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2nd December 2001

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Medical

  • Eczema: The eternal itch
  • Beware of backache
  • Prostate cancer: check it early 
  • Dealing with menopause
  • A healthy cuppa
  • Eczema: The eternal itch

    The term eczema comes from ancient Greece and literally means 'to boil over'. This is exactly how the skin feels for around 1 in 5 children and around 1 in 10 adults who are affected with eczema. 

    Their skin becomes itchy, dry, flaky, and often red and painful. Eczema can appear anywhere on the body but is found most commonly in the skin creases of the elbows and wrists, and behind the knees. Babies are commonly affected on their faces, in particular, the cheeks.

    The commonest type of eczema is called atopic eczema. It tends to develop in childhood, sometimes just after birth. Many children grow out of it as they get older but it can flare up again when they are adults. This type tends to run in families and is more likely if someone also has other atopic conditions such as asthma or hayfever.

    The other common type is contact eczema, which usually affects adults. It's caused by contact with something that the person is allergic to - for example, nickel - or something that irritates the skin, for example, detergents. Many other common substances such as soaps and perfumes cause contact eczema.

    Other less common types are seborrhoeic eczema, which commonly affects the scalp and eye-lashes as a very severe form of dandruff; and discoid eczema, which causes circular patches of eczema all over the body.

    Many victims find that certain things will make their eczema worse. These are called triggers, and the common ones include emotional or physical stress,changes in the weather, in women, their periods and for some people, certain foods. An important part of the treatment of eczema is to try and avoid any triggers if you can.

    If dry, itchy, eczematous skin is scratched and left untreated then it not only becomes infected but the skin thickens and becomes unattractive to look at. Although eczema cannot be cured, it can be kept at bay - and it's very important to do this to keep the skin healthy and looking good.

    The mainstay of treatment is keeping the skin moisturised. Even when the eczema is under control the skin must be moisturised every day to prevent it from becoming too dry. Otherwise the eczema will flare up. 

    Emollient creams or ointments keep the skin hydrated and can also be used as a soap substitute since many soaps dry the skin by removing its protective moisture layer. 

    Emollient liquids can be mixed in the bath water to achieve the same effect. When the skin is itchy, rubbing some of these creams into the itchy areas instead of scratching will soothe the itch without causing further damage.

    A steroid cream or ointment is usually used to calm flare-ups. 

    Since these are often triggered by the staphylococcus aureus bacteria, an antibiotic cream can be combined with the steroid as a convenient combination treatment. 

    For healthy skin it's also important to get a good intake of Vitamins C and E.


    Beware of backache

    Backache is among the commonest complaints of patients and yet doctors are notoriously slow at treating it: in most cases, no exact diagnosis is made, and no reliable treatment is given. There are many medical causes, from arthritis to muscle tears, to abnormal curvature of the spine that cause backache. Seeing a doctor the first time you develop back pain may rule out treatable medical problems, especially if the sufferer is young.

    In the acute stages of backache following a sudden strain or injury, some treatment will help most people. Regular and effective pain relief is essential. Pain killers at fixed intervals and alternate hot and cold compresses may also help relieve pain. Take the strain off the back by lying flat as much as possible, in between periods of gentle mobilization. If this is not enough to hold the pain, a doctor should be sought. It is possible to prevent low back pain, or reduce the chance that it will recur. As a general rule, being fitter and having a strong back and good posture also helps. Two good types of exercise for backs, especially while recovering from an injury, are cycling and swimming. Some sports put extra strain on the back, such as golf and racquet sports and are best avoided. Making the home and work environment "back-friendly" will help. Many back problems are the result of, or aggravated by, poorly designed furniture, chairs which slope the wrong way and don't support the lumbar spine, soft beds, floppy pillows, work surfaces at the wrong height. Whatever the posture, the spine should be as straight as possible.

    And last but not the least, learn how to lift safely. Sudden lifting of heavy weights is a common cause of precipitating or aggravating back problems. Take the pressure off the spine by lifting with bent knees.


    Prostate cancer: check it early 

    Prostate cancer is among the commonest cancers in men, as breast cancer is in women.The cause of prostate cancer is unknown, although some studies have shown a relationship between high dietary fat intake and increased levels of the male hormone, testosterone. When testosterone levels are lowered either by surgical removal of the testicles (orchiectomy) or by medication, prostate cancer can regress. 

    Prostate cancer is the third most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men over 75 years. Prostate cancer is rarely found in men younger than 40 years. With the advent of Prostate Specific Antigen (PSA) testing, most prostate cancers are now found before they cause symptoms. Urinary hesitancy (delayed or slowed start of urinary stream), urinary dribbling, especially immediately after urinating, urinary retention, pain with urination and lower back pain are among the commoner symptoms. When these symptoms occur frequently a doctor should be consulted and he will often do a rectal examination. A rectal exam often reveals the hard, irregular surface of an enlarged prostate if it is cancerous. 

    Treatment options vary based on the stage of the tumour. In the early stages, surgical removal of the prostate (prostatectomy) and radiation therapy may be used to eradicate the tumor. Metastatic cancer of the prostate may be treated by hormonal manipulation (reducing the levels of testosterone by drugs or removal of the testes) or chemotherapy. Surgical treatment is usually only recommended after thorough evaluation and discussion of the treatment options. A man considering surgery should be aware of the expected benefit of the procedure, as well as its risks. 


    Dealing with menopause

    Centuries ago most women died long before they even reached menopause, and for the rest it was seen as a sign that old age had arrived. These days, instead of marking the end of the road, menopause simply opens the door to a new phase in a woman's life - a phase which will last at least 30 years in most cases. 

    But menopause can bring profound physical changes to the body and it is extremely helpful to be aware of them. As a woman gets older the supply of eggs in the ovary slowly runs out. Once she stops producing eggs, the major supply of oestrogen is lost and levels in the body drop considerably. The average age at which this occurs is 51, although it can begin as early as 40 or as late as 60. 

    This drop in oestrogen causes short term problems as the body adapts to low levels (hot flushes and night sweats, difficulty in sleeping, tiredness, headaches, emotional problems such as depression, irritability and mood swings), intermediate effects (thinning and drying of the skin, vaginal discomfort, dryness and urinary problems) and long term changes to the body ( an increased risk of heart disease, osteoporosis and cancers of the reproductive tract).

    At least 70% of women have some sort of short-term symptoms when the menopause begins. It is best to try and accept the problem as just a temporary phenomenon. If simple remedies such as taking a sedative to help sleep bring relief , there is no harm in trying them as long as they are not continued indefinitely. 

    There are endless shelves of products in the pharmacy deal with the intermediate changes of menopause - dry skin and vaginal dryness. However, it is best that these are taken only on the advice of a doctor.

    It is also important to look out for osteoporosis.

    Menopause is also a time when the risk of heart disease increases, especially if other risk factors (smoking, a family history of heart disease, high blood pressure and being overweight) are present. If these risks are present, it is best to ask a doctor for help. Menopause also increases the risk of cancers of the female reproductive system: breast cancer, endometrial cancer and ovarian cancer. Having the breasts examined, reporting any abnormal bleeding or symptoms of vaginal discharge as soon as possible to a doctor and a cervical smear test can help allay these anxieties. 

    Hormone Replacement Therapy (HRT) provides a supply of oestrogen to top up the falling levels of the hormone. Some women swear by it, others don't, but what the research does show is that HRT can dramatically reduce your risk of heart disease and osteoporosis. There are different types of HRT, but sadly many women don't persist long enough with treatment to find one that suits them. This must be discussed with a doctor.


    A healthy cuppa

    By Dr. D.P. Atukorale
    Tea is one of the healthiest beverages today due to its high content of antioxidants, called flavonoids. Antioxidants can protect us from the harmful effects of free radicals. 

    A free radical is an unstable substance which can disrupt and damage molecules in the body and have been implicated in the slow chain reaction of damage leading to heart disease, cancer and the aging process. The best known antioxidants are Vitamin C,E and beta - carotene found in fruits, vegetables, cereals and vegetable oils. The antioxidant capacity of tea depends on how long you brew it. Within five minutes of brewing, 85% of the antioxidant potential of tea was released and the other 15% after another five minutes.

    One should not drink more than 10 cups of tea per day. If consumed in excess, tea produces undesirable effects. 

    At the Epidemiological Congress 2001, a joint meeting of Canadian and American Scientific Societies, a new research paper on the health benefits of drinking black tea was presented. The paper recorded that of 1764 Saudi women studied, tea drinkers were 19% less likely to suffer from cardiovascular disease. The women who consumed black tea had total cholesterol, triglycerides and LDL cholesterol (bad cholesterol) levels which were significantly lower than in non-tea drinkers. The most marked reduction in blood lipid levels was observed in women who consumed six or more cups of black tea per day. 

    Studies confirm the critical role of antioxidants found abundantly in tea to prevent heart disease. Drinking tea can soak your brain in antioxidants thus slowing down brain decline. There is evidence that tea can cut the risk of strokes. Japanese researchers at Saitoma Cancer Center Research Institute have found that in heavy consumers of green tea, the cancer spread to lymph nodes was less frequent. 

    Green tea appears to improve prognosis and survival by suppressing the spread and growth of breast cancer.

    A little milk with tea actually boosts protection against breast cancer, but, too much abolishes the anti-cancer effects. So take a couple of teaspoons of milk in an eight ounce cup of tea. Tea also helps prevent tooth decay as it contains a solid dose of fluoride. Black tea helps to keep plaque from forming on your teeth. British researchers have found that female tea drinkers have stronger bones than non-tea drinkers. Tea also helps you to burn more calories and may stave off signs of aging.



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