Go Low and Take it Slow

What level of sodium becomes injurious to women health?

It is mostly agreed that Sodium is an essential mineral for the body, we all need the daily recommended amount of sodium for a proper functioning of our body like maintaining blood pressure, maintaining a level of body fluids etc. The normal level for blood sodium is 145 mEg/L. Sodium levels higher than this may cause Hypernatremia, a condition that causes symptoms such as confusion, Hyperreflexia, seizures, coma and Neuromuscular excitability. The recommended dietary allowance of sodium for adults in 500mg and not more than 2300 mg per day and between 120-400mg per day for children.

Sodium content in drinking water is not usually a major health concern unless the person suffers from any condition that requires them to restrict the sodium intake. Drinking water may contribute to 10% of an individual’s total sodium intake.

Everything is good when consumed in moderation and sodium intake is no exception. Sodium if consumed in excess quantities may be a contributor to many diseases, particularly for people suffering from chronic conditions like Hypertension. It has been said that sodium in drinking water causes elevation of blood pressure, although it is still not proven. Even in women, high dietary sodium intake can cause cardiovascular diseases and add the same through the intake of water can increase the risk. Increased intake of water high in sodium content during pregnancy can harm the infant.

 

What kind of issues they can face if they are drinking high sodium water?

Excess sodium consumption will lead to the excess availability of sodium in the blood which leads to restrained blood vessels. This will, in turn, cause the cardiac muscles to thicken which can cause increased risk of hypertension, stroke and CCF (congestive cardiac failure).

Otherwise generally sodium content in drinking water does not pose as much a risk because there are regulations for the level of sodium content in bottled waters and that amount may not necessarily cause adverse effects on the health of an individual unless one is on a sodium free diet.

 

How precautions woman in Dubai should take?

Sodium content in water is close to negligible, high content of sodium is definitely not good and will harm the body, hence when worrying about excess sodium content, one should think of the sodium content in the food consumed than the water. Because of the hot weather in Dubai, a lot of people generally get dehydrated, hence the amount of water consumed may not be possible to limit but what can be done is reducing the sodium intake in food. Precautionary measures to reduce sodium intake is eating a lot more of fresh food, opting for ‘low sodium’ products, excluding salt from recipes whenever possible, limiting the use of sodium laden condiments like soy sauce, salad dressings, sauces, dips, mustard etc. Instead of more spices and herbs must be used to season the food, salt substitutes should also be used wisely.

Dr.Keya Rahul Shivadey

Specialist Obstetrician & Gynaecologist 

Aster Clinic, Business Bay 

Dr Keya

News Source – http://www.thenational.ae/uae/uae-doctors-urge-residents-to-monitor-sodium-content-in-drinking-water

The National - 31st Dec-min

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Myths About Prostate Cancer

Prostate cancer is one of the most prevalent cancers among adult men in the UAE. In the larger conversation about male organs and glands, the prostate gland often gets overlooked. Part of the male reproductive system, located under the bladder in front of the rectum and surrounding the beginning of the urethra, the prostate is actually a small gland. As a key part of the male reproductive system, the prostate gland produces and secretes fluid into the semen. Despite its small size and limited function, however, the prostate gland too can become cancerous.

Cancer begins when cells in one part of the body grow uncontrollably and then start spreading to other areas. The spread of the cancerous cells may be slow or rapid depending on the type of cancer and the body’s response to it. Just like other forms of cancer, prostate cancer too begins when the cells in the prostate gland begin to grow uncontrollably. Although the prostate gland functions as part of the reproductive system in men, its close proximity to the bladder results in individuals with prostate cancer exhibiting many urinary symptoms such as burning sensation or pain during urination; difficulty urinating; loss of bladder control; blood in the urine (hematuria) etc. However, these are not definitive symptoms, hence, it is strongly advised for adult male’s post the age of 40 to get themselves screened regularly for prostate cancer.

Despite the wide prevalence of prostate cancer, the conversation about it is only limited within the medical community, which has led to the perpetuation of many myths and a serious lack of awareness about the condition in this region. Myths and misconceptions about such a serious medical condition can be harmful to those who might be at risk for prostate cancer but ignore their symptoms as signs of a less detrimental condition. Some common myths regarding prostate cancer include:

  • Prostate cancer only affects older men: Statistics show that the probability of getting prostate cancer is higher in older men, however, middle aged and men in their late 40’s are also at risk for prostate cancer. The risk factors for prostate cancer extends beyond age including race, family history, physical health, geography and lifestyle.
  • Lack of symptoms implies the absence of prostate cancer: Unlike other forms of cancer, prostate cancer can be completely asymptomatic, particularly in its early stages. In such cases, a diagnosis can only be made by a doctor during a checkup and follow-up tests.
  • Prostate cancer is a slow-growing cancer: This isn’t always the case. There are different types of prostate cancer often present in different parts of the prostate. There are those that advance slowly as well as those that advance rapidly and can be fatal in their outcome.
  • Since prostate cancer doesn’t run in my family, the odds are that I will not get it: Although the probability of developing prostate cancer is higher if it runs in the family, the fact remains that even those without a predisposed hereditary risk factor can develop prostate cancer.
  • The Prostate-specific antigen (PSA) test is a cancer test: The PSA test only determines the amount of PSA/ protein present in the bloodstream and not cancer. If an abnormal level of PSA is found, then the doctor recommends further tests to determine if the cause is prostate cancer. PSA test is not a prostate cancer determining test, for instance sometimes a high number may not mean you have the disease and a low number may not mean you don’t.
  • Vasectomy can cause prostate cancer: After extensive research, it has been concluded that vasectomy does not increase a man’s chances of getting prostate cancer.
  • Prostate cancer treatment results in incontinence or impotence: Although chemotherapy might have some side effects such as erectile dysfunction and urinary incontinence, these effects are subject to the patient’s age and physical health.
  • Prostate cancer is contagious: The chances of having prostate cancer increases in men who have a family history of the condition. But in no way, shape or form is prostate cancer contagious among men.

Despite the widespread prevalence of prostate cancer, early detection and treatment have led to a complete recovery for a majority of the patients. To put things into perspective, the 5-year, 10-year and 15-year survival rates are nearly 100%, 98% and 95% respectively. But it is important that men get regular screening involving either a Digital rectal exam (DRE) or the PSA test if they notice any unusual symptoms or urinary functions. It is also recommended that all men above the age of 40 get prostate cancer screening despite not showing any symptoms because it will help identify cancer early when the treatment is most effective. Prostate cancer is one of the few cancers that can be neutralised completely, once detected. All that is required is the right knowledge about the condition and the initiative to get yourself tested regularly.

Dr.Rahul Bhatt

Specialist Urologist

Aster Clinic, Bur Dubai (AJMC)

Dr.-Rahul-Bhatt

*Aster Clinics are currently running a 50% discount on prostate cancer screening in line with the aim of promoting awareness about the importance of regular screening especially for men over 40. For more information, visit – http://asterclinic.ae/prostate-cancer-screening/

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Recurrent Headache

A headache is one of the most common and painful conditions for which a patient seeks medical attention. Globally, the percentage of the adult population with active headache disorders are 46% for headaches in general, 11% for migraines, 42% for tension-type headaches and 3% for chronic daily headaches. The disability attributable to tension-type headaches is larger, worldwide than that due to a migraine. On the World Health Organization’s ranking of causes of disability, headache disorders fall into the 10 most disabling conditions for the two genders, and into the five most disabling conditions for women.

Headaches are divided into two broad categories which are, primary headaches (without any underlying cause) and secondary headaches (with an underlying cause).

Primary headaches usually include Migraines, Tension-type headaches and Trigeminal Autonomic Cephalalgias. With migraines and tension-type headaches being the most common causes of headaches.

About 90% of headaches are caused by primary headaches, with the remaining 10% being caused due to secondary headaches. The responsibility of the clinician is to identify a secondary headache (which is more dangerous) as early as possible in order to prevent complications. There are some warning signs or red flags for the diagnosis of a primary headache. The presence of these red flags indicates the diagnosis of a secondary headache. The red flags are as follows.

  • A headache that is worse in supine, disturbs sleep or presents immediately upon awakening
  • A headache triggered by a cough, Valsalva, bending & exertion
  • A headache associated with Visual obscuration’s, double vision, transient changes in vision with change in posture
  • Vomiting preceding the headache
  • Headache onset after the age 50
  • First severe headache of life
  • Worsening of headache day by day
  • A headache associated with known systemic illness or systemic symptoms (Fever, neck stiffness)
  • A headache with abnormal neurological examination
  • New onset severe Headache during pregnancy or post-partum
  • A headache worsened in standing & relieved in supine
  • A thunderclap headache (time to peak headache intensity is sec to 5 min)
  • A new headache in a patient with AIDS and cancer patients

If the patient has a headache and presents any of the above features, it is important to rule out the secondary causes of a headache by doing the appropriate investigation (which in most cases is a brain MRI).

If the patient does not have any of the red flags, and their history is suggestive of one or more of the primary headache syndromes then the diagnosis does not require further tests and investigation.

The historical points in favour of the diagnosis of migraines are as follows:

  • One-sided headaches with alternating sides getting affected
  • The presence of visual or sensory aura symptoms before a headache begins.
  • Associated with nausea, vomiting, irritation of light, sounds and or smell during a headache
  • Pulsating nature of a headache
  • Triggered by a lack of sleep, stress, fasting, excess sunlight exposure, strong smell, travel, food items etc.
  • A headache worsened by and causing the restriction of the movements

The historical points in favour of tension-type headaches are as follows:

  • Both sided headache
  • Pressure like or band-like sensation
  • No or mild nausea, irritation of light or sounds (Any one of them)
  • Mild to moderate in severity
  • Usually not aggravated by movement

 

Patients with recurrent headaches should seek medical attention to decide whether they are suffering from the primary or secondary cause of a headache.

If it is a primary headache condition, it is important to prevent the medication over-use i.e. overuse of over the counter painkillers. They are detrimental because of two reasons 1) Painkiller overuse itself can trigger a headache 2) Long-term effects on the kidneys

If it a secondary headache condition, it is important to determine the appropriate cause by relevant investigations to prevent any further complications.

 

Dr.Vishal Pawar

Specialist in Neurology 

Aster Speciality Clinic, International City 

Dr.-Vishal

 

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The Papanicolaou test (Pap Test, Cervical Smear, Pap Smear or Smear Test)

What is Pap smear?

A Pap smear is a simple test to check your cervix to make sure it is healthy. Your cervix is the opening of the womb. The Pap test (or Pap smear) looks for precancerous cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

 

Why are cervical screening tests advised?

Cervical cancer is a disease that can often be prevented. Early changes can be detected in the neck of the womb (cervix), which indicate that cancer may develop. It usually takes 3–7 years for high-grade changes in cervical cells to become cancer. Cervical cancer screening may detect these changes before they become cancer. Since screening started, the numbers of cases of cervical cancer have dramatically dropped. It is one of the few types of cancer which can be detected and stopped before it ever begins.

 

What causes cervical cancer?

An infection with a virus called HPV (human papillomavirus) is the cause of almost all cervical cancers. There are more than 100 different types of HPV. Two of these types are known to cause most of cervical cancer. HPV is very common. Most people (four out of five) will have HPV at some time in their lives. Anyone who has ever had sex can have HPV. In most cases, HPV clears up by itself in a few years. This means that most women who are infected with HPV do not develop cancer. Sometimes the virus can stay in your body longer and can lead to cervical cancer. This usually takes a long time.

 

How is Pap smear done?

During the Pap test, the doctor will use a plastic or metal instrument, called a speculum, to widen your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are then placed on a slide or in a bottle of liquid and sent to a laboratory. The laboratory will check to be sure that the cells are normal. If the test shows any abnormality, you will have treatment to stop you ever getting cancer of the cervix. So, an abnormal test does not mean you have cancer. It means you should have some treatment to stop you getting cancer. Cervical screening tests are not painful, although some women find the speculum uncomfortable. It generally helps if you can relax – this makes the experience better for you and easier for the person taking the sample.

 

When does Pap smear need to be done?

The screening guidelines vary from country to country. In general, the Pap test is recommended for all the women about the age of 21 – 25 years and continuous until the age of 65 years. It can be done in a doctor’s clinic. Screening is typically recommended every 3 to 5 years as long as the results are normal.

Pap smear screening is also recommended for those who have been vaccinated against HPV. As the vaccines don’t cover all types of HPV and the vaccine does not protect against HPV exposure before vaccination.

Only cancer for which the Pap test screens is cervical cancer. It does not screen for ovarian, uterine, vaginal, or vulvar cancers. So even if you have a Pap test regularly, if you notice any signs or symptoms that are unusual for you, see a doctor find out why you’re having them. If your Pap test results are normal, your doctor may tell you that you can wait three years until your next Pap test.

 

What do the results of the cervical screening test mean?

In most women, the cells that are taken are found to be normal. Abnormal cells are found in some women. An abnormal result does not mean cancer in the vast majority of cases. Abnormal cells indicate that cancer may develop sometime in the future. About 6 women in 100 will have an abnormal result that requires further testing or treatment.The results are reported as one of the following:

  • Normal.
  • Inadequate.
  • Abnormal – of which there are several grades or degrees of abnormalities from low grade to high grade.
  • Possible cancer cells: invasive or glandular neoplasia.

Most of these changes will not lead to cervical cancer. Treatment can be given to prevent cancer from developing in women with abnormal cells. Depending on your test results, your health care provider may recommend:

Routine follow-up testing. Depending on your age and tests received, this may be every 3-5 years.

Follow-up testing with a Pap test and an HPV test.

Colposcopy and cervical biopsy

Like a lot of medical testing, it’s not very pleasant to do a pap smear but the brief discomfort isn’t a good reason to neglect your wellbeing. Getting regular pap smear is the best way to protect your health from cervical cancer.

Dr.Usha Sethi

Specialist Gynaecologist 

Aster Clinic, Tecom (Barsha Heights) 

Dr.-Usha-Sethi1

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Are you feeling SAD this season?

Have you ever experienced being sad, irritable, moody or have you lost interest in your usual activities all at the same time every year? We have all heard about seasonal changes, even in areas that have only two seasons, but have you heard of seasonal changes in a person?

As surprising as it may sound, some people experience a serious mood change with the change in weather, some people feel down and experience seasonal depression during the winter months particularly. This is a psychological condition known as Seasonal Affective Disorder or SAD.

When the temperature levels drop and winter begins to set in, we all begin to function a little slower. We feel like staying at home and cuddling in a blanket to stay cosy. For some people, this feeling gets critical to an extent that it begins interfering with their lives. It is normal to feel irritable or tired during the winter months because of reduced light and shorter days but if this becomes a recurring issue every year during the winter months, making it difficult to function normally, chances are that you may be suffering from Seasonal Affective Disorder. SAD is a sub-type of depression that comes and goes during seasons.

Feeling slightly down every now and then is normal as everybody goes through this feeling at some point in time. However feeling sad and depressed can sometimes become incapacitate and have severe consequences to the extent of the person feeling suicidal.

Symptoms of Seasonal Affective Disorder vary from feeling depressed throughout the day for almost every day, having very low energy, no interest in things you generally like to do, to feeling irritated, having difficulty in concentrating, sleeping etc. Symptoms also vary depending on seasons. The winter specific symptoms of SAD include tiredness, changes in appetite, weight gain, feeling lethargic, feeling of heaviness in the limbs, hypersensitivity to rejection, withdrawal symptoms etc.  However, the symptoms of depression aren’t always as obvious, as they manifest themselves in many other ways. Sometimes the changes may be very subtle and the person undergoing the changes may fail to realise it, although people surrounding will surely notice the changes.

Melatonin is a hormone produced in our body to regulate sleep and wakefulness. Light affects the amount of melatonin produced in the body. Normally melatonin levels remain high throughout the night and drop in the morning. This may differ with seasonal changes, during the shorter days the body may produce melatonin either earlier or later than usual, hence leading to symptoms of SAD. This causes a disruption in the normal functioning of the body’s internal system because melatonin slows down the nervous system and induces sleep and low levels of energy.

Seasonal depression in the winter is linked to excess production of melatonin, however, SAD may affect people even in the summer months. Research shows that people in the UAE suffer from the inverted form of SAD where people feel that they are trapped indoors because of the scorching heat in this region during the summer months. The study also established a link between depressive symptoms and decreasing levels of Vitamin D.

SAD, however, is a treatable disorder and the awareness among people about the condition is rather less. There are some ailments that can be resolved without medical help, however certain symptoms, particular symptoms of SAD when appears all together is an indication that urgent medical attention is required.  Consulting a specialist on noticing any of the visible and obvious symptoms of depression is recommended. At an individual level, on noticing symptoms of SAD, one can undertake a few steps like;

  • Soaking up some sun even in the winter months. Sitting by the window, opening all the blinds or curtains during the day will help absorb as much sunlight as possible. Even the smallest amount of sunlight counts.
  • Regular physical activity is a must to keep the body from feeling lethargic and to keep the blood flowing. Simple exercises like stretching or yoga can be done indoors.
  • Photo therapy, the practice of light treatment can be used to mimic sunlight, the feeling of being in the sun indoors. It can also be used even during the dark hours.

Despite all this, medication and therapy may be required if the symptoms get too extreme. Getting over the symptoms of SAD may not be as easy as it may seem. Sometimes people require extra help because if the symptoms get severe, people may resort to activities like excess alcohol intake, drug abuse and even suicide. There are a number of treatment options for SAD and it is best to visit a doctor sooner than later when new symptoms develop.

Dr.Mohammed Yousef

Specialist Psychiatrist

Aster Clinic, Al Muteena (DMPC)

Dr.-Mohammed-Yousaf- muteena

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