaze triggers a complex hormonal stimulation, in preparing the body and organs for lustful contact. If these hormones are provoked unnecessarily and last long in the circulation, the effects are drastic. Just some of these effects include: Bad smell from feet and axilla, Pionidal sinuses, Acne, Perianal abcesses, migraine, peripheral neuropathy, Osteoarthritis. Effects in the heart include: Deep vein thrombosis, Raynoids Phenomena, atherosclerosis, fat embolism, aortic dilation, increased blood pressure. In the G.I.T (Gastro Intestinal Tract): Constipation, Anal fissure, Hemorrhoids and much more. In the do’s, Islam encourages us to include, honey, olives, milk, fig, kalonji-black seed, raisins, dates, khumbi man mushrooms and much more in our diet regimes, as all of these, possess great health benefits.
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Therefore, it suffices me to say, by simply following the shari’a, Allah’s prescription for us, we can earn long, healthy and prosperous lives. The dart is in our hands and our goal has been identified, all we need to do is AIM! Medicine in Islam, integrates mind and body, matter and spirit. Islam is code of life and it is a complete way!
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BRAIN CONDITIONS Schizophrenia
Over Active Minds Can Be Disasterous By Salma Lalji Schizophrenia is the splitting of the mind which is characterized by distortion of thinking , perceptions and is usually accompanied by emotions that are in appropriate or blunted .It is a devastating brain disorder-the most chronic and disabling of the severe mental illnesses. There are 4 types of schizophrenia namely: Simple Schizophrenia -is a type of the psychotic disorder schizophrenia in which the symptoms are mild and don’t exhibit psychotic traits. Symptoms of simple schizophrenia include inability to perform in society, poor hygiene and other minor physical and psychological problems. Treatment for this type of schizophrenia is possible with psychotherapy and counselling. Hebephrenic Schizophrenia -a form of schizophrenia characterized by severe disintegration of personality including erratic speech and childish mannerisms and bizarre behaviour; usually becomes evident during puberty. Paranoid Schizophrenia -is the most common type of schizophrenia in most parts of the world. The clinical picture is dominated by relatively stable, often paranoid, delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances. Disturbances of affect, volition, and speech, and catatonic symptoms, are not prominent. Catatonic Schizophrenia -is a type (or subtype) of schizophrenia that includes extremes of behaviour. At one end of the extreme the patient cannot speak, move or respond - there is a dramatic reduction in activity where virtually all movement stops, as in a catatonic stupor. At the other end of the extreme they are overexcited or hyperactive, sometimes mimicking sounds (echolalia) or movements (echopraxia) around them - often referred to as catatonic excitement.
the symptoms of the disease. Treatments include antipsychotic medications and various psychosocial treatments. Rehabilitation emphasizes social and vocational training to help people with schizophrenia function better in their communities. Because schizophrenia usually develops in people during the critical career-forming years of life (ages 18 to 35), and because the disease makes normal thinking and functioning difficult, most patients do not receive training in the skills needed for a job. Rehabilitation programs work well when they include both job training and specific therapy designed to improve cognitive or thinking skills. Programs like this help patients hold jobs, remember important details, and improve their fun
EDITORS NOTE: Academy award winning movie of 2001 ‘a beautiful mind’ stars Russell Crowe depicting a person suffering from schizophrenia. Can you tell which type?
Some Facts About Schizophrenia. •
In the U.S., approximately 2.2 million adults, or about 1.1 percent of the population age 18 and older in a given year, have schizophrenia.
Rates of schizophrenia are very similar from country to country-about 1 percent of the population.
Schizophrenia ranks among the top 10 causes of disability in developed countries worldwide.
The risk of suicide is serious in people with schizophrenia
How is schizophrenia treated? Because the causes of schizophrenia are still unknown, treatments focus on eliminating
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Losing Density Makes Bones Float By Zainab Moloo Osteoporosis is a disease characterized by Low Bone Density (LBD) and loss of bone tissue that may lead to weak and fragile bones. If you have osteoporosis, you are at an increased risk for easily getting bone fractures, particularly in the hip, spine, and wrist. The disease may be classified as primary type 1, primary type 2, or secondary. Primary type 1 (postmenopausal): most common in women after menopause. Primary type 2 (senile): occurs after age 75 and is seen in both females and males. Secondary: secondary osteoporosis may arise at any age and affect men and women equally due to predisposing medical problems or disease, or prolonged use of Medications like steroids. Two essential minerals for normal bone formation are calcium and phosphate. Throughout youth, the body uses these minerals to produce bones. Calcium is essential for proper functioning of the heart, brain, and other organs. To keep those critical organs functioning, the body reabsorbs calcium that is stored in the bones to maintain blood calcium levels. If calcium intake is not sufficient or if the body does not absorb enough calcium from the diet, bone production and bone tissue may suffer. Thus, the bones may become weaker, resulting in brittle and fragile bones that can break easily.
EDITORS NOTE: Our body height/length keeps on increasing from birth upto 25 years because of our bone growth. As we get older we slightly decrease in height because our bone density decreases. Other conditions that may lead to osteoporosis include overuse of corticosteroids (Cushing syndrome), thyroid problems, lack of muscle use, bone cancer, certain genetic disorders, use of certain medications and habits like cigarette smoking and alcohol consumption
which lowers calcium in the diet. Early in the course of the disease, osteoporosis may cause no symptoms. Later, it may cause dull pain in the bones or muscles, particularly low back pain or neck pain. Later in the course of the disease, sharp pains may come on suddenly. The pain may not radiate (spread to other areas); it may be made worse by activity that puts weight on the area, may be accompanied by tenderness, and generally begins to subside in one week. Pain may linger more than three months. Treatment for osteoporosis focuses on slowing down or stopping the mineral loss, increasing bone density, preventing bone fractures, and controlling the pain associated with the disease Diet: Young adults should be encouraged to achieve normal peak bone mass by getting enough calcium (1,000 mg daily) in their diet (foods listed below), performing weight-bearing exercise such as walking or aerobics (swimming is aerobic but not weight-bearing), and maintaining normal body weight. Super Foods For Your Bones: •
The pop star of calcium sources is undoubtedly milk. A single 8-ounce cup of milk, whether skim, low-fat, or whole, has 300 milligrams of calcium.
Not a milk drinker? A cup of yogurt has at least as much calcium as an 8-ounce cup of milk. And 1 ounce of Swiss cheese has nearly as much.
Another excellent source is sardines. All those
little fish bones have just what you need to build bone mass in your own body. You might be surprised to learn that calcium is plentiful in many vegetables. Go for dark leafy greens.
Breakfast foods are a great start -- fortified orange juice has up to 240 milligrams of calcium, and fortified cereals deliver up to 1,000 milligrams per cup
New research suggests plant-based chemicals called isoflavones strengthen bone density as well. Isoflavones are plentiful in soy foods, such as tofu, and appear to have an estrogen-like effect on the body.
Salmon and other types of fatty fish offer an array of bone-boosting nutrients. They contain calcium as well as vitamin D, which assists in calcium absorption.
Salt is a major culprit in depriving the body of calcium. The more salt you eat, the more calcium gets carried away by urine. Sticking to a low-salt diet can help you keep more calcium to strengthen your bones.
Sunshine is not a food. But the body produces vitamin D in response to sunlight. Without vitamin D, our bodies cannot properly absorb the calcium in foods.
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SEEING IS BELIEVING Optometry
Giving Sight Must Be Gratifying By Alia Hameer Lalji The ability to see and to be able to see clearly contributes a lot to ones educational achievement, occupational productivity and overall the quality of life, vision and eye health are vitally important for all of us.
Counseling of patients with partial sight, colour blindness and hereditary vision defects.
The profession of Optometry is not all about ‘prescribing and fitting glasses and contact lenses’ and its definitely not about ‘is this lens better or is the other lens better’, it involves much more such as a comprehensive eye examination that includes an assessment of various aspects of the eye, like visual skills, eye-body coordination, alignment and focusing mechanisms of the eye and much more.
You do not just end here, after having completed your BSc you can have the following opportunities: In specialty eye clinic as a • Contact lens practitioner • Paediatric optometrist • Orthoptist • Low vision practitioner • Setting up one’s own optical outlet and practice • Serve as an Consultant Optometrist and dispensing adviser in corporate optical outlets • Work with Multinational companies as a technical expert, professional services, etc. • Academics • Research work
Not only that, optometrists also play a very important role in increasing awareness on visual problems to the public and co-managing the cases with other health care providers. They only refer patients to an ophthalmologist or eye hospitals for surgical and therapeutic management.
On the successful completion of Bachelors in Optometry one can pursue higher education in the form of: • Masters in Optometry • M. Phil • PhD
I have never doubted that I want to work in a field of health science and wanting to be an Optometrist. During my years in high school and on studying about the human body, I came to realize that it is one of the greatest machine ever engineered by God and the one thing that attracted me the most is the ›eye›, the organ which gives us the sense of sight, allowing us to learn more about the surrounding world than we do with any of the other four senses. From that moment, I knew what I wanted to be, an eye doctor, an Optometrist.
My determination to become an optometrist has strengthened over the course of many years’ studying optometry at the Manipal University, India. The more I learned about this profession, better I understood about myself. I choose optometry because of its interdisciplinary nature, its intellectual challenges, and most importantly, the satisfaction in knowing that I can impact people’s lives through the act of healing. In terms of working environment it does not confine you and gives you flexible working hours and of course a good pay :):)
Optometrists are independent primary health care providers who examine and diagnose conditions that affect the eye and visual system. They are trained to manage the defects of the eye and associated structures that do not warrant pharmacological prescription and surgical intervention.
Attaining a BSc in Optometry usually consists of 3 years of studying+ 1 year of Internship, on becoming an Optometrist you are allowed to: • Examine patient’s eyes to diagnose vision problems and eye diseases. • Prescribe contact lenses. • Prescribe and fit spectacles. • Provide vision therapy and low-vision rehabilitation.
Optometry is a dynamic and challenging career that allows me to help people, achieve personal growth and community respect. It is a career that is filled with exciting challenges and unlimited possibilities, and I know that I will never doubt my choice of becoming an Optometrist and would strongly advice others to go for it too.
I CRIED ... Crying
What a Beneficial Act By Neelam Ismail
Before the men out there start cursing me for giving their women another reason to cry, spare 2 minutes of your time and hear me out.
Other benefits of crying are: Mood Benefits: it’s a great way to uplift your mood. And you know it!
How many of us feel better after a good cry? That unexplained feeling of lightness and relief. Ever wonder why? Science in today’s world unveils the reason.
Calming effects: Crying has calming effects such as the slowing of breath, thus feeling relaxed and thinking clearly. However during the cry, you may experience increased heart rate and sweating; but once that is over, the calming effects usually last longer Prevents depression due to suppressed emotions – sometimes we feel bad just because we have some emotions inside of us that needs to come out, crying is one of the best healthy ways to get out those suppressed emotions. Go ahead do it!
Whether it’s to mourn or because of the sheer frustration of a bad day at work, once you come to wipe the tears away, the world can seem like it’s been put back together again. Crying in many cultures is considered a weak trait – more often in males than women. Our bodies override any effort to suppress the urge to cry. But when we hold back our tears, we only amplify the motions or stress our body is trying to release. Crying is actually one of your body’s answers to natural stress relief. Allowing the tears to flow is a powerful release of emotions and therefore, very self nurturing and freeing. A study was carried out where volunteers watched a sad movie and later cut onions while collecting their tears during both activities. They found that the chemical make-up of the two sets of tears were vastly different. Sad tears include stress hormones and various toxins such as adrenocorticotrophic hormone (ACTH), where as the reflex tears from onions were relatively chemical free. Removing this chemical from the body is beneficial because it triggers cortisol, the stress hormone – too much of which can lead to health problems associated with stress heart disease, high blood pressure, type-2 diabetes and obesity.
You’ll look better! Surprising but true. After the puffy and red eyes, look past the sniffling and observe yourself in the mirror, your face will have a sudden face-lift Other good stuff: Emotional tears open up the lungs, exercise the eyes, and soften the temper. The release you feel is one of the mind, body, and soul. So, yes, there are times when it’s acceptable to cry. We can cry tears of joy, right? We can cry at weddings, graduations, or births. We can even cry when we laugh. So why should we stuff down the tears when we really need to let them out; when we are emotionally stressed, sad, in physical pain or depressed. Allow yourself to cry. Natural stress relief is really the best of all options. So next time you hear someone say to the other, “don’t cry, it won’t help” go stop them and say “go on cry, you will feel better, let the emotions flow”
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
5 GRUELING YEARS A Thin Grey Line
To Become What Many Would Love By Aisha Vinolia Ansah My relationship with this show began long before my application to medical school. And eight seasons later, the show still has a strong hold on me. Characters on a show grow and evolve in more ways than one, but so do the viewers on the other side of the screen. Coming a long way from Season 1, I’d be ashamed if all I’ve been doing amounts to blind assimilation.
Needless to say, I haven’t always been a medical student. Let me come up to say I’ve always been a series student though. I did mean, “A series student” for those of you eagerly looking to pick out typos. Let me be quick to point out that most of us are. My theory is this: If you like a series enough to watch it in the first place, you must be studying the characters close enough, breaking down their every move and every word, possibly peering at them for all your eyes worth and I’d even go so far as to assume that even if just for a fraction of a second, you are utterly fascinated by their line of profession so much so that the more accepting amongst you would even admit having wished you did whatever it is they do for a living. Let me bring up a certain series called Grey’s Anatomy and admit to secretly wishing that was me doing what all those characters did best – which is save lives. I strongly point out that this wish was before I got myself entangled in the medical field. Personally, I am a Grey’s Anatomy junkie. Shake your head all you want, but might I remind you, “To each his own; live and let live”? Just for those who are unfamiliar with it, Grey’s Anatomy is a medical drama that follows the lives of surgical residents in what is presumably one of the most technologically equipped hospitals in USA.
My decision to join the medical field is truly independent of all the Grey’s Anatomy type shows out there. As a veteran medical student, I’d like to think I’ve gotten a little wiser. Out of the many things I’ve now come to understand, There is a reason why most medical schools require you to submit a personal essay as to why you want to be a medical professional. It is not so that you can move any hard core admissions officer to tears or so you can swear on how you aim to cure humanity of all its diseases. It is so that, the true sense of why you are where you are keeps you moving forward. At the end of the day, it is not the eagerness of obtaining a fancy degree that serves as a strong enough motivation. Everybody’s reason is different. It is so because what motivates the next person doesn’t necessarily serve as your motivational float boat. There is nothing fancy or dramatic about running up and down hospital hallways saving lives and there is no way you will eternally look lipstick perfect or respond bright eyed and bushy tailed to every emergency and start blurting out quick save techniques like an encyclopaedia. What will happen is this: you may be required to dedicate yourself selflessly in no matter what awkward moment to help in an emergency. You may not immediately know what to do unless with regular practice because you are no medical encyclopaedia. All you are is human. Committing grave mistakes are not automatically accompanied by heart wrenching background music. All you get are raw human emotions. That’s it. So to all the medical oriented series out there, if there was ever such a thing as graduating from any of you, I hope I’ve made it magna cum laude if not summa cum laude. And although I might probably not make it so as to remember every rare footnote disease or extra ordinary life saving measure what I do hope for myself is this: that I graduate in the real medical field with a deeper understanding and respect for every human life and that in no matter what small way, I do make a difference.
Noise Induced Hearing Loss You’re in More Trouble than You Think By Zohra Damji iPods, city traffic, loud concerts, football stadiums, and all these things have one thing in common, and that is exposure to high levels of noise. A few hours after a noisy game, the tinnitus (ringing in your ear) begins to diminish. Within days, your hearing threshold (the softest sound that your ear can detect) returns to normal. The injury is no longer apparent as it was before. Does that signal a recovered ear? Research at Massachusetts Eye and Ear Infirmary (MEEI) in Boston, MA has shown that an insult to the ear continues to progress for several days, or even months, after the noise exposure ends. To understand what happens during noise exposure, let us revisit some basics. Sound enters the ear and through the process, the sensory cells of the ear convert the mechanical sound energy into electrical or neural impulses which can then be interpreted in the brain. A number of studies have shown that outer hair cells as well as inner hair cells(sensory cells in the ear), various supporting cells, and cochlear nerve fibers may degenerate for days to weeks following exposure. In some animals, for instance birds, their hair cells have the ability regenerate after an injury. However, in the case of humans and other mammals, they are born with a fixed number of hair cells in the cochlea, and these 20,000 cells can neither be repaired nor replaced. Once these cells are injured, they are gone forever.
not mean that they are functional. Additional research on noise-induced hearing loss has shown changes in the neural elements that convey messages from sensory hair cells to the brain. These kind of inner ear injuries causes damage at the cellular level, and this damage makes it difficult to hear high pitched sounds, certain speech sounds, as well as converse with friends in a noisy restaurant. According to Sharon Kujawa, Associate Professor of Otology and Laryngology at Harvard Medical School and Director of the Department of Audiology at MEEI, these cellular deficits could also worsen other hearing problems, such as presbycusis (age-related hearing loss). As mentioned earlier, within days to weeks after noise exposure, hearing thresholds may return back to normal. How does that still relate to hearing difficulties? Dr. Kujawa couldn’t have put it any better, “They might hear you, but not understand you.” Noise is actually dangerous, and the best way to prevent future injury from noise is simply by prevention.
EDITORS NOTE: One more reason to state why Music is Haram in Islam. A fact known way before modern technology could prove it
Some hair cells, however, do survive the insult. Nonetheless, the detection of surviving hair cells does
Benefits of having Alzheimer’s disease 5. You never have to watch reruns on television. 4. You are always meeting new people. 3. You don’t have to remember the whines and complaints of your spouse. 2. You can hide your own Easter eggs. 1. Mysteries are always interesting.
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
21st CENTURY Techology News
Whats New in the Medical World By Syed Jaffer Rizvi As we grow old, the risk of needing surgical treatment increases. Though, surgery that takes 10-20 hours has to be ruled out because there is a much greater chance that something will go wrong. However a new technology seems to have come to the rescue of the elderly.
than the several days typical handmade replacements take to put together. It took 33 layers to build 1mm of height, so there were many thousand layers necessary to build for this jawbone. In order for the woman’s immune system to accept the jaw, the titanium was coated with a bioceramic that was compatible with the patient’s tissue. An 83-year-old woman Surprisingly, even has successfully been though it is constructed implanted with a brand from metal and new lower jaw, but ceramic, it only weighs without the very long 107 grams; 30 grams surgery and recovery more than the original time usually associated bone structure. with such a reconstrucThe success of the tive procedure–typicalsurgery is due to ly 20 hours followed by collaboration between up to 4 weeks in hosresearchers, surgeons, pital. Instead, 3D printand companies A computer model of the fitted 3D-printed jaw is ing was used to create specializing in shown next to an image of the manufactured part a new jaw for her, which advanced medical was fitted in only a fractechnology. 3D printing is tion of the time (4 hours surgery, 4 days in hospital), pretty much going to be the manufacturing method of therefore cutting the risks significantly. the future, considering the lack of waste, the absurdly low cost, and the intricacy of the designs possible. The The old woman had developed a chronic bone infection availability of 3D printing to create perfectly matched of the lower jaw and hence it needed to be removed. implants for every patient could revolutionize these
NEED A NEW BONE? Not quite the way to finish out your life, with no jaw, so doctors used a 3D printer to build a titanium and organic ceramic jaw to replace her old one. The replacement mandible was constructed by using a 3D printer that printed titanium powder layer by layer, while a computer controlled laser ensured that the correct particles are fused together. It was a tailormade design that only took a few hours to create, rather
types of surgery. Technicians say the operation’s success paves the way for the use of more 3D-printed patient-specific parts. If the time it takes to create and “install” new parts in our body is cut by 75%, surgery waiting times will be cut, as will risk even for younger patients because they can leave hospital much sooner and return to their day-to-day lives.
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BECOMING SOMEONE Doctors
Difficult but Rewarding By Dr Sibtain Moledina One of the most difficult decisions that one has to make in life is the decision to choose a career path after completing A-level studies. A number of young students consider going into medicine but what does a career in medicine actually involve? Becoming a medical doctor is one of the most rewarding professions. Majority of people who choose medicine as a career do so because they would like to help people and have a positive impact on their lives. While this is an excellent motivator, there are many aspects in Medicine that pursuing students are unaware of. Medicine requires a very strong determination to work and study hard, not just for the years spent in medical school, but for many more years after graduating since there are always new developments occurring and a good doctor needs to be well informed of the latest research in various fields. So how do you know if medicine is the right choice for you? Medicine is a science, therefore you need to have a mind capable of critical thinking, analytical skills and the ability to retain large amounts of information. Most of the time, as a doctor, you will be working with people of different backgrounds and interacting with patients on a day-to-day basis, hence good people skills is vital. Medical school is not easy and to succeed, one needs good time-management and leadership skills. Many of these skills are learnt as one progresses through medical school and thereafter. Medicine is one of the most highly respected professions and many doctors would tell you that it is very rewarding and gives you a sense of selfsatisfaction when you manage to help someone who is in need of your help. Furthermore, medicine is a very vast field and there are a lot of opportunities to go into various different fields after undergraduate degree. If you prefer a quiet job, you can opt to become an outpatient doctor or at the other extreme, you can go into a more daring field like surgery and the like. Apart from clinical work, one may also opt to go into research or teaching after obtaining the undergraduate degree. But a career in medicine is not without its “disadvantages”. You should be prepared to work for long hours, both as medical student and later as a medical doctor. Most of the time, your schedule will not be a typical 9-5 job and depending on the field you choose, you may find yourself working for
36 straight hours. Patience is also very important in the medical profession. The length of time it takes to go from 1st year of medical school all the way to the final graduation as a specialist is quite long when compared to other non-medical professions. Dealing with patients and their families requires a sense of empathy and emotional toughness.
Still unsure whether medicine is the career path for you? You may want to consider attaching yourself to a hospital as a volunteer and shadowing a doctor during work hours. It will give you a taste of what to expect in the future. Talk to qualified doctors in the field and get their advice and opinions. Medicine is an ever-growing profession, so learning never stops once you enter into medicine. But even with all the struggles involved in your path of becoming a doctor, there is no better feeling than knowing that you have positively affected the lives of different patients and the reward for which is not only in this world, but also in the world hereafter.
Undergraduate degree in medicine is 5 years after which 1 year of internship follows (then you get your license). You usually need at least 1 or 2 years of work experience before you start your masters which can be 2-4 years depending the field you opt for. WE ARE MED STUDENTS BECAUSE • • • • • •
We can write 100 words a minute but can’t read our own handwriting Our IQ is greater than our weight We know the sizes of RBC n WBC, but We don’t know our shirt sizes We consider any non medical course ‘easy’ Our photocopy and books bills are higher than our pocket money.
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
Sakina M. Sikiladha Pharmacist
Zahra Habib Dentist
Maryam Khimji Doctor of Medicine
Syed Jafar Rizvi Dentist Fatemazahra Karim Doctor of Medicine
TROUBLE TOTOS Child Nutrition A Unique Set of Rules By Fatema Zuher Esmail For a child a number of aspects are important to grow into a fruitful and successful human being. These aspects include family, social environment, peers, nutrition, good health, physical activities and many more. In this section we will concentrate on a vital aspect which is almost thought to be too simple however, a childs’ future health and growth could be affected if not done correctly. This aspect is Nutrition in a Child’s Life.
not an alternative as it contains to much non essential nutrients like calories, salt, fats, sugars these can lead to diseases in early ages like obesity, diabetes, heart problems.
When we hear nutrition, names of various healthy foods come in our mind, but how much of these healthy foods do we provide our children?? When feeding our child do we realize how much nutrients the food provides or is the food filled with sugar and fats?? How much time do we take to prepare a child’s meal or due to our busy schedule do we hurry on providing meals too? A child’s meal requires 3 main principles: Variety, Balance and Moderation. The greater the variety of food the child eats the higher the chances of receiving all the essential nutrients, vitamins and minerals. Children need a balance in their diet for optimum growth. Eating a variety of food in moderation will provide a balanced diet. After the above 3 principles, it is important to know the essential nutrients required in a meal. These include carbohydrates, proteins, fats, vitamins and dairy. We will see one of the main nutrient that is extremely important but has been neglected is Calorie. A calorie is the amount of heat produced after burning up a food item so that a child’s body can use to play, build body tissues and maintain body temperature. It is important to know that amount of calories in a daily diet is limited to body weight and age, and calorie needs will depend on child’s individual level of activity and growth rate. Below is an average guideline of calorie intake/pound of body weight. 1 – 3 years old : 46 calories/pound of body weight 4 – 6 years old : 41 calories/pound of body weight 7 – 10 years old : 32 calories/pound of body weight Adults : 13 calories/pound of body weight Remember that; 1 gram of Fat contains 9 calories, 1 gram of Carbohydrates contains 4 calories and 1 gram of Protein contains 4 calories. Parents and caregivers should spend quality time in preparing a meal that is nutritional and contains the right amount of the requires essentials, packed food is
Menu Planning Checklist •
Does the menu meet the calorie requirements for all the children for the day?
Is a good source of vitamin C included in at least one meal or snack daily?
Is a good source of iron included in at least one meal or snack daily?
Is a good source of vitamin A included in a meal or snack at least three times a week?
Does each meal include foods with different textures?
Does each meal include foods with different colors?
Is a new food included along with some favorite foods?
Are some foods that represent the cultures of the children included?
Are all the foods safe for the ages of the children? (For example, grapes are peeled and sliced in half; chicken is cut in very small pieces)
Health is an important aspect in our lives; I hope this information has been a useful guideline for you to prepare a better meal for your child.
WHITE COATS | A JAMSA PUBLICATION | JUNE 2012
SILENT DEMONS Lifestyle Changes A must in diabetics By Shariza Kanji.
Diabetes is on the rise, yet what many people don’t know is that this disease is lifestyle dependant. In fact, in newly diagnosed patients, healthy life style and diet changes can prevent the need to use anti-diabetic drugs for up to 10 years. You can improve your health in a big way by making small changes in the ways you eat, adding in a little exercise and losing even a modest amount of weight. The goal is to achieve and maintain blood glucose levels in the normal range or as close to the normal as possible. The following tips are helpful in achieving the goal: DIET • • • • • • • •
Eat a lot of non-starchy vegetables and fruits such as apples, pears, peaches, berries, mangoes, papayas. Eat grain in the least ‘processed’ state possible. For example: whole-kernel bread, brown rice, millet - brown chapatti, bajra ni roti Limit white potatoes and refined grain products like white bread, white pasta. Limit concentrated sweets, reduce fruit juice and instead take fruits directly. Eat a healthful type of protein at most meals example: beans, fish or skinless chicken. Choose foods with healthful facts like Olive oil, nuts (almonds, walnuts, pecans) and avocados. Instead of having 3 large meals a day, divide your daily intake into 5-6 smaller meals. Never ever fill up your stomach.
EXERCISE When it comes to preventing or managing diabetes, you can’t afford to overlook exercise. You don’t need to become a gym rat or adopt a grueling fitness regimen. One of the easiest ways is to start walking for 30 minutes five or more times a week. You can also try swimming, biking or other moderate activity (meaning you work up a light sweat). Even house/yard work counts!
REDUCTION OF WEIGHT IN OBESE INDIVIDUALS Body Mass Index (BMI) of an individual determines the ideal weight of an individual. It is a must for all diabetics to try to get to the normal level if they want to effectively control their blood sugar level. Underweight
Less than 18.5
NB: Calculating BMI = Weight in kg / (height in meters)2 Foods you must avoid/reduce intake: Salt, sugar (substitute with sweeteners), red meat, tea, coffee, white flour and its products. Special foods for diabetics are: Bitterground (Karela), Fenugreek (methi), Indian blackberry (Jamun), garlic, onions, flaxseed (rich source of Omega 3 fatty acid), fibres, Cinnamon.
HYPOCHONDRIAC Antibiotics Overuse
Do You Swallow These As Soon As You Sneeze? By Sakina M. Sikiladha
Every year we face illnesses like colds, sore throats and viruses, so when we go to a doctor, do we automatically expect a prescription of antibiotics? Most of us do, in fact we get surprised or even angry when we leave the doctor’s office empty-handed, after all which of us do not want to get well as quickly as possible. But have we ever thought that the doctor might be doing us a favor by not reaching for the prescription pad. Antibiotics are no longer the powerful tool once they were. No longer can we depend on them to effectively destroy harmful bacteria. Part of this disturbing trend is due to overuse because the more we use antibiotics the more we give bacteria an opportunity to develop resistant strains and cause life-threatening infections. Antibiotic resistance is a world-wide public health problem that continues to grow. Many patients expect or ask their physicians to prescribe antibiotics when they feel sick or have a common cold. But it’s necessary to understand that antibiotics are intended to treat bacterial infections, not viral infections. And many times, common cold is a viral infection. Most common misuse and abuse of antibiotics are: 1. Physicians prescribing antibiotics for viral infections 2. Not finishing the full dosage of the antibiotic. When an antibiotic prescription is not finished (even leaving one or two pills), it leaves some bacteria alive and resistant to future antibiotic treatment. 3. To minimize the risk of bacterial resistance, some tips can be useful like: 4. Treat only bacterial infections, seek advice and ask questions. If your child is given antibiotics, be sure to use antibiotics as prescribed
5. Don’t save antibiotics for next time 6. Never use another person’s prescription. 7. Fighting antibiotic resistance by taking simple steps can help prevent the spread of infections. 8. Encourage hand washing and make sure your children are up to date on immunizations. Both physicians and patients have a role to play in decreasing the misuse of antibiotics. Physicians should only prescribe antibiotics when it has been confirmed by test that the infection is bacterial, since viral infection cannot be treated using antibiotics. Hence there is a need for physicians to change their prescribing practices. Patients can be prescribed on narrow spectrum antibiotics only for identified infections and by using shorter duration of therapy when appropriate. Educating patients about the ineffectiveness of treating viruses with antibiotics can prevent unnecessary use. But perhaps, even more importantly, physicians need to educate their patients regarding the risk of using antibiotics and spend more time discussing prevention. In summary two simple rules can be followed. First, try not to use antibiotics and Second, try not to use too many of them.
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MAKERS BREAKERS Pharmacy A Career in Diligently Hard work By Farhan Yusuf What is Pharmacy?
Why Take Pharmacy?
Contrary to popular belief, pharmacy is not limited to counting and dispensing pills and is not similar to shop keeping. According to Britannica Encyclopedia Concise, Pharmacy is the science dealing with collection, preparation and standardization of medicines.
For the love of chemistry as a science with major parts of biology as well.
Patient Care – More access to patients mostly because of community pharmacies.
A broad spectrum of career opportunities with scientific and business – related elements.
Flexible work schedules for most pharmacy related occupations and good working environments.
In demand everywhere expectations
Usually a shorter course compared to other health sciences
Pharmacy revolves around people and medicines with special emphasis on the manufacture of medicines, their supply, appropriate use and effects. The ultimate concern of pharmacy is to ensure that the patient receives the appropriate medicines and benefits from their proper use. Pharmacists, who must earn a qualified degree, prepare and dispense prescribed medications and give health related information to patients and the general public. They also advise patients on the use of both prescription and over-the-counter medicines. Career Opportunities in Pharmacy Pharmacists can work in many diverse environments depending on their interest: •
Community Pharmacies – providing medicines and health care information to patients in the community.
Hospitals and Medical Centers – working as the medicine experts side by side with other medical professionals.
Pharmaceutical Industries – involvement in research, synthesis, production, marketing and sales of proven medicines.
Government Agencies – dealing with laws to protect the general public with respect to medicinal products and pharmacy practice in the country.
Universities and other Academic Institutions – conduct research and educate future professionals.
Medical and Scientific Publishing – writing with regards to medicinal products.
Having your own career serves as an identity for an individual. If chosen correctly, your career will show you your place in this world and give your life a true purpose and meaning. I know choosing Pharmacy has done that for me. So make sure you make your choice well and do not be afraid to ask. Choosing a good career is the step that begins your journey of a thousand miles. Good luck!
A man goes into a drugstore and asks the pharmacist if he can give him something for the hiccups. The pharmacist promptly reaches out and slaps the man’s face. “What did you do that for?” the man asks. “Well, you don’t have the hiccups anymore, do you?” The man says, “No, but my wife out in the car still does!”. Customer gets a topical cream. Direction: apply locally two times a day. Customer says to the pharmacist: “I can’t apply locally, I’m going overseas.”