Public Health

SPECIAL SUPPLEMENT WEDNESDAY 26 APRIL 2017

PHCC honours employees at

annual awards ceremony

Hearing loss: Don't take your ears for granted

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ACTING MANAGING EDITORMohammed Salim Mohamed

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Fazeena Saleem The Peninsula

Many countries, including Qatar, mark the World I m m u n i s a t i o n Week this week.

The World Immunisation Week is marked annually in the last week of April, and aims to pro-mote the use of vaccines to protect people of all ages against diseases.

The Ministry of Public Health (MOPH) and Hamad Medical Corporation (HMC) have urged families to follow the country’s vaccinations schedule and pro-tect children, starting at birth when they’re most susceptible to life-threatening illnesses.

They also encourage people to take vaccines recommended for adults and as well as for travellers.

“Qatar’s vaccination pro-gramme has been always leading in the region. We are getting most of the vaccinations free for everyone. As of now, we have 99 percent coverage and aim to reach 100 percent with the implementation of 2017-2022 public health strategy,” said Dr Sheikh Mohammed Al Thani, Director of Public Health at the Ministry.

“We make sure that every-body is protected by taking the vaccination properly, also cre-ate awareness that vaccination is safe in Qatar as it is going through the correct procedure with quality management,” he added, speaking on the sidelines of a three-day training workshop held on vaccine management to train healthcare providers on proper storage and delivery of vaccination. The training work-shop was conducted by WHO affiliated trainers from Oman and Kuwait.

Immunisation saves millions of lives and is widely recognized as one of the world’s most suc-cessful and cost-effective health interventions.

However, according to the World Health organization (WHO), there are still 19.4 mil-lion unvaccinated and under-vaccinated children in the world.

According to the US-based Centers for Communicable Dis-eases (CDC), vaccine-preventable diseases include cervical cancer, diphtheria, hepatitis A & B, human papillomavirus (HPV), influenza, measles, meningococ-cal, tuberculosis, typhoid and yellow fever. Most of these dis-eases can be prevented if women get vaccinated and also stick to their children’s immunization schedule right after their births.

T h e r e c o m m e n d e d

immunization schedule is designed to pro-tect infants and children early in

life, when they are most vulner-able and before they are exposed to potentially life-threatening diseases.

Basic vaccines are given at an early age and each of them has a specific time for starting example, measles, mumps and rubella (MMR) vaccine is not effective till one year of age.

Each of the vaccines have to be spaced by a defined interval to ensure their effectiveness and the immunisation schedule of Qatar has been prepared accord-ingly. The National Immunisation Committee makes changes in the schedule according to the trends of disease prevalence in Qatar.

Qatar is following World

Health Organization’s vaccine schedule and in accordance with child’s age. A total of 14 different vaccines (Including Bacille Cal-mette-Guerin – BCG, Hepatitis B, Hexavalent, Pentavalent, Poli-omyelitis and Haemophilus Influenza Type b, Rotavirus, Oral Polio, Pneumococcal, MMR, Vari-cella, Hepatitis A, Influenza and Meningococcal) are scheduled for children aged zero to 12 years to protect them against major life threatening diseases of childhood.

“We have some 14 vaccines in the National Immunization Program and it was updated in 2017, according to the recom-mendation of WHO,” said Dr Hamad Eid Al Rumaihi, Direc-tor, Health Protection and Communicable Disease Control Department at the MoPH

While, this year marks the halfway point in the Global Vac-cine Action Plan (GVAP) – endorsed by 194 Member States of the World Health Assembly in May 2012 – which aims to prevent millions of deaths from vaccine-preventa-ble diseases by 2020 through u n i v e r s a l a c c e s s t o immunization.

Despite improvements in individual countries and a strong global rate of new vaccine intro-duction, all of the targets for disease elimination—including measles, rubella, and maternal and neonatal tetanus—are behind schedule. In order for everyone, everywhere to survive and thrive, countries must make more concerted efforts to reach GVAP goals by 2020. Addition-ally, those countries that have achieved or made forward progress towards achieving the goals must work to sustain those efforts over time.

The main goal of the 2017

immunization campaign is to raise awareness about the criti-cal importance of full immunization throughout life, and its role in achieving the 2030 Sustainable Development Goals.

As part of the 2017 campaign, WHO and partners aim to high-light the importance of immunization as a top global health investment priority, pro-mote understanding of the action steps required to achieve the Global Vaccine Action Plan and showcase immunization’s role in sustainable development and global health security.

During 2015, 116 million infants worldwide received three doses of Tetanus, Diphtheria and Pertussis (Tdap) vaccine, protect-ing them against infectious diseases that can cause serious illness and disability.

In Qatar, in addition to the childhood vaccination an annual Tdap national school vaccination being held. In 2016, more than 8000 tenth grade school students were vacci-nated. Also Qatar has not recorded any case of whoop-ing cough — a highly contagious respiratory disease — among adolescents for the last ten years, due to the vaccination programme.

In 2015, about 85 percent of the world's children received one dose of measles vaccine by

their first birthday through rou-tine health services – up from 73 percent in 2000.

Qatar aims at eliminating measles, mumps and rubella by 2020. A minimum of two doses of vaccination administered at age of nine months and 12 and children are 95 percent immune to measles. However, a third dose is recommended to pre-vent any outbreak of measles. Therefore every year the MOPH holds a campaign and recom-mend parents to have children between age of one and 13 vac-cinated against MMR.

In 2016, until September 22 cases of measles has been reported. However the inci-dence rate and number of measles cases in Qatar have dropped rapidly during the last few years, from 160 confirmed cases in 2012 to 18 cases in 2015. Also 21 cases of Mumps and seven cases of Rubella have been detected in 2015.

Regarding Polio, the number of cases have decreased globally by more than 99 percent since 1988. As of now only three countries (Afghanistan, Nigeria and Paki-stan) remain polio-endemic, down from more than 125 in 1988.

Besides the vaccines that are administered to children in Qatar, there are also travel vac-cination programmes including for Haj and Umrah pilgrims as well as to protect from seasonal and other infectious diseases for adults. Such vaccinations are recommended to get before ten days of travel either from health centres or at the travel clinic at HMC’s Communicable Diseases Centre. Also Influenza vaccine is recommended for children starting from two years as well as for adults.

BCG and HBV0: given at birth.

6-in-1 vaccine known as Hexavalent, usually given at two months. It pro-tects against diptheria, tetanus and pertussis (whooping cough), Hepa-titis B, Polio and Haemophilus influenze type b disease (Hib).

Pentavalent vaccine almost same like Hexavalent given at two, four and six months.

MMR protects against measles, mumps and rubella (new recom-mendation - two times at 12 and 18 months).

Hepatitis B series vaccine given at 24 months, 3-4 years, 4-6 years and 11-12 years.

Chickenpox (varicella) vaccine given at 12 months and 3-4 years.

Pneumococcal vaccine (given at two, four, six and 15 months) protects against pneumonia (chest infection), ear infections and meningitis (a brain infection).

Rotavirus vaccine (given at two and four months) protects infants against rotavirus, the most common cause of serious diarrhoea in babies and young children.

Meningococcal ACYW135 (given from two years) prevents four strains of the bacteria that cause Meningococcal disease: A, C, Y, and W-135.

Influenza vaccine is recommended for children starting from two years.

Immunisation saves millions of lives

The World Immunization Week is marked annually in the last week of April, and aims to promote the use of vaccines to protect people of all ages against diseases.

A workshop held on vaccine management to train healthcare providers on the proper storage and delivery of vaccination.

Qatar’s vaccination programme has been always leading in the region. We are getting most of the vaccinations free for everyone. As of now, we have 99 percent coverage and aim to reach 100 percent with the implementation of 2017-2022 public health strategy.”

Dr Sheikh Mohammed Al Thani, Director of Public Health

Vaccines given to children

7

Public Health

WEDNESDAY 26 APRIL 2017

2

PHCC honours employees at annual awards ceremonyP

rimary Healthcare Qatar hosted an annual employee appreciation and recognition cere-mony celebrating a

record of its employee’s successes, corporate contributions and achievements.

The annual Award ceremony hosted at the Qatar National Con-vention Center brought together employees from various depart-ments to recognize them for their outstanding contributions in the workplace. PHCC honoured indi-viduals, groups and health centers for their exemplary service efforts.

Dr Mariam Abdul Malik, Man-aging Director of the Primary Healthcare Corporation, opened the ceremony by highlighting PHCC achievements and congrat-ulating employees for their dedication and hard work, which has being the driving, force behind PHCC’s success.

“PHCC’s Award Ceremony is presented annually to recognize employees who show an out-standing demonstration of company values and who make a significant difference with their achievements and milestones throughout the year,” “the employees’ continued dedication

to provide excellence in service a is a great reflection of the Corpo-rations commitment to promoting a motivating working culture that will drive forward PHCC goals and inspire success in achieving our vison.

This year’s PHCC Awards win-ners were recognized in the

following categories:- The Outstanding Health

Centers Award for excellence rec-ognizes the outstanding achievements of PHCC Health Centers, who continue to strive for excellence, best practice manage-ment and improvements in the workplace.

- The Corporate Anniversary Award honours PHCC’s 25 year Corporate Anniversary

- The National Health Strat-egy team Award acknowledges the work of PHCC employees who work in partnership with other stakeholders to improve and con-tribute to Qatar National Health

Strategy.- The Star of the year Award

rewards the successes and achievements of individuals within PHCC. The honoured employees expressed their appreciation and enjoyed an engaging ceremony followed by a private dinner for employees and their families.

Patient Forum at Um Salal Health CenterThe Primary Health Care Cor-

poration (PHCC) Fifth Patient Forum took place for

the first time at Um Salal Health Center on Tuesday, March 28, 2017.

A Multidisciplinary team including Umm Salal Health Center management and leads successfully created a fruitful platform of discussion that gave the opportunity to engage patients in a constructive dialogue.

The vast majority of patients

were Qataris and actively involved in the interactive work-shop forum that will contribute to the development of the Corpora-tion and improvement of services provided by Um Salal Health Center to the public. key messages and requirements, shared by the patients, were acknowledged by Um Salal Health Center and will be considered to promote their engagement and empowerment through patient involvement in the decision-making process of planning, design and delivery of

healthcare services.The Patient Forum initiative

is part of PHCC Patient Consulta-tive Council Project, which aims at providing additional support to patients and enhancing service user’s participation.

The collaborative partnership between PHCC and the patients truly reflects the voice of the Com-munity and its views that are vital in visualizing the impact on the public opinion, and paves the way for better healthcare achievements.

Public Health

WEDNESDAY 26 APRIL 2017

3

ing

In Qatar, and worldwide, awareness of Autism Spec-trum Disorder (ASD) is increasing, and so are the numbers of children and

adults being diagnosed.The Primary Health Care

Corporation (PHCC) is continu-ously supporting developing integrated pathways for people suffering from ASD. Since 2012, PHCC has been fully involved in the screening for ASD.

PHCC has developed two cycles of screenings for ASD to be done for all babies that visit PHCC Well-Baby Clinic by the age of 18 months and 30 months. “We are honoured to be a part of this national collaborative leadership to develop and implement a national strategy for high stand-ard services targeting people with autism spectrum disorder in Qatar. This will be done through raising awareness, promoting the utilization of screening and early identification services, referral to appropriate care and high

quality research for achieving optimal health outcomes across the lifespan. :” said PHCC Head of Child and Adolescent Depart-ment, DR Sadriya Al-Kohji.

“PHCC will provide commu-nity based services which are individual–centred, safe and efficient toward achieving national goals and add great value to patient care across Qatar “she added.

In addition, PHCC works very closely with Hamad Med-ical Corporation for the early diagnosis and detection of ASD. Children identified as ‘at risk’ of developing ASD at PHCC Level are referred to the Child Devel-opment Centre at Rumailah hospital.

During National Autism Awareness Month, PHCC is host-ing the following series of activities to engage the public in taking action to support people on the spectrum. This year, PHCC wishes to expand aware-ness towards a full acceptance

and inclusion of people suffer-ing from Autism.

- A Qatar Autism Event, which was held at Al Shaqab Arena. PHCC professionals were at hand sharing useful informa-tion and consultative advice about autism and autism-spe-cialised services.

- Lecture on Autism Aware-ness will be held at PHCC Al Thumama and Rawdat Al Khail health centers and led by Dr Madeeha Kamal a Senior Pedi-atric Consultant.

- Through its School Health Program Initiative, PHCC will take the opportunity to educate students about Autism.

- Online Engagement through messaging has already commenced, design panels as well as through creating conver-sations in PHCC Health Centers, social media, and, on the PHCC Website. It is also a great oppor-tunity for the public to Share PHCC awareness messages on their social media.

The Primary Health Care Corporation (PHCC) Breast and Bowel

Screening Program entitled ‘Screen For Life’ participated in the recent high-profile Conference entitled: “ The First Combined Gulf Cancer Conference in Kuwait”, where Dr. Shaikha Abu Shaikha, Cancer Program Manager at PHCC, introduced the National Program and its key achievements to leading oncologists and healthcare professionals.

In line with the conference tagline ‘Awareness Strategy: Reality and Ambition’, Dr Abu Shaikha hosted a session introducing the program’s vision, mission, values and key achievements that included the inauguration of three ded-icated spa- like breast and bowel cancer screening suites staffed by highly qualified

doctors, the launch of first of its kind mobile screening unit and a bespoke call center with a personnel reaching pro actively to eligible people encouraging them to register for free of charge breast and bowel screening.

In tandem with the oper-ational success of the program,

‘Screen For Life’ also increased awareness levels by initiating a dedicated team working to engage with Qatar society and elevate level of awareness across local community.

Dr Abu Shaikha completed her address by emphasizing how ‘Screen For Life’ plans to expand its reach moving for-wards and further enhance awareness of the benefits of early cancer detection through screening.

“The Primary Health Cor-poration is particularly proud of its participation in The First Combined Gulf Cancer Con-ference. Participation in major events, such as this confer-ence, are hugely important to help spread the message, share ideas and receive health sec-tor updates as the corporation continues to provide Qatar with world-class cancer care,” Dr Abu Shaikha said.

Autism awareness events held

Prominent role at Gulf cancer conference

Dr Shaikha Abu Shaikha

Public Health

WEDNESDAY 26 APRIL 2017

4

The Obstetrics and Gynaecology Depart-ment at the Al-Ahli Hospital is one of the busiest clinics in which

diversified services are provided. From routine gynecological care to high-risk pregnancies, from fibroids to clinical trials, it offers a range of obstetrics and gyne-cology services to care for every woman’s needs.

The Obstetrics and Gynae-cology Department presently performs procedures at an aver-age of 2,000 deliveries a year and 1,500 to 2,000 gynaecolog-ical surgeries. Each day consultants and specialists see between 15 to 25 guests per day.

“To ensure the best care and services for the mothers and their babies, the general services under Obstetrics, we have rou-tine clinics and deliveries section. We offer special care for pregnant mothers with compli-cations such as high-risk cases like diabetes with pregnancy, anemia, high blood pressure, previous pregnancy loss, previ-ous Caesarian section, multiple pregnancies, breech presenta-tion, growth restriction babies and premature labors,” said Dr Waleed Barghouthi, Director Obstetrics and Gynecology Department, Al-Ahli Hospital.

“With gynaecology services we also provide clinics for rou-tine checkups for sort of disorders. We also provide gyne-cological surgeries for medical disorders like conventional sur-gery for fibroids and other non conventional like laparoscopy surgery for diagnostic purpose and operative laparoscopy,” he added.

Pregnant women with any medical disorder such as hyper-tension and diabetics are given specialised care at the Obstetrics and Gyanecology Department.

The care for pregnant moth-ers with diabetes is provided in collaboration with the Endo-crinology department and the Obstetrics and Gynaecology Department.

“We don’t deal with diabetic patients on our own, they need to be seen and well controlled by

the Endocrinology Department. For hypertension, if it is preg-nancy induced hypertension usually we deal, as it needs man-agement until delivery but if it's chronic hypertension then the cases are dealt by the cardiology doctors. However, all care for pregnant women with any med-ical disorder includes antenatal care as well as post delivery or surgery care,” said Dr Barghouthi.

Besides it regular services Al-Ahli Hospital’s Obstetrics and

Gynaecology Department has recently introduced antenatal classes. Antenatal classes are designed to help the pregnant mother prepare for the baby’s birth and learn to look after and feed the baby. It helps to stay healthy during pregnancy, and give confidence and information to the pregnant mother. She can learn about the different arrangements for labour and birth, and the choices available. During antenatal classes the pregnant mothers will be also

meet some of the people who will look after her during labour.

Antenatal classes are pro-vided usually after 30 weeks of pregnancy. Depending upon the need classes will be provided once a week or in suitable intervals.

“The programme has been designed by the Al-Ahli Hospi-tal to address the needs. During the antenatal classes we teach how to go though the lovely but stressful period of time in a womb’s life. It includes support during delivery and post deliv-ery period as well. If needed we also make home visits,” said Dr Barghouthi.

He explained about the ben-efits of antenatal classes saying, “Pregnancy for the first time is something the woman is enter-ing into the unknown, traditionally the woman listens to her mother, neighbour or friends. But there are things the pregnant women don’t know if it's normal or abnormal. Ante-natal classes help them to underhand the pregnancy is a natural process a woman will go through hopefully safely. It also teaches how to go though labour process easier.”

Vitro Fertilization (IVF) is another unique facility at the Al-Ahli Hospital. Al-Ahli Hospital’s IVF programme is the first and largest private IVF clinic in the country and is equipped with the most advanced technologies available.

The assisted conception unit at Al-Ahli Hospital provides medical services to solve a range of fertility issues in a comforta-ble private environment. With a cooperative team of gynaecolo-gists, embryologists, urologists and andrologists, this unit uses the most scientific protocols in the diagnosis and treatment of infertility.

IVF unit in Al-Ahli Hospital provides the full range of serv-ices from simple evaluation to state-of-the-art reproductive

technologies, in a well-equipped lab, one of the most important factors in giving high success rates in achieving pregnancy.

“We nurture our guests in a caring environment, where the major emphasis is placed not only on technological excellence but also on accessibility, personal attention, and emotional support. The IVF unit is new and run by two consultants. But it is now becoming well known as a cen-tre in Doha,” said Dr Barghouthi.

While, Gynaecology services at the Al-Ahli Hospital includes regular check up clinics and services for disorders such as fibroses and endometriosis.

Dr Barghouthi advises women to do regular screening for cervical cancer every three years, as well as for Human pap-illomavirus (HPV) infection which is the most important cause of the cervical cancer.

“Regular screening will help early diagnosis and treatment of any disorder. Also women should watch their menstrual cycle. If it's regular then a good sign of hormonal balance. If the men-strual cycle is irregular and abnormal, they must consult a gynaecologist and get advice,” he said.

With the available services at the Obstetrics and Gynecol-ogy Department at the Al-Ahli Hospital is also aiming to improve and expand its services according to the demand and needs of the country.

Al-Ahli provides best services in gynaecology & obstetrics

Dr Waleed Barghouthi, Director, Obstetrics and Gynaecology Department, Al-Ahli Hospital.

The Obstetrics and Gynaecology Department at the Al-Ahli Hospital is one of the busiest clinics in which diversified services are provided. From routine gynaecological care to high-risk pregnancies, from fibroids to clinical trials, it offers a range of obstetrics and gynaecology services to care for every woman’s needs.

“Pregnancy for the first time is something the woman is entering into the unknown, traditionally the woman listens to her mother, neighbour or friends. But there are things the pregnant women don’t know if it's normal or abnormal. Antenatal classes help them to underhand that pregnancy is a natural process a woman will go through hopefully safely. It also teaches how to go through labour process easier.”

Launches the 1st Fertility and IVF Unitin the Private Sector

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Public Health

WEDNESDAY 26 APRIL 2017

6

Summer is the time when we experience all kinds of hard-to-reach itches in various parts of the body. They often get transformed into ugly-looking lumps, bumps, rashes, scabs, swellings and fluid-oozing pustules after several minutes of constant scratching, picking and touching.

Solving summer skin problems

If you have a very sensitive skin, choose to stay within air conditioned environment during the day. Sun allergies usually start with a mild burning sensation on the affected part of the skin.

During summer days, your skin is sure to develop some or other problems due to

the heavy heat accompanied with the high humidity. This weather is not particularly-friendly for the skin and the extreme heat wave is most likely to cause painful and irri-tating skin conditions, sooner or later. However, the best thing is that these summer skin issues can be prevented and treated. There are a number of home remedies that can effec-tively treat the skin problems prevalent during summer.

It is hard to think of any-thing more annoying than an itchy, burning and irritated skin. Summer is the time when we experience all kinds of hard-to-reach itches in vari-ous parts of the body. They often get transformed into ugly-looking lumps, bumps, rashes, scabs, swellings and fluid-oozing pustules after sev-eral minutes of constant scratching, picking and touching.

Itching and other kinds of skin irritations could be the results of causes like bug bites, dry skin, allergic reactions or sweat-induced infections. However, sometimes an itch or a rash can become hard to fig-ure out and treat. Here, we've discussed six common summer time skin conditions and how they can be treated.

Sun allergySun allergy is a common

summer skin problem for peo-ple with high skin sensitivity. Unlike sunburn, sun allergy can affect you even if you chose to stay indoors when the sun is high. This is a skin condition caused as an allergy to the sun rays and heat. Sun allergies can be of different types and they can be of different extent. Com-mon types of sun allergies will

reduce naturally within 1-2 days and take around 1 week to cure completely, if not exposed to heat. If the condi-tion seems to worsen with time consult a skin specialist.

The best prevention from sun allergies is to stay away from sun and heat. So, if you have a very sensitive skin, choose to stay within air con-ditioned environment during the day. Sun allergies usually start with a mild burning sen-sation on the affected part of the skin. So, as soon as you feel anything like that treat it with cold water or a mixture of cold water and witch hazel. Aloe Vera gel can also be helpful.

Rashes Hot and humid weather is

the prime time for heat rashes. These appear when perspira-tion gets trapped under the skin due to clogged sweat ducts. Heat rashes surface as small, itchy bumps or blisters, usually seen within skin folds or in places that frequently get grazed by clothes.

How to treat Heat Rashes? In the usual course, a heat

rash will disappear on its own within a few days. However, as a preventive measure, one can wear light, breathable gar-ments that allow for perspiration to get evaporated. One should also steer clear of heavy creams, make-up or

ointments that can end up blocking the sweat ducts. In a few exceptional cases, if the rash lasts for more than three to four days or gets worse with time, one should immediately consult a doctor as it could indicate a bacterial, fungal or viral infection.

Hives Hives - raised red welts

with clearly defined edges - appear in reaction to different kinds of allergens like animal dander, insect bites, medica-tions, pollen, certain types of foods, infections, or as reaction to stress, heat, cold as well as excessive sweating. Hives can appear anywhere on the body and can expand, spread and merge with other welts, chang-ing shape and size.

While most cases of hives disappear on their own within a few hours, some can last longer. One should resist the urge to scratch, as that could worsen the hives, and use OTC antihistamine for relief. It's also recommended to avoid hot showers and body-hugging clothing.

If there's no improvement with antihistamines, one should immediately contact the doctor. Left ignored, in some rare cases, hives can blow up into a much serious

condition called anaphylaxis. Keep on the lookout for symp-toms like dizziness, tongue or face swelling, shortness of breath, tightening of the throat or wheezing.

Folliculitis Don't be lazy and change

out of your workout clothes as soon as you're done with your fitness session for the day. Fol-liculitis is bacterial infection that develops easily in the warm, dark, humid environ-ment provided by a sweaty skin. It is, therefore, particu-larly easy to contract Folliculitis in summers. Folliculitis appears like red bumps or pustules and is usually seen on shoulders, thighs and buttocks. These bumps could itch or burn or both.

Tight clothing is a common cause of folliculitis. Such clothes compress hair follicles, which makes it easier for bac-teria to grow there. Also, people who love taking hot tub baths need to ensure that their tubs are properly chlorinated.

To prevent the occurrence of Folliculitis, one should take a shower immediately after workout and also carry an anti-bacterial cleanser.

Contact dermatitis Contact dermatitis is a skin

condition that occurs due to

contact with something that leads to a rash or an allergic response. It can cause itchiness, redness and some amount of skin flaking. More severe cases can even cause blisters, hives and swelling.

Poison ivy is the most com-mon of the contact dermatitis that occurs through contact with poison ivy or poison oak, in outdoor settings like camp-ing and hiking. Some flowers can also be the culprits for cer-tain other kinds of contact dermatitis, e.g., lavender, daf-fodils, alstroemeria and Chrysanthemums.

Prevention is the best cure for this condition. Experts advise you to beware of your surroundings and get to know what poison ivy and poison oak look like. One should also avoid walking through tall grasses and use walking pathways instead. However, if one is still unfortunate enough to get con-tact dermatitis, one could deal with the symptoms through OTC medication like hydrocor-tisone. In cases of more severe rash outbreak, one may also need to visit a dermatologist.

Athlete's foot Despite its misleading

name, Athlete's foot is a skin condition that can take hold of anybody. This fungal infection is contacted due to reasons like: sweaty feet in closed-toe shoes,

a minor skin or nail injury or even through a pedicure done with poorly sterilized tools. The infected site has cracked, flak-ing, peeling skin between the toes, along with oozing and scabbed blisters.

OTC antifungal creams like Lamisil and Lotrimin can bring immediate relief and continu-ous application can clear away the condition. However if the symptoms seem to persist, one may want to visit the doctor for a prescription of antifungal creams/pills.

Yeast infection Many women suffer from

yeast infections during the warm, humid summer months. The naturally warm and moist conditions of the vagina are ideal for such infections with the most common agent being a fungus called Candida Albi-cans. The infections usually occur when the acidic balance in the vagina shifts due to rea-sons like antibiotics or steroids, during pregnancy and men-struation, and also due to birth control pills. The symptoms usually include redness, swell-ing, itchiness, irritation, and/or a thick white vaginal discharge.

OTC medications can offer instant relief, however, a visit to the doctor is highly recom-mended. This is because sometimes bacterial and fun-gal infections of the vagina display similar symptoms. However, the treatment med-icines would vary. If the problem persists, one is also advised to get a gynecologist's opinion.

Sun allergy is a common summer skin problem for people with high skin sensitivity. Unlike sunburn, sun allergy can affect you even if you choose to stay indoors when the sun is high. This is a skin condition caused as an allergy to the sun rays and heat. Sun allergies can be of different types and they can be of different extent.

Public Health

WEDNESDAY 26 APRIL 2017

7

Certain conditions, including age, illness, and genetics, may play a role in hearing loss. Modern life has

added a host of ear-damaging elements to the list, including some medications and plenty of sources of loud, ongoing noise.

With so many untreatable cases of hearing loss, prevention is the best way to keep hearing long-term. If you've already lost some hearing, there are ways to stay connected and communi-cate with friends and family.You can lose your hearing for lots of reasons: age, genetics — and all those blaring rock concerts you attended in your youth.

What Causes Hearing Loss?Advanced age is the most

common cause of hearing loss. One out of three people age 65-74 has some level of hearing loss. After age 75, that goes up to one out of every two people.

Researchers don't fully understand why hearing declines with age. It could be that lifetime exposure to noise and other damaging factors slowly wear down the ears' delicate mechan-ics. Your genes are also part of the mix.

Noise wears down hearing if it's loud or continuous. In some workplaces, ears are exposed to dangerous noise levels every day. To understand the impact of noise, consider this: 44% of car-penters and 48% of plumbers report some hearing loss. Other noisy lines of work include the military, mining, manufacturing, agriculture, and transportation.

For many people, auditory loss happens so gradually that they barely realize it. Others find that their ears seem to be work-ing fine one day and not so well the next.

Check out these four com-mon types of hearing problems and what you can do about them.

Track and measure your way to better brain health with a sub-scription to Staying Sharp.

1. You have trouble hearing people in a noisy restaurant.

Why it happens: As you age — especially if you've been exposed to frequent loud noises — you might have presbycusis,

a type of gradual hearing loss caused by the death of hair cells in the cochlea, in your inner ear. Those are the cells that translate sound vibrations into brain signals.

"The cochlea contains only 15,000 of these hair cells, and they don't regenerate," says And-rea Boidman, executive director of the Osteo Science Foundation, a research organization in Phil-adelphia. "When they die, it becomes difficult for people to recognize certain sounds or to hear speech clearly."

Difficulty hearing in noisy places is often one of the first noticeable signs of hearing loss. That's because filtering out back-ground noise is a fairly complex process that requires precise auditory input from both ears. Quiet conversations aren't quite so taxing.

How to fix it: Although you can't repair damaged cells, you can prevent further loss by lim-iting your exposure to loud noises. Most conversations occur between 40 and 60 decibels; any sound higher than 85 decibels puts you at risk. Common cul-prits include smartphones, music players and sound speakers that can blast out as many as 105 decibels.

"Listening to just one loud song can cause immediate dam-age to hair cells," says Monica Okun, an otolaryngologist (ear, nose and throat specialist) at Lenox Hill Hospital in New York. Her advice: If others can hear your music while you're using earbuds, the volume is too loud.

If your hearing loss is start-ing to affect your everyday activities, talk to your doctor about a hearing aid. And before you balk, consider this: The new-est models are so sleek that they're practically invisible.

"The latest technology effec-tively reduces background noise while simultaneously enhancing the ability to hear speech more clearly," says Ellen Finkelstein, chief audiologist at East Side Audiology in New York. "People can also hear voices that would be completely inaudible other-wise." For severe hearing loss, you may want to consider coch-lear implants. Whereas hearing aids amplify sounds so that dam-aged ears can detect them, cochlear implants bypass

damaged parts and directly stim-ulate the auditory nerve.

Red flags: People with kid-ney or heart disease have a higher than average risk of developing age-related hearing loss. Researchers think that may be because poor kidney function leads to the accumulation of tox-ins that can damage nerves in the inner ear. And cardiovascular disease can decrease blood flow to the inner ear. "Improving kid-ney or cardiac function won't reverse hearing loss, but it can prevent it from worsening," Okun says. "I recommend get-ting a formal hearing test if you have either condition." The reverse may be true, as well; if you have hearing loss, check your kidney and cardiovascular health.

2. You have a feeling of full-ness in your ears.

Why it happens: Excess mucus from an infection or allergy can block the eustachian tube, the small canal

that connects the throat to the middle ear and regulates airflow, particularly when you swallow or yawn. Besides feeling fullness and muffled hearing, you might also experience popping, pain or tinnitus (ringing in the ears), or have difficulty maintaining balance.

A buildup of earwax can cause that feeling of fullness, too.

How to fix it: Most eus-tachian tube dysfunctions improve when the infection goes away, says otolaryngologist David S. Haynes, Cochlear Implant Programme director at Vanderbilt University Medical Center in Nashville.

If not, a doctor can prescribe decongestants and antihista-mines to help reduce inflammation. As for earwax, any health care provider can remove it with a suction device, irriga-tion tool or nasal spray, Haynes says. Don't try to do it yourself, though, as you can easily dam-age your eardrum.

Red flags: Hearing loss with

fullness that's accompanied by significant pain could be otitis externa, or swimmer's ear, an infection of the ear canal that carries sound to the eardrums. The infection is typically caused by water in the ear, which breaks down the skin and provides a breeding ground for bacteria. Otitis externa is usually treated with ear drops that contain an antibiotic.

3. Your hearing loss is sudden.

Why it happens: Swelling or fluid buildup as a result of a virus or ear infection can affect hair cells and nerves, as can taking high doses of certain medications, including aspirin, intravenous antibiotics, chemotherapy drugs and diuretics.

How to fix it: "If an audiogram shows nerve injury, hearing can be recovered if steroids are given within 72 hours of the onset of hearing loss," Okun says. Steroids reduce

inflammation and prevent swelling of the auditory nerve, which, if left untreated, can cause permanent hearing loss. Loss of hearing because of use of certain drugs — a condition called ototoxicity — requires an immediate change in your medication if possible.

Red flags: See your physician if you have sudden hearing loss. In rare circumstances, this could be the sign of a tumor pressing on the auditory nerve. Other uncommon causes include syphilis, Lyme disease, autoimmune disorders and thyroid disease.

4. Hearing loss fluctuates and is accompanied by dizzi-ness, nausea or trouble with balance.

Why it happens: You may have Ménière's disease, an uncommon disorder with no known cause that alters the amount, flow and chemical com-position of endolymph, the fluid in the inner ear. According to the Hearing Health Foundation, 1 in 500 people in the United States have the condition.

How to fix it: Ménière's can't be cured, but it can be treated. A low-sodium diet and a pre-scribed diuretic can help reduce fluid in the inner ear. In rare cases, doctors may recommend injecting a steroid into the mid-dle ear to reduce inflammation, or inserting a tube into the ear to drain excess fluid.

Red flags: Dizziness accom-panied by fluctuating hearing loss can also signal other medi-cal conditions, such as a change in blood pressure, cardiovascu-lar problems, dehydration and anxiety.

If you're experiencing this type of hearing loss, consult your primary care physician or an ear, nose and throat specialist right away. Sometimes dizziness is not accompanied by hearing loss, which could be a condition known as benign paroxysmal positional vertigo (BPPV). This can usually be helped by a sim-ple series of head turns done under the direction of a health care expert.

Hearing loss is often per-manent, so do what you can to protect one of

your most valuable natural assets.

Wear earplugs when you're around sounds as loud or louder than traffic. Lawn mow-ers, power sanders, vacuums, and most concerts are all loud enough to harm unprotected ears. When possible, move away from the source of the noise. For example, cross the street or cover your ears when you walk past a loud road con-struction site.

If you work in a noisy workplace, talk to your employer about ear safety. The National Institute for Occupa-tional Safety and Health (NIOSH) recommends that

employers install barrier walls or mufflers in noisy plants to protect their workers' hearing.

TreatmentsIt depends on the type and

source of your hearing loss. Prompt medical treatment for sudden hearing loss may raise your chance of recovery.

Surgery may reverse hear-ing loss caused by otosclerosis, scar tissue, or infection, while Ménière's disease is sometimes treatable with medication and a different diet.

Hearing loss caused by infection can often be cleared up with antibiotics.

If you think your hearing loss stems from medication use, talk with your doctor about drug options.

Most people with perma-nent hearing loss can benefit from a hearing aid -- yet only one in five people who could use them do. You typically wear these tiny instruments in or behind your ear to make sounds louder. Things do sound differ-ent through a hearing aid though, so you should talk with your doctor to set realistic goals.

Other sound-enhancing technologies include personal listening systems that allow you to tune in to what you want to hear and mute other sounds. TV-listening systems make it possible for you to hear the tel-evision or radio without turning the volume way up. Different kinds of phone-amplifying devices as well as captioned

phones that let you read what your caller is saying make con-versations possible on home and mobile phones.

Cochlear implants are used mainly with young children, but they're becoming more popu-lar among older adults with profound hearing loss.

Living With Hearing LossFor starters, set up your

home so your rooms are well lit and places to sit face each other. When people talk, watch their mouths move as well as their facial expressions.

Remove avoidable sources of background noise. For instance, turn off the TV when no one's watching it.

Let people know what they can do to help you understand them better:

Get your attention before they start talking.

Make sure you can see their lips moving.

Speak clearly, but don't shout.

Hearing loss: Don't take your ears for grantedYou can lose your hearing for lots of reasons: Age, genetics — and all those blaring rock concerts you attended in your youth. For many people, auditory loss happens so gradually that they barely realise it. Others find that their ears seem to be working fine one day and not so well the next.

Take good care of your ears

Public Health

WEDNESDAY 26 APRIL 2017

8

Acidity is a condition that points towards symptoms caused mainly due to an imbalance of the acid secreting mechanism of our stom-ach and other organs. When the

gastric glands of our stomach produce excess quantity of acid, it results in acidity. It can be a dangerous health condition that can cause symptoms such as heartburns and ulcer formation.

Acidity can be managed very easily and effectively through making a few lifestyle mod-ifications. Food that we eat plays a major role in managing the acidity levels in our body. Nutri-tion has magical powers of healing. That’s why the experts say the best way to get healthier always tends to pass through our kitchen.

At the entrance to your stomach is a valve,

which is a ring of muscle called the lower esophageal sphincter (LES). Normally, the LES closes as soon as food passes through it. If the LES doesn't close all the way or if it opens too often, acid produced by your stomach can move up into your esophagus. This can cause symptoms such as a burning chest pain called heartburn. If acid reflux symptoms happen more than twice a week, you have acid reflux disease, also known as gastroesophageal reflux disease (GERD).

What causes acid reflux disease?One common cause of acid reflux disease

is a stomach abnormality called a hiatal her-nia. This occurs when the upper part of the stomach and LES move above the diaphragm, a muscle that separates your stomach from

What is acidreflux disease?

your chest. Normally, the dia-phragm helps keep acid in our stomach. But if you have a hiatal hernia, acid can move up into your esophagus and cause symptoms of acid reflux disease.

These are other common risk factors for acid reflux disease:

Eating large meals or lying down right after a meal

Being overweight or obeseEating a heavy meal and

lying on your back or bending over at the waist

Snacking close to bedtimeEating certain foods, such as

citrus, tomato, chocolate, mint, garlic, onions, or spicy or fatty foods

Drinking certain beverages, such as alcohol, carbonated drinks, coffee, or tea

SmokingBeing pregnantTaking aspirin, ibuprofen,

certain muscle relaxers, or blood pressure medications

What are the symptoms of acid reflux disease?

Common symptoms of acid reflux are:

Heartburn: a burning pain or discomfort that may move from your stomach to your abdomen or chest, or even up into your throat

Regurgitation: a sour or bit-ter-tasting acid backing up into your throat or mouth

Other symptoms of acid reflux disease include:

BloatingBloody or black stools or

bloody vomitingBurpingDysphagia -- a narrowing

of your esophagus, which cre-ates the sensation of food being stuck in your throat

Hiccups that don't let upNauseaWeight loss for no known

reasonWheezing, dry cough,

hoarseness, or chronic sore throat

How is acid reflux disease diagnosed?

It's time to see your doctor if you have acid reflux symptoms two or more times a week or if medications don't bring lasting relief. Symptoms such as heart-burn are the key to the diagnosis of acid reflux disease, especially if lifestyle changes, antacids, or acid-blocking medications help reduce these symptoms.

If these steps don't help or if you have frequent or severe symptoms, your doctor may order tests to confirm a diagno-sis and check for other problems. You may need one or more tests such as these:

Barium swallow (esopha-gram) can check for ulcers or a narrowing of the esophagus. You first swallow a solution to help structures show up on an X-ray.

Esophageal manometry can check the function of the esophagus and lower esopha-geal sphincter.

pH monitoring can check for acid in your esophagus. The doc-tor inserts a device into your esophagus and leaves it in place for 1 to 2 days to measure the amount of acid in your esophagus.

Endoscopy can check for problems in your esophagus or stomach. This test involves inserting a long, flexible, lighted tube with a camera down your throat. First, the doctor will spray the back of your throat with anesthetic and give you a sedative to make you more comfortable.

A biopsymay be taken dur-ing endoscopy to check samples of tissue under a microscope for infection or abnormalities.

Can this be treated with diet and lifestyle changes?

One of the most effective ways to treat acid reflux disease is to avoid the foods and bever-ages that trigger symptoms. Here are other steps you can take:

Eat smaller meals more fre-quently throughout the day.

Quit smoking.Put blocks under the head

of your bed to raise it at least 4 inches to 6 inches.

Don't eat at least 2 to 3 hours before lying down.

Try sleeping in a chair for daytime naps.

Don't wear tight clothes or tight belts.

If you're overweight or obese, take steps to lose weight with exercise and diet changes.

Also, ask your doctor whether any medication could be triggering your heartburn or other symptoms of acid reflux disease.

Can the disease be treated

with medications?In many cases, lifestyle

changes combined with over-the-counter medications are all you need to control the symp-toms of acid reflux disease.

Antacids, such as Alka-Selt-zer, Maalox, Mylanta, Rolaids, or Riopan, can neutralize the acid from your stomach. But they may cause diarrhea or constipation, especially if you overuse them. It's best to use antacids that contain both magnesium hydroxide and aluminum hydroxide. When com-bined, they may help counteract these gastrointestinal side effects.

If antacids don't help, your doctor may try other medica-tions. Some require a prescription. Your doctor may suggest more than one type or suggest you try a combination of medications such as these:

Foaming agents (Gaviscon) coat your stomach to prevent reflux.

H2 blockers (Pepcid, Tag-amet, Zantac) decrease acid production.

Proton pump inhibitors (Prilosec, Prevacid, Protonix, Aciphex, Nexium) also reduce the amount of acid your stom-ach makes.

Prokinetics (Reglan, Ure-choline) can help strengthen the LES, empty your stomach faster, and reduce acid reflux.

Don't combine more than one type of antacid or other medications without your doc-tor's guidance.