Category: BlogPost

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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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Overview

E-cigarettes, battery powered devices which are also known as Electronic Nicotine Delivery System (ENDS) by the World Health Organization (WHO), were first invented in the 1960s, but didn’t really take off until a decade ago when it was brought to life by a Chinese pharmacist, Hon Lik, who himself is a heavy smoker.^{2, 3}

Despite the presence of multiple manufacturers of e-cigarettes, the basic design of the device is similar, consisting of a plastic tube, an electronic heating element, a liquid nicotine cartridge, and a lithium battery and atomization chamber with a membrane to suspend ingredients.³[/vc_column_text][vc_empty_space height=”10vh”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

E-cig-parts

The act of puffing on an e-cigarette is called “vaping”.⁴ An e-cigarette converts nicotine containing liquid (e-liquid or e-juice) into vapour that can be inhaled. E-juice contains additives including propylene glycol giving various aromas and flavours, such as tobacco, coffee, mint and fruits, and in more colours than iPhone 5C! ^{3, 4} Besides, the nicotine content in e-juice cartridges may vary between brands and manufacturers and so, various concentrations of nicotine can be delivered through “vaping”.⁵  This device mimics tobacco cigarette by vaporising nicotine so that it is readily entrained into airway system and then enters the bloodstream, leading to a near instantaneous nicotine reward in the central nervous system.³

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What is the cost of e-cigarettes?

There are more than 250 brands of e-cigarettes in the market. The Tobacco Vapour Electronic Cigarette Association estimates the device starter kit costs between US$30-100 (~ MYR104-347).6 In the U.S, a current research study revealed that there has been rapid expansion in ever and current e-cigarette consumption over the past 4 years. Major population of users are young adults and current cigarette smokers. Even though smokers are most possible users of these products, nearly one third of current users are non-smokers.⁷ E-cigarettes will contribute a booming sales in the industry if the trend continues. According Wells Fargo securities analysts, e-cigarettes were about to hit US$1 billion sales in 3 years since 2010.⁵

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Are e-cigarettes safe?

Burning of tobacco produces smoke which is known as the biggest danger to smokers and second-hand smokers whereas e-cigarettes don’t burn. Therefore, e-cigarettes are widely believed and marketed as less harmful alternatives to conventional tobacco cigarettes. Most significantly, scientists showed that e-cigarettes can help smokers cut down their cigarette intake and eventually to smoking cessation.^{5, 8} However, the lack of studies and reviews means the failure to establish the claim of e-cigarette as a safer substitution to regular cigarettes.

In contrast, a recent report released by the U.S Food and Drug Administration (FDA) stated that vapour dispersed by e-cigarettes contains traces of the solvents in which flavourings and nicotine can be dissolved. Those tested solvents are known cause lung irritation.⁹ In addition, some new studies showed that vaping not only delivers a cocktail of toxic chemicals including carcinogens to the lungs but also leads to bacterial infections resistant to antibiotics. Furthermore, “vapers” can inhale substantial amount of tiny aerosols which in turn can deposit in the lung’s smallest and deepest airways.¹⁰ There have been reports of e-cigarettes battery explosions caused either by prolonged charging and use of improper chargers or by design defects, suggesting e-cigarettes may be the cause of fire accidents.¹¹ For instance, a mid-aged man was reported dead following an explosion of his e-cigarette “gun”.[/vc_column_text][vc_empty_space height=”10vh”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Ecig-explode

So far, introduction of e-cigarettes has triggered a fierce debate among researchers and health experts who ultimately aim to reduce the prevalence of tobacco-related diseases and deaths. Regardless of e-cigarettes make the problem better or worse, many countries and global health organizations such as WHO and FDA urge to ban its use indoors due to concerns on potential harm caused by inhalation of vapour.^{10, 11}[/vc_column_text][vc_empty_space height=”10vh”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

E-smoking

Even though existing evidences show that e-cigarettes are by far less harmful than smoking tobacco, more researches should be conducted to strengthen and/or elaborate current findings related to the use of e-cigarettes as well as implementation of lawful regulations. Lastly, all healthcare professionals play a major role in counselling their patients on the FDA-approved quit smoking approaches if they wish to stop smoking, rather than switching to another form of puffing.[/vc_column_text][vc_empty_space height=”10vh”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

References

1. McGill N. Research on e-cigarettes examining health effects: Regulations due. The Nation’s Health; 2013; 43 (5): 1-10.
2. Consumer Advocates for Smoke-free Alternative Association (CASAA). E-cigarette History [internet]. [cited 2014 Dec 1]. Available from:http://casaa.org/E-cigarette_History.html
3. Kuschner WG, Reddy S, Mehrota N, Paintal HS. Electronic cigarettes and thirdhand tobacco smoke: two emerging health care challenges for the primary care provider. Int J Gen Med. 2011; 4: 115–120.
4. Action on Smoking and Health. ASH briefing: Electronic Cigarettes; Nov 2014.
5. Henley J. E-cigarettes: miracle or health risk? [internet]. The Guardian; 2014. Available from:
6. Neporent L. 5 Things You Need to Know About E-cigarettes [internet]. ABC News; 2013 [cited 2014 Dec 2]. Available from:
7. McMillen RC et al. Trend in Electronic Cigarette Use Among U.S Adults: Use is Increasing in Both Smokers and Nonsmokers. Nicotine Tob Res; 2014; doi: 10.1093/ntr/ntu213
8. Morgan Griffin R. E-Cigarettes 101 [internet]. WebMD; 2014. Available from:
9. Shute N. Health Organizations Call for a Ban On E-cigarettes Indoors [internet]. National Public Radio; 2014. Available from: http://www.npr.org/blogs/health/2014/08/26/343382661/health-organizations-call-for-a-ban-on-e-cigarettes-indoors
10. Raloff J. Health risks of e-cigarettes emerge [internet]. Science News Vol. 185 No. 13; 2014. Available from:https://www.sciencenews.org/article/health-risks-e-cigarettes-emerge
11. Farsalinos KE, Polosa R. Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Ther Adv Drug Saf. ; 2014; 5(2): 67–86.

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