Health World News and Features

Gone are the days when mothers prohibited daughters to look at - much more feel - their private parts at that particular age when young women are starting to be curious about their different body parts. With the proliferation of mass media outlets, however, barriers are slowly crashing down, and more enlightened discussions on the feminine mystique are being encourage.

Still, the area of feminine hygiene is not often spoken or written about. Her are a few tips on how to take care, for example, of your vulva or external female genitalia.

· In contrast to the male organ, the female organ is more moist due to sticky secretions of the glands that may vary with the time of your menstrual cycle. Its is, therefore, important to wash these secretions spreading to the labia and to clean the crease between the labia minora where the secretions tend to accumulate.

· The vagina is the canal from the labia minora leading up to the cervix. It is really a self-cleaning organ and is cleaner than your mouth. It contains lactobacilli that continually secrete lactic acid, keeping the acidity of the vagina from 3.8-4.2 and thus discouraging that can cause itchiness or vaginal discharge.

· Soaps are, therefore, not deal for washing the vagina and vulva since most soaps have a Ph OF OVER 7 which is alkaline. That’s why vaginal washes were formulated to maintain the acidity of the vagina that will beat support the growth of the lactobacilli to keep infection away.

· Be careful though in choosing the brand of feminine wash since there have been many clinic consultations on vaginal itchiness, rashes, blisters within two months from shifting to a new brand of feminine wash. Be sensitive to your symptoms. Feminine washes with lactic acid are more physiologic since they mimic the natural condition in the vagina.

· Since the vagina is very close to the anus, which contains bacteria that can cause vaginitis and urinary tract infections, it is best to wash in a front-to-back direction, making sure the water is delivered in front and not behind. It might even be best to use your forefinger and middle finger to wash the vulva, and your ring finger and pinky to wash the rectum. That will minimize contamination.

· If you use public bathrooms most of the day, feminine wipes, which are available commercially, come in handy. This keeps the acidity of the vagina at the correct pH, minimizing infection and odor.

· The front-to-back direction also holds true for wiping with tissue to dry the vulva. A cool-setting hair dryer may also be used to dry away the vulva.

· Buy only unscented, white toilet paper to avoid allergic reactions that my come from dyes and perfumes.

· Avoid douching since it mechanically washes away your protective bacteria in the vagina. If you must, do it only once a month on the last day of your menstrual period to wash away the remaining blood. Douching has been found to increase the risk for pelvic inflammatory disease.

· The vulva and menstrual blood normally don’t have a foul odor. There is a musky smell that is unique to each individual, but it should not smell bad. A foul odor is a sign of bacterial build-up. Consult your doctor for this or for any abnormal vaginal discharge.

· Avoid powdering the external genitalia. This has been found to increase the risk of ovarian cancer.

· Do not apply perfumes, or feminine hygiene sprays that may irritate the skin and cause allergies and promote the risk for vaginal infections.

· Public hair grows because it has a function: To reduce friction during sex so it is not meant to be shaven. But if you must for one reason or another, make sure the wax, shaving cream or depilatory is tested on a small area outside the labia majora to insure you are not allergic to it. Avoid contact of chemicals with the labia minora because it is covered with thinner skin and is more permeable than the labia majora.

· Use only water-based lubricants on your sensitive female genitalia. Oil-based lubricants like petroleum jelly can cause condoms to tear. Besides, it is difficult to wash off so it can alter the vaginal flora and promote infections.

Knowing the basics of feminine hygiene can help tremendously in warding of visits to the gynecologist’s office. That’s precious time and money saved. Taking care of the most intimate part of you is something you owe to yourself…. As well as to your partner.!

REBECCA B. SINGSON, M.D., January 13, 2004 Manila Bulletin

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Our theme for this year’s Diabetes Awareness Week activities, “Diabetes in Motion,” seeks to convey two messages.

The first message is a simple and practical one. Motion, such as exercise or physical activity, is essential to good diabetes management.

Exercise includes anything that gets moving. It could be walking, dancing, or even doing household chores. You don’t have to go to the gym or use fancy equipment to be physically active. There are many opportunities for you to be active throughout the day. For instance, walk instead of drive. Park your car at the far end of the parking lot then walk to your office. Or take the stairs instead of the elevator. Walk in the garden, or do some house-cleaning every day.

The benefits of exercise are numerous. Exercise can lower your blood glucose, blood pressure, and cholesterol. It can also reduce your risk for heart disease and stroke, relieve stress, and strengthen your heart, muscles, and bones. In addition, regular activity helps your insulin work better, improves your blood circulation, and keeps your joints flexible.

Exercise should always be a part of any diabetes treatment regimen.
The second message is more abstract but hopeful. Diabetes (management) is in Motion: That is, the treatment of diabetes is rapidly evolving. In fact, in the last few years, we have seen major shifts in the treatment approach to diabetes.

Earlier use of combination therapy (two or more oral antidiabetic drugs, even in newly diagnosed patients) allows us to address both pathophysiologic defects in diabetes. Plus the recent availability of fixed-dose combinations decreases the pill count for most patients.

Earlier institution of insulin therapy allows us to decrease the harmful effects of high blood glucose (glucotoxicity) and augment pancreatic function. Insulin is no longer considered the “last resort” but an effective therapeutic option that should be offered to the patient early in his treatment.

More aggressive control of glucose levels should be the norm in all patients, to target prevention not only of microvascular (small blood vessels such as the retina, kidneys, nerves) but macrovascular (large blood vessels) complications. In addition, multiple risk factor intervention should be undertaken, looking not only at blood sugar levels, but also blood pressure, lipids (cholesterol and triglycerides), obesity (especially abdominal obesity or beer belly), smoking, and other cardiac risk factors such as prothrombotic state.

DR. AUGUSTO D. LITONJUA, July 24, 2004 Manila Bulletin

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For people who smoke, have high cholesterol levels, high blood pressure and diabetes, death and disability are likely to come in three’s – heart attack, stroke or peripheral arterial disease (PAD). These life-threatening conditions have one thing in common: they are caused by atherothrombosis.

Atherothrombosis occurs when a blood clot forms on fatty deposits in the wall of a blood vessels. The formation of a blood clot is a called thrombosis and the fatty deposit in the blood vessels is often referred to as an atheroma.

The rupture of plaques, and the subsequent development of a clot, can cause partial or complete blockage of an artery in various parts of the body. When a vessel in the heart is partially or completely blocked by a clot, the result can be a heart attack.

The same process can cause a stroke or brain attack. This process can also lead to reduction or blockage of blood flow in the arteries of the legs – a condition known as peripheral arterial disease, a significant risk factor for heart attack or stroke.

Atherothrombosis is responsible for more than 28 percent of deaths worldwide, according to the World Health Organization. In Asia, 4.5 million deaths in 2001 were attributed to atherothrombosis. In the Philippines, the prevalence of atherothrombosis is unknown, but heart attack and stroke have become the number one causes of death, accounting for more than 25 percent of all deaths in the country.

Smoking cessation, weight loss, and control of diabetes, hypertension, and dyslipidemia are essential in preventing a stroke or heart attack. However, since lifestyle modification alone is not enough, it will have to be combined with drug therapy.

It is necessary to reduce cardiovascular and cerebrovascular risks in all these patients with anti-platelet therapy. Currently available anti-agents include aspirin and clopidogrel.

Clopidogrel has been shown to be effective in multiple clinical trials in both coronary and peripheral arterial disease. Currently, clopidogrel is the only anti-platelet agent that is US FDA approved for reduction of thrombotic events in patients with established PAD.

Manila Bulletin

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People often suffer from heart attack when the blood supply to the heart is impaired or obstructed. One of the factors leading to obstruction in blood supply is Diabetes.

Diabetes does this through several possible mechanisms. For one, diabetes makes the blood thicker and viscous. This state allows for easy clothing of blood within the blood vessels leading to the heart – hence, the obstruction.

Secondly, high blood glucose levels as manifested by diabetes promote production of "free radicals" that leads to a reduction in a compound known as nitrous oxide (NO). This then leads to the relative inability of the blood vessels to dilate and therefore leads to atherosclerosis (hardening of the vessels) and hypertension (high blood). Not only does hypertension increase the workload of the heart, but it can also decrease the supply of blood therein.

Thirdly, high blood glucose in diabetes can lead to injury of the lining of the blood vessels. This predisposes those blood vessels to fat deposition and atherosclerosis.

Diabetes can lead to a myriad of pathologies that leads to heart attack. In fact, it has been estimates that 50-60 percent of parents of patients with diabetes will eventually succumb to heart disease.

The good news, however, is that morbidities and complications associated with diabetes can be prevented. Huge clinical studies like the Diabetes Control and Complications Trial (DCCT), the United Kingdom Prospective Diabetes Study (UKPDS) and the Kumamoto study have all consistently shown that tight blood glucose control can dramatically reduce the risk of these complications associated with diabetes.

Tight blood glucose control can be achieved through diabetes education, proper diet, adequate exercise, appropriate medications and self-monitoring of blood glucose.

Diabetes education primarily involves enlightening individuals to the nature of diabetes and how they can act appropriately to address the disease. Diabetes education is crucial to the success and to the sustainability of medical strategies. Hence, it is considered one major cornerstone of effective diabetes management.

Manila Bulletin

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BERLIN (DPA) – Research into the fertility of men who regularly carry and use mobile phones has suggested their sperm count can be cut by up to 30 percent, reducing chances of conception.

The study is the first to indicate male fertility may be damaged by the radiation emitted by mobiles. Men who carry the phone in a belt holster or trouser pocket are thought to be at the highest risk and could one day be advised to put the mobile in a bag or briefcase and away from vulnerable areas.

Details of the research were released recently at an international scientific conference of fertility experts in Berlin.
The researchers studied 221 men for 13 months comparing the sperm of those who used their phones heavily with others who did not.

They found that heavy users of mobile phones, those who carried their phone around with them most of the time, had their sperm counts reduced by nearly 30 percent. Many of the sperm that did survive showed abnormal movements further reducing fertility.

While the research suggests an effect on the sperm, the scientists say further work will need to be done to confirm the finding and establish the mechanism by which it might happen.

In the paper, Dr. Imre Fejes of the obstetrics and gynecology department at the University of Szeged in Hungary concludes: "The prolonged use of cell phones may have a negative effect on spermatogenesis (sperm production) and make fertility, that deteriorates both concentration and motility."

Unlike previous studies, the researchers believe that phones may cause damage while in stand-by mode.

Although not in use, they make regular transmissions to maintain contact with the nearest radio masts. It had been assumed such transmissions were too short to cause harm.

Manila Bulletin

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Diabetes may be a life-threatening disease but it is not insurmountable. While a cure is yet to be discovered, there are ways to manage the disease, which will allow the patient to continue his daily activities.

Acceptance that one is a diabetic is the first step in managing the disease. Then the person can start with a new lifestyle. Having a ‘can do’ attitude, observe the following healthy rules:

One: Start by following the correct diet and fortify it with Charantia Ampalaya Food Supplement. The right diet plays a big role in controlling blood sugar level, which is the first defense against diabetic complications. Watch the amount of fats, carbohydrates and proteins. In general, stick to a low-fat, high-fiber diet to have better blood sugar control. Keep in mind that factors such as age, gender and activity level affect metabolism. It is important to consult a dietitian or diabetes doctor for the meal plan that suits a person.

Fortify the diet with nutrients that help achieve blood sugar balance. Charantia is a good add-on to a low-fat, high-fiber diet. In tea or capsule form, Charantia helps control elevated blood sugar levels when taken after every meal.

Two: Have an exercise program. Exercise helps increase metabolism. Having a regular regimen – about 15-30 minutes per day, three to four times a week – ensures a better chance to controlling your blood sugar level. Exercise can range from aerobics, jogging and gym workout to brisk walking. Get some exercise in the office, choose to walk around, instead of using the phone to call a colleague, or take the stairs instead of the elevator. Consult the doctor or physical therapist as to the level of impact a patient can perform to avoid injuries.

Three: See a health care team regularly. Diabetes is a lifetime disease. To stay in good shape, the patient should keep a regular communication with a health care team. This includes a diabetes doctor, dietitian, nurse, physical therapist, psychologist, dentist and eye and foot specialist. Ask each of them how often the check-ups should be. The frequency of visits to each health care professional depends on a patient’s condition.

Four: Take care of the feet. The diabetic’s feet are especially vulnerable to blisters, cuts or wounds. If left untreated, they may develop into ulcers that can lead to amputation. Check the patient’s feet daily for redness, swelling or cracks, and tell the doctor about it. Always wash the patient’s feet with lukewarm (not hot) water and let them dry. Apply non-medicated powder (baby powder) before putting on shoes, socks or stockings. The diabetic should also remember not to walk barefoot. When trimming toenails, soak them first in warm water to soften the nails before cutting straight across.

Five: Reach out. Living with diabetes may hang heavy on one’s shoulders. But with the support from family and friends, the problem is less daunting. The diabetic should reach out to people he or she trusts. Also get in touch with other diabetics. Sharing stories with people with similar needs and experiences exudes a heartening feel.

Manila Bulletin

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