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Overview

Haze is an aggregation of very fine, widely dispersed, solid or liquid particles or both in relatively dry air atmosphere which gives the air an opalescent appearance. The severity of haze condition is measured by PSI (Pollutant Standards Index) which is an index developed by the United States Environmental Protection Agency (USEPA) and is determined by the level of air pollutants. In general, healthy people should minimise outdoor activities when the PSI is greater than 200 whereas those who are of higher medical risk including children should minimise outdoor activities when the PSI is greater than 101.

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Health Effects of Haze

The pollutant particles that make up haze can go deep into the lungs, and in some cases, enter into the bloodstream. The highest health risk is posed by the so called PM2.5 particulate matters that can penetrate right into the small air sacs in our lungs when inhaled.

Short-term exposures to haze particles (hours or days) cause asthma attacks, acute bronchitis, aggravate lung disease as well as increase the risk of getting respiratory infections. In people with heart problems, short-term exposures can be linked to possible heart attacks and arrhythmias. On the other hand, long-term exposures to hazy atmosphere have been associated with problems such as reduced lung function and the development of chronic bronchitis.

In addition, the health effects can be further categorized into local and systemic effects. Local effects can result in mild to severe eye, nose, and throat irritations. People with history of sinus problems or sensitive nose are more likely to develop nasal congestion, sore throat and coughing. Furthermore, incidents of skin irritations may be increased and people who are suffering from eczema or other skin diseases may encounter exacerbation of conditions. Systemic effects on the other hand can range from respiratory conditions such asthma attacks and worsening of heart diseases such as heart failure to increased risk of cancer.

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General Advice During Hazy Days 

• Stay healthy with adequate sleep and hydration.
• Get annual flu vaccine injection.
• For those with chronic illnesses, medications should be taken regularly.
• Outdoor activities should be limited when PSI > 100. Wear N95 mask at outdoors. (N95 mask may increase the effort of breathing. Do not wear it for prolong period.)
• Stay indoor when PSI > 200.

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References

1. Haze and Health Effects. 2014. https://www.rafflesmedicalgroup.com/docs/default-source/health-advisories/rmg-advisory-haze-27052014-public.pdf?sfvrsn=2. Accessed 07/09/2015.
2. Malaysia Meteorological Department. 2013. Haze. http://www.met.gov.my/index.php?option=com_content&task=view&id=70&Itemid=160. Accessed 07/09/2015.

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Overview

Gout is a form of arthritis caused by high level of uric acid in the body, which can then deposit around joints and form needle-like crystals leading to acute painful gout attacks. Pain comes very quickly, often at night.

Most common part of the body affected by gout:

• Big toe.

Other possible areas:

• Elbows
• Hands
• Knees

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Signs and Symptoms

• A classic picture of gout is excruciating, sudden, unexpected and burning pain.
• The affected joints become swollen, warm, red and painful.
• An extremely tender joint, painful and sensitive to touch- sometimes even the weight of the bed sheet can cause severe pain.
• May have fever or chills developing.

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Contributing Factors

• Family history.
• Drinking too much alcohol.
• High intake of rich foods.
• Long term consumption of low dose aspirin and diuretic.
• Certain health problems (e.g. kidney problem).
• Congenital or presence since birth.

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Avoid

Not more than one item once a week:

• Herring
• Meat extracts
• Meat gravies
• Sardines
• Fish roe
• Alcohol
• Anchovies
• Meat soup

 

Not more than one item 4 x a week:

• Asparagus
• Cauliflower
• Beans
• Lentils
• Mushrooms
• Oysters
• Peas
• Spinach
• Whole-grain cereals
• Bread

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Acceptable

As often as desired:

• Beverages – tea, coffee, cocoa, chocolate
• Fruits
• Vegetables (except those under *Avoid)
• Bread and cereals (except wholegrain)
• Eggs
• Milk and milk products
• Nuts –  all kinds, peanut butter

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Medicines

Consult our doctors or pharmacist for suitable medicines for you if you:

• Have tried lifestyle modification and failed
• Have family history of gout
• Have kidney problem or the presence of kidney stone(s)
• Have unexpectedly high uric acid level

 

Medicines to relieve pain

• NSAIDS

 

Medicines to prevent gout attacks: (e.g. Allopurinol)

• May be started after a few attacks. Usually started with a low dose then increase gradually.
• Do not start taking gout prevention medicines during or after an attack, otherwise the attack may be prolonged.
• These medicines do not relieve an attack that has already started and will prevent attacks only while you take them regularly. Taking these medicines on-and-off may put you at risk of an attack.
• Gout attacks may continue to occur during the first 3-6 months of taking the medicines. Despite this, you may be advised by your doctor to continue taking these medicines during this initial period. This could be attributed to the rapid uric acid lowering effect of the medicine which reduces the uric acid level to below the saturation point therefore causes existing crystals in joint cartilage to partially dissolve and become smaller.

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Self-care

• See a doctor for treatment as soon as symptoms start.
• If you are on long-term medication to prevent gout, you should take your medication every day even in the absence of gout symptoms, otherwise attacks of gout may recur.
• Drink lots of water.
• Avoid vigorous exercise, but keep your joints mobile with regular moderate exercise.
• Maintain your ideal weight. Consult our doctors/pharmacist at BP Diagnostic Centre/Lovy Pharmacy for a weight management programme
  Stay away from alcohol and foods that are high in purines. Consult our nutritionist at BP Diagnostic Centre/Lovy Pharmacy for further information.

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Supplements

• Fish oil – shown to have anti-inflammation properties
• URAL – Urine Alkalinizer to neutralise the uric acid and also helps to flush out excess uric acid

 

*Consult a pharmacist at Lovy Pharmacy when choosing a supplement for your condition.

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