Information for doctors, medical students, other health practitioners and patients.

Thursday, September 11, 2008

The New Anti-Rabies Law

Dogs straying around the streets are a common sight in the Philippines. Sadly, most of these are unvaccinated. This was the main reason why the dreaded effects of rabies in the Philippines could not be eliminated totally.

Good thing that the senate has approved of a law called the Anti-Rabies Act of 2007 also kn own as the Republic Act 9482 last May 25, 2008 authored by Sen. Pia Cayetano.
The components of the program are:
  1. Mass vaccination of dogs
  2. Establishing a central database for registered and vaccinated dogs.
  3. Impounding of stray dogs
  4. Field control and disposition of unregistered stray, and unvaccinated dogs
  5. Information and educational campaigns to prevent and control rabies
  6. Pre-exposure treatment for high-risk people and post-exposure treatment for the animal-bite victims
  7. Free routine immunization of schoolchildren who are aged 5-14 in places with significant incidence of rabies
  8. Encouraging responsible pet ownership
  9. Prescribing penalties for violation of the law
The penalties for violation of the law are:
  1. P2,000 for failing or refusing to have their dog registered and immunized against rabies. If the dog bites someone, the owner will pay for the vaccination of the dog and the person bitten.
  2. P10,000 for refusing to place their dog under observation after it has bitten a person
  3. P25,000 for refusing to have their dog observed and for not shouldering the medical expenses of the bitten person
  4. P500 for refusing to put their dogs on a leash.
We just hope that this law could be implemented strictly.
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Tuesday, July 15, 2008

Osteoporosis and Men

The US National Osteoporosis Foundation (NOF) has released a guidelines recommending a bone mineral density xray test for all men aged 70 and older as researches found out that this disease, previously believed to highly afflict women is common in both sexes as they age.

Nearly six percent of men over age 50 will suffer a hip fracture, and 20 to 25 percent of all hip fractures occur in men. There’s a recognition, more so now than in the past, that men are at risk,” says Jay Magaziner, MD, of the University of Maryland medical school, who has long researched hip fractures — osteoporosis’ most feared complication.

New Recommendations

In addition to routine bone check for older men, the new NOF guidelines recommend the following:

• Treat postmenopausal women and men 50 and older who have thinning bones, but are not osteoporotic yet, if they have at least a 20-percent risk of any major fracture in the next decade, or at least a three-percent risk of a hip fracture.

• Check for osteoporosis risk factors in postmenopausal women and men 50 and over, to see who needs a bone density test before their senior year.

• A bone density test is recommended for anyone who has any type of fracture after age 50 or who has conditions associated with bone loss, such as rheumatoid arthritis.

• For adults over 50, prescribe 1,200mg. a day of calcium and 800 to 1,000 IU a day of vitamin D. (Note that this is more vitamin D than the present recommendation.)

• Do regular weight-bearing and muscle-strengthening exercises.
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The Right and Effective Home Remedy for Acid Reflux

Are you fond of eating junk food, protein-rich food and processed foods? If you do, well, this is bad news for you. You are certainly a candidate for an acid reflux problem in your stomach and esophagus.

Acid reflux is a condition that is a prelude to ulcer. It is caused by a disturbance in the acid-alkaline condition in the stomach.

Eating specific acid foods that are hard to digest induces stomach spasms or twitching which causes the cardiac sphincter, opening between the esophagus and stomach to open for gases to form that should not.
This is an indigestion problem that has gotten out of hand and created acid wastes to flow up to your esophagus causing an irritation. This irritation, if not controlled can result to ulcers and other infections. The acid reflux diet that you have been eating should now be changed.

Once you have the symptoms of acid reflux, you need not resort to medications at once to cure the problem. You can start with home remedies that are surely less expensive.

You may start with changing your diet. You have to say goodbye to the following food and beverages: tea, coffee, radishes, garlic, onion, spices (pepper), oils, alcohol, sugar, soft drinks, diet soft drinks, asparagus (Brussels sprouts), high protein foods, pasta noodles, corn starch, eggs, plums, prunes, cranberries, and all processed foods including junk foods. Now, you may want to cry. All your comfort foods are gone.

If you think, you cannot abruptly eliminate them in your diet; start with taking just small amounts. Then start substituting them with the following: fruits, citric fruits in small amounts though due to their acidic content, all kinds of vegetables and almonds.
If you feel that you are not feeling the acid reflux symptoms anymore, you may go back to your previous diet in moderation though to prevent recurrence of the acid reflux.

Aside from proper diet, there are practical home remedies to avoid the acid reflux symptom. They are:
· Avoid smoking before or during meals.
· Eat in an upright sitting position.
· Do not lie on the bed immediately after eating.
· Take small walks after eating. It stimulates the digestive system.
· Avoid exercise after a large meal.
· Avoid wearing tight clothes.
· Do not drink alcohol while eating.
· Chew food slowly and thoroughly.

One of the home remedies for treating acid reflux is the ginger alternative. Ingesting ginger with a meal helps to reduce an upset stomach. The ginger is grounded and added to foods and taken in tea or capsule form. Most herbalists recommend consuming 500mg. of ginger with a full glass of water after meals.

We are often told by our physicians to drink more water, if possible at least 8 glasses each day. The water helps eliminate body toxins and allow the body to expel acid naturally.

Green tea has been used for centuries in Japan and other oriental countries as an after dinner drink. Green teas assist the body in the digestion process, and help soothe the stomach's sensitive tissue.

Herbal teas containing peppermint, chamomile, ginger, licorice root and catnip even in just small traces help the stomach lining repair itself. Often, one cup of tea following dinner is enough to reduce future acid reflux symptoms.

So, kiss acid reflux symptom goodbye!
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Avoid Food/Beverages That Cause Acid Reflux, Change Your Lifestyle

Many people get hungry because they lack food. Children become malnourished if they are not given the right amount of food which contains the needed vitamins and minerals which in turn make the body strong and healthy.

The fact is, not all foods are healthy. The most popular unhealthy food is 'junk foods'. Just as the word suggests, junk, which means it is like garbage. But many people are still patronizing these kinds of food.

People diagnosed with certain diseases often are given a list of foods to avoid. And this is true with the case of a person having acid reflux. Acid reflux or the GERD is a condition wherein stomach acids go back to the esophagus because of the improper functioning of the lower esophageal sphincter. If this condition is not treated, it will only get worse which can cause serious complications.

You can effectively tell if you have acid reflux if you experience symptoms like sour taste, burning sensation in the chest or upper abdomen and your throat's back, excessive belching, breathing difficulties, tightness of throat, difficulty in swallowing food, and bad breath.

If you frequently experience these symptoms, then you probably have acid reflux. Visit your doctor to get an accurate diagnosis, so that you will know the severity of your condition.

There are certain beverages and foods which cause acid reflux, and this includes the following:

- chocolate
- coffee
- spearmint and peppermint
- alcoholic drinks
- fruit juices
- fatty foods and fried foods
- onions
- citrus fruits
- spicy foods
- products which are tomato-based
- caffeinated drinks

A change in your diet is the most effective way to deal with acid reflux. Although at first you may feel deprived of these foods, think of what will happen if you continue to eat or drink these beverages and foods.

Start your change in diet by keeping a record of your food intake. In this manner, you can tell which of the foods or beverages causes your acid reflux. So every time you experience that burning sensation, take note of what you've actually eaten. Once you have the list accomplished, put it somewhere where you can easily see it, like the refrigerator.

A lifestyle change may seem rather difficult. Your doctor can greatly help you in your transition. The very first thing that you should do is to set a goal, like for instance eating small meals, while avoiding those above-mentioned foods. Slowly quit smoking and drinking. Of course, you can't expect an abrupt change.

Every time you feel any of the symptoms, you will be instantly reminded that you're on the wrong path. Self-discipline is very much important to attain a successful lifestyle change.

While many people are taking antacids, others are finding it better to stick with the natural way. On the long run, antacids are not that good for your body, even to your stomach. It would be better to start changing your lifestyle, the sooner the better.

Besides, a healthy lifestyle doesn't only prevent acid reflux but other diseases as well. You will gain more benefit in changing your life entirely, especially regarding food eating habits. Eat the right kinds of food at the right amount, and you'll stay healthy. Prevent acid reflux, change…
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Acid Reflux and the Cure: Apple Cider Vinegar

Snow white slowly took a small bite of the apple and she fell to the ground losing consciousness. Most children, and even the adults, are familiar with this fairy tale story. It is in fact just a tale, but in real life, the apple can make wonders.

In reality, many people suffer from many diseases; and the worst thing to happen to a person is to die from suffering such disease. But before the situation leads to an unpleasant end, you must be aware that these are still old-time home remedies which really work.

The apple cider vinegar has been used in many homes for many years now. It is proven to cure many ailments like allergies, acne, sinus infections, flu, high cholesterol, candida, chronic fatigue, contact dermatitis, sore throats, gout, arthritis, and acid reflux.

There are a large number of people suffering from acid reflux or the GERD (gastro-esophageal reflux disease). This usually happens when the LES or the lower esophageal sphincter does not function properly. The contents of the stomach, particularly the liquid, go back to the esophagus. The liquid contains pepsin and stomach acids. The pepsin digests proteins and the acid from the stomach burns the walls of the esophagus causing heartburn.

Experiencing heartburn once in a while should be a cause for worry, but if you experience the sensation more than two times each week, it's time that you consult a doctor.

Acid reflux is harmful once the esophagus' lining is destroyed, so you should undergo medication once you've been examined and diagnosed with acid reflux to prevent further complications.

Acid reflux is usually treated with antacids, but some people complain that it only makes the situation even worse. If you use antacids, the body will only produce more acids to compensate the decrease in body acids. The reflux will only worsen after the dose wears off at the end of the day.

Apple cider vinegar is now more preferred by people who want a natural way to cure their acid reflux. Going back to natural medicines are also helpful, but it requires patience and time. Natural remedies take some time before you can actually see the effects or results.

A bottle of apple cider vinegar costs between three to four dollars. It's even cheaper than buying antacids. The best possible cure for acid reflux is just in your kitchen. But if you can't find one in your kitchen, look for it in the supermarket.

Here is the dosage of drinking apple cider vinegar: two tablespoons of apple cider vinegar (ACV) diluted in water at least thrice a day. You need a much stronger concoction if you're currently treating the disease.

Some experience side effects like a metallic/acid taste and a burning tongue. Most people don’t like its taste, but to be cured, you must withstand its unpleasant taste. The apple cider vinegar really works wonders; in fact, you can find many customer testimonials about the benefits of the vinegar.

It doesn’t matter what brand of apple cider vinegar you choose to buy, as long as it gives the needed relief. Studies have proved its effectiveness, so don’t hesitate to use it. Perhaps Snow White was better off drinking apple cider instead of biting that big red apple that the old woman offered.
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The Two Most Common Acid Reflux Surgery with Quick Recovery

Did you know that unhealthy eating habits can cause acid reflux? Based on scientific research, anyone, even infants and young children have a tendency to have acid reflux. This disorder is most common in infants and young children but in time, disappears. Acid reflux known also as gastro-esophageal reflux disease can definitely affect adults too. This is a disorder that could happen anytime especially to someone who had just had a large meal with lots of acidic foods or even someone with history of acid reflux, thus, having recurrences of the disorder due to unhealthy eating patterns.

Unhealthy diet and an inappropriate eating schedule can cause acid reflux. As a person consumes a heavy meal, full of acid foods, an abnormality in the stomach can occur like bringing back the food induced to the esophagus and throat. Acid reflux is unexplainable to many because this condition can occur anytime but are most likely to occur after several heavy meals or unhealthy eating habits.

Many people with acid reflux can control their condition by means of medical treatment and even appropriate diet. Some people with a severe condition of acid reflux should consider surgical procedures because for most people, acid reflux surgery is the best solutions for this disorder. There are several surgical procedures that acid reflux patients can choose from. The most effective and safe acid reflux surgeries are Laparoscopic anti-reflux surgery, also known as Laparoscopic Nissen Fundoplication and Intraluminal Endoscopic surgery that most patients encounter.

Laparoscopic Nissen Fundoplication, or fundoplication for short, is the most common form of acid reflux surgery. This surgery is performed by tightening the walls of the esophagus in the area next to the stomach then adding pressure to the lower esophageal muscles. When the pressure increased between the stomach and esophagus, this medical procedure prevents the content of the stomach to go upward inside the throat and esophagus. Another method mostly considered by other patients with acid reflux is having the esophageal valve tightened in order to seal the esophagus and prevent gastric acid to enter.

Intraluminal endoscopic acid reflux surgery is another acid reflux surgery that most patients prefer. This surgical procedure has the same procedure as the fundoplication except that it involves a small optical, tubular instrument that is needed to be inserted in the body and at the same time, view the inner parts of the body that needs surgical or biopsy attention thus allowing an actual biopsy or surgery to be performed. This is possible through the so called endoscope. Intraluminal endoscopic acid reflux surgery is quick and has minimal risks for the patients. As such, a post-operatory treatment is not required but allows possibly fast recovery for patients as well.

Because of medical advancement and millions of modern treatments, acid reflux can now be treated. Patients who wish to rid of acid reflux can do so because of the options given to them through possible medications, proper diet or surgery. Likewise, surgery is most recommended to people with chronic acid reflux but is now available to patients with less serious conditions of acid reflux. Henceforth, surgical procedures have been the most common way of getting rid of acid reflux completely and permanently. In mind, patients that are considering surgery will have quick recovery after the surgical procedures and will no longer have acid reflux.
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Acid Reflux in Baby: Keeping Your Baby Protected

Acid reflux, which is also termed as gastroesophageal reflux, is one of the most frequent problems among infants. Babies with acid reflux often suffer from a range of conditions, from a mild degree to a severe one, such as recurrent spitting up, abdominal pain, and night waking.

This discussion would be more comprehensive with the understanding of the physiological or the mechanical aspect of the condition. The body has a band of muscle in a circular structure that is called the lower esophageal sphincter. This muscle detaches the esophagus from the stomach. When food comes into the stomach, it closes so as to prevent the stomach acids and contents from backing up into the esophagus or regurgitating. But in the case of some babies, the lower esophageal sphincter has grown immature. As such, the partially digested food and digestive acids are allowed to be refluxed. This condition causes irritation in the esophagus lining which results to inflammation that is also commonly called as heartburn.

Acid reflux among babies usually develops when they are between two to four weeks old. Doctors usually prescribe medicines that minimize the production of digestive acids. Within six to nine months, the acid reflux starts to naturally subside. At this time period, the babies spend most of their time in an upright position. This is to apply the law of gravity on the food taken in; that is, the food stays down more naturally and reduces possible regurgitation.

The following are helpful pointers on feeding and positioning of babies to lessen acid reflux:

Prepare smaller feedings recurrently. It makes sense to feed your baby more than usual but less than the accustomed. If lesser volume of milk goes into the stomach, the digestion will be faster and there will be fewer amounts of contents available for regurgitation.

Maintain the baby in an upright position after feeding. As discussed earlier, gravity helps to keep the digestive contents down. Position your baby seated in your lap while his head rests on your chest. Keep this position for at least half an hour after feeding.

Breastfeeding helps a lot. Breast milk is well-known to have many advantages over other commercial formula, mainly for babies with acid reflux. Breast milk can be digested faster, which of course lessens spitting up, and it has special enzymes that assists digestion. In addition to that, breast milk does not trigger allergy to babies compared to other milks available in the market. But for those who are formula-feeding, it is advisable to use milk with a hypoallergenic formula as advised by a doctor. Aside from having higher tolerance with sensitive intestines, hypoallergenic milk can also be digested faster by the stomach so as to minimize refluxes.

Set your baby in a comfortable position when asleep. Since when a baby lies flat when sleeping, gravity cannot help in keeping the food down in this set-up. As a result, a baby with acid reflux often has to endure a sore night waking. If a baby can sleep soundly, then there will be no need to call for a change in his habit. But some babies become restless, which can be noted by abdominal pain, acid breath, and wet burps. In this case, it is recommended to elevate the baby’s crib to about 30 degrees. This will be enough to reduce the regurgitation. You may also try to train him to sleep on his left side. It is in this position where the inlet of the stomach is higher than the exit. This will also help to keep the food down.
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Keeping Pregnant Women Away From Acid Reflux Dilemma

Many women tend to experience heartburn symptoms when they are still carrying their babies, and this happens for several reasons.

One of these is the increase of hormones in the women’s body while they are pregnant. The occurrence of this will result in softening the ligaments which function is to keep the lower esophageal sphincter (LES) firmly closed. When the LES rests at unsuitable periods, tendency is, this will let the gastric acid and food to reflux back to the esophagus and throat.

One more reason of experiencing heartburn during pregnancy is because the changes in the body and the development of the baby creates more pressure in the women’s stomach. Therefore, the stomach contents are forced right into the LES, and then to the esophagus.

However, there are several methods that a pregnant woman can observe to lessen the discomfort brought by heartburn. The following are good advices, although this may not remove the heartburn totally:

• Avoid the food that triggers heartburn. Examples of this are chocolates, spicy foods, citrus fruits and juices, mustard, tomatoes and tomato based products, fatty foods, fried foods, and highly seasoned dishes. Try to refer to medical specialists to know the complete list of foods to avoid Acid Reflux. Also, for foods that you may take which contains little danger of causing heartburn.

• Get rid of drinks that have caffeine, like tea, coffee, and soda. Too much of these will cause the LES to relax and let the acid to return into the esophagus.

• Stay away from alcohol beverages. This, like caffeine tends to relax the LES thus, creating the same effect—triggering heartburn.

• Avoid eating large meals. It is suggested that taking numerous small meals throughout the day will be better.

• Avoid rush in eating your meals. Chewing food thoroughly will really help in avoidance of heartburn, so better take your time in eating.

• Rest for at least three hours after having your last meal before taking your sleep.

• A pregnant woman is advised to take more glasses of water a day, at least 8 to 10 glasses, though this must be taken not just during meals. Through this, the stomach will expand, and then the LES will be given more pressure, obliging it to open inappropriately. Hence, it is really recommended to drink more water and other fluids in between meals.

• When sleeping elevate the head of the bed for at least six to eight inches. Try to sleep with an elevated head and shoulders through a wedge pillow. Through this, the gravity will work as much that it will keep the acids in your stomach in their place—in the stomach, not in the esophagus. Try to consult physicians to gain additional knowledge on how to relieve nighttime heartburn.

• Don’t wear tight fitting clothes. Tightness around the waist and stomach will trigger heartburn as it causes uneasiness.

• When bending, do it at the knees, not at the waist. This will avoid in creating too much pressure in the stomach.

• Don’t slouch; rather sit erect in a relaxing chair.

• Maintain a sensible amount of weight, too much weight and fatness will give more stress in your stomach. As a result, this will force stomach contents throughout the LES and to the esophagus. Stay with your doctors guidelines.

• Avoid smoking. Doctors stated that smoking could cause several effects to a pregnant woman, much that it can add to the possibility of experiencing heartburn.
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Magnifying Acid Reflux: What Filipinos Need to Know with Acid Reflux Disease

Gastro Esophageal Reflux Disease (GERD), the medical term for “Acid Reflux” is defined as the product of abnormal reflux of gastric contents into the esophagus thus, creating a mucosal damage, likewise known as the chronic symptom.

This disease strikes adult primarily, while infants and children can also be affected. Normally spurred by eating certain foods, if not pregnancy, or taking a sleep right after eating a heavy meal, a large number of persons suffer from acid reflux at one time or another.

Heartburn or acid indigestion is another name that refers to acid reflux. Heartburn, the major symptom of Acid Reflux in the esophagus, is described to cause a burning uneasiness at the back of the sternum.

The symptoms may come as coughing, voice transformation, hoarseness, constant ear ache, or sinusitis. The complications brought upon by acid reflux may lead to esophageal ulcers or worse this can lead to esophageal cancer.

However, constant heartburn sensations do not necessarily mean that one has captured GERD already. The risk occurs when heartburn happened more than once a week, this occasion could possibly lead in developing GERD.

The usual cause of GERD is the increase in acidity or gastric acid production in the body, obesity, pregnancy, or tight-fitting apparels, these all can add to the problem. The yeast infections are also thought to be one of the causes of GERD-like symptoms.

An added ironical cause of the GERD is the insufficient production of stomach acid in the body. The explanation says that the valve, the hollow organ with a flap that insure the one-way course of fluid through the organ, once emptied triggers acidity in the intestines. If the valve fails to open, the contents of the stomach will be blended into the esophagus, and then irritation occurs.

Meanwhile, there are already several treatments for GERD today, one of which is the balance and healthy eating habits. Now if proper diet fails to work, one can shift to medication therapy or surgery as suggested by the doctors. Below are the lists of several selections of Acid Reflux treatment:

• Proper Diet: the natural way to cure Acid Reflux is through change in their eating habits. A good number of people affected by GERD found success in following this method. Avoid the food ingredients which can intensify heart burn such as caffeine, soft drinks, and smoking. Avoid eating two hours before sleeping; likewise, avoid lying down after taking meal. These are the regular suggested change in lifestyle.

• Another easy way to treat GERD is to elevate the head of the bed. The pharmacologic therapy, the combination of prevention of food two hours before sleeping and the rise of the head of the bed, there is a great chance for a patient to gain a 95 percent relief. The rise of the head of the bed is suggested to range for only 6 to 8 inches or 20 cm. Using this method the backflow of gastric fluids will be hampered.

• Drug Treatment: Drugs reduce the secretion of the gastric acid, for instance and famotidine and omeprazole lessen the secretion of gastric acid and the Antacids counteract the acid.

• Surgical treatment: the Nissen fundoplication, the standard surgical treatment for Acid Reflux, the medication process will only cover a short period of time. The function of this is to support the sphincter, a spherical bond of muscles that opens and closes to let the food or waste to pass, as well as stop Acid Reflux, and of course restore the hiatal hernia.
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