October, 2014 - Best Private Hospital in Dubai Al Mankhool | IMH Dubai

Aggressive prostate cancer can be caused by vitamin D deficiency…..

“Aggressive prostate cancer caused by vitamin D deficiency” scientists now declare

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Men with suboptimal or deficient levels of vitamin D are much more likely than other men to develop prostate cancer, according to a new study conducted by the U.S. National Institutes of Health (NIH). Researchers from NorthwesternUniversity ,Chicago found that vitamin D deficiency can increase the risk of aggressive prostate cancer in some men, highlighting the need for increased focus on natural sunlight exposure and supplementation.

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The study, published in the journal Clinical Cancer Research, suggests that vitamin D may play an important role in how prostate cancer starts and spreads, although it does not prove a cause-and-effect relationship. Vitamin D seems to regulate normal differentiation of cells as they change from stem cells to adult cells. And it regulates the growth rate of normal cells and cancer cells

The research was based on an assessment of more than 600 men from around the Chicago area who came from varying ethnic backgrounds. Each of the men had elevated PSA levels or some other risk factor associated with prostate cancer going into the study, and each was evaluated for vitamin D deficiency prior to undergoing a prostate biopsy.

After adjusting for external factors that may have influenced the results, including things like diet, obesity, smoking status and family history, the researchers determined that vitamin D levels are inversely associated with prostate cancer risk. This means that, for each unit of decrease on the vitamin D scale, there is a corresponding increase on the prostate cancer risk scale, and this increase is even more pronounced among certain ethnic groups.

Vitamin D deficiency is more common and severe in people with darker skin and it could be that this deficiency is a contributor to increased incidence of prostate cancer and cancer progression among African-Americans.Vitamin D deficiency could be a biomarker of advanced prostate tumor progression in large segments of the general population.

The latest prostate cancer discovery demonstrates the need  to pay closer attention to vitamin D intake.Vitamin D, the sunshine vitamin is an essential Vitamin that is a part of the steroid hormone superfamily.Hormone sources include both dietary intake and conversion from an inactive to active Vitamin D in the skin through sunlight exposure.

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Most foods that contain vitamin D only have small amounts, so it’s almost impossible to get what your body needs just from food. Because there are only small amounts of vitamin D in food there are only two sure ways to get enough vitamin D:” “Exposing your bare skin to sunlight to get ultraviolet B (UVB)” and taking vitamin D supplements.”Normal vitamin D levels are in the range of 30 to 80 nanograms per milliliter (ng/ml).

VITAMIN D AS A DETERMINANT OF PROSTATE CANCER RISK ALSO COMES FROM SEVERAL EPIDEMIOLOGIC OBSERVATIONS:

1. Men living in Northern latitude with less exposure to sunlight-derived UV exposure, have a    higher mortality rate from Cancer Prostate.

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2. Prostate Cancer occurs more frequently in older men, in whom Vitamin D deficiency is more common both because of less UV exposure and age related declines in hydroxylases responsible for synthesis of active Vitamin D.

3. African-American, whose skin Melanin block UV radiation and inhibit activation of Vitamin D, has the highest worldwide incidence and mortality rates for Prostate Cancer.

4. Dietary intake of dairy products rich in calcium, which depresses serum level of Vitamin D, is associated with higher risk of Prostate Cancer.

5. Native Japanese, whose diet is rich in Vitamin D derived from fish have a low incidence of Prostate Cancer.

It is recommended that more men should be screened for vitamin D deficiency, since minor deficiencies can be asymptomatic.  A  good rule of thumb for  health maintenance is to spend at least 15 minutes out in the sun every day without sunscreen during the summer, or to supplement with at least 5,000 international units (IU) of vitamin D3.

Dr. Shameer Hameed
MBBS, MS (General Surgery),Dip Lap, MCH (urology)
Specialist Urologist

Guidelines for Prevention of Adult Heart Disease in Early Life

A family at risk = a member with:
Myocardial infarction(heart attack) before age of 60
Hypertension or Stroke
High level of LDL
Low level of HDL
Obesity
Adult-onset diabetes
Smoking habit

Risk Reduction Strategies

Smoking cessation
Weight reduction
Physical activity
Specific dietary interventions
Blood pressure control
Lipid control
Diabetes control
Interventions for psychologic factors
Prophylactic medication in selected patients

 

Prevention of Heart Disease with Diet and Lifestyle changes:  Attributes to Define Low-risk

1) Diet
Good fat: low saturated and trans-fat, high polyunsaturated fat, high fish oil
Good carbohydrates: low glycemic load, high fiber (whole grains)
High folate (vegetables, fruit)
2) Not currently smoking
3) Moderate alcoholic beverage drinking
4) Regular exercise
One half-hour daily (eg, 2 miles per hour walking)

5) Body mass index < 25 kg/m2 (optimal < 21 kg/m2)

Dr. Anil Grover,
MD, MBBS
Specialist Internal Medicine

 

 

10 strategies for supportive and effective assistance with school assignments


This school year, your children’s homework may be challenging for everyone. Discover which methods are best for helping them learn how to study and complete assignments.

“What’s the answer?” may be the question your child expects you to resolve. But handing over the answers will not help in the long run. Doing their homework for them will not earn them the top grades they’re seeking, even if it is tempting and seems easier.
The point of homework is to reinforce classroom material, add information, improve study habits and test knowledge. Your job is to ensure your children meet these goals in order to improve their grades and retain the knowledge. It’s the reason for education.
The following methods of assisting with homework are beneficial for developing long-lasting skills.

1. Stick with a schedule

Schedule specific times for homework—whether after school or after dinner, it should be free from television viewing, video games, texting or other social functions, even if they prefer to multitask. It’s proven that they aren’t as focused. Stick consistently with the same time and be flexible with other activities.

2. Pick a location

Whether at a desk in their room, the dining room or kitchen table, with siblings or alone, find out which space has the least distractions and is most conducive to productivity. Some kids prefer sound in the background in order to focus, but keep television, phone, internet (except for research) and other tech stuff off-limits.

3. Help them find the answer

“Look it up, you’ll remember it longer,” is a wise remark passed on over generations. Don’t do homework for your child just because you know how. Do one problem together and let them do the rest on their own. This helps them learn and problem solve, a critical skill to acquire. Show interest and be available. This improves a student’s performance.

4. Review work

Follow up to see how your child scored on an assignment and look over mistakes. Mistakes are opportunities for discussion to see if they understand the material. Suggest tips for remembering facts, use flash cards to review material or review concepts. An interactive way of learning is effective, perhaps with an older sibling or fellow student.

5. Meet with teachers

Parent involvement shows teachers that there’s a supportive environment at home that gives a student an advantage in the learning process. If your child lags behind, show concern and teachers will have suggestions to encourage your child and perhaps recommend supplemental studies with a tutor in a subject. Maybe other students don’t understand a lesson either, and the teacher needs to know a method needs reinforcement.

6. When you don’t know the answer

Ask questions. Your child’s homework is also an opportunity for you to learn. Do some research to find out the answers even though you won’t hand them over. Like a reference librarian, be a valuable resource to show kids how to research answers. Be sensitive to their needs. How do your child learn—are they a visual or audial type—by seeing or hearing or both?

7. Make a plan

Get an assignment schedule calendar. When the workload increases and kids are juggling various assignments, your support with timemanagement skills will offer valuable guidance in working through difficult tasks and completing homework. Find out about long-term projects in order to schedule and develop a work plan and get necessary supplies to avoid a last-minute rush to finish.

8. Offer incentives

Motivate children and show them how to prioritize their workload, such as studying for tests. If they receive good scores and maintain grade averages, give them certain privileges.

9. Set an example

Read books. Discuss ideas. Go to a science museum together. Augment their studies with relevant information, such as word and math games. Your actions speak volumes when advice may be ignored.

10. Offer praise

Show off work well done—a test with a high grade, an art or science project. Encourage your kids. If you show you believe in them, it builds confidence. Complimenting children gives them a sense of pride in their academic accomplishments.

Mental Heath in UAE

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‘Living with Schizophrenia’
“On October 11, 1994, John Forbes Nash Jr.won the Nobel Prize for the pioneering works in game theory. Nash was 66 and most of his adult life he’d suffered from paranoid schizophrenia.
Nash began his Ph.D at Princeton in 1948- when he was just 20. He went on to MIT and for eight years dazzled the mathematical world. Then, disaster! Mental illness wrapped about him like an evil cloud. He began hearing voices. For 25 years, mental illness owned John Nash. He became a ghost, wandering the halls of Princeton and suffering in some private hospital. It was in mid 1980s that Nash at last learned to manage the demon and once again, he could do mathematics”.
World Mental Health Day is observed on 10th October every year, with the overall objective of raising awareness of mental health issues around the world and mobilizing efforts in support of mental health. The theme for 2014 is “Living with schizophrenia”. The focus of the World Health Organization will be living a healthy life with schizophrenia.
What is schizophrenia?

Schizophrenia is a severe form of mental illness affecting about 7 per thousand of the adult population, mostly in the age group 15-35 years. It affects about 24 million people worldwide. Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups around the world. Symptoms such as hallucinations and delusions usually start between ages 16 and 30. Men tend to experience symptoms a little earlier than women. People with the disorder may hear voices other people don’t hear. They may believe other people are reading their minds, controlling their thoughts, or plotting to harm them. This can terrify people with the illness and make them withdrawn or extremely agitated.

Mental health – world scenario

It is estimated that approximately 450 million people worldwide have a mental health problem.( WHO 2001) One in four families worldwide is likely to have at least one member with a behavioural or mental disorder.CDC report :Mental illness surveillance among US adults shows, Mental illness is an important public health problem in itself- about 25% of US adults have a mental illness. The office for National Statistics Psychiatric Morbidity report found that in any one year 1 in 4 British adults experience at least one mental disorder and 1 in 6 experiences this at any given time. In United Arab Emirates, Neuropsychiatric disorders are estimated to contribute to 19.9% of global burden of disease (WHO, 2008).
Mental health scenario in UAE
Even when well standardized studies on mental health in UAE are scarce, the available old and new studies show alarming increase of mental health problems in this Middle Eastern country. Depressive disorders, addictive disorders, stress related disorders, anxiety disorders, childhood behavioural problems like ADHD are in the forefront along with other psychotic disorders like schizophrenia.

Living with schizophrenia
WHO aims at healthy living with schizophrenia for people who are inflicted with this disease and also for their caretakers. “Living with Schizophrenia” as a theme is the need of the hour. It is important because of the great burden imposed by schizophrenia on the family and on society as a whole but essentially on the patient him (her) self.
“Living with Schizophrenia” can be approached from many perspectives. Who are those who live with schizophrenia? It is basically the patients themselves. The experience is an intense, long-lasting and often unbearable pain coupled with a perception of social isolation produced by prejudice and discrimination. The relatives (the carers) also live with schizophrenia and such is also the case with the professionals, the advocates and society as a whole. WHO, this year aims at targeting a healthy life for schizophrenia patients, their care takers and society at large.
Challenges
Stigma, poor awareness, absence of proper screening, lack of insight & poor help seeking, acceptance problems in family and society, poor drug compliance, difficulties with reintegration of schizophrenic people back into society, inadequate funding, care centers and resource personals, huge financial expenses incurred on long term treatment and absent insurance schemes, inadequate mental health policies by the government are some of them.
Region specific challenges
The quantum and impact of mental health issues in these parts of world are not well studied. Available short and small studies show the prevalence and incidence of mental illness at par with rest of the world statistics. A study conducted in early 90s in Dubai by prof Rafia Gubash shows overall prevalence rate of psychiatric disorders as 22.7%,depressive disorders 13.7%, anxiety disorders 7.0 %, psychotic disorders 1.9%, which are in line with international rates. Outpatient and inpatient statistics in Mind wellness clinic at International modern hospital Dubai also shows similar numbers. WHO statistics 2011 shows in UAE – mental health professionals working in mental health sector, per 100,000 is for Psychiatrists 0.3,Nurses 2.12,Psychologists 0.51,social worker 0.25 and that of developed countries, like US and Australia-Psychiatrists(US-7.79,Aus-12.76)Nurse(US-3.07,Aus-69.54)psychologist(US-29.03,Aus-62.48).World health statistics 2014 shows UAE spends2.2% of its GDP on health while UK and USA spend 7.0%, 13.6% of their GDP respectively. When we talk about schizophrenia status DALY (Disability adjusted life years) in UAE is 267.316 against164.255 and 185.182 in Australia and UK respectively. Discrepancies between DALY rates and prevalence may arise from differences in availability of medical treatment: Years lived with mental disorders carry significantly higher DALY values when un-medicated than when medicated.
Challenges specific to this part of world regarding schizophrenia are; No mental health act, inadequate funding, no insurance coverage, non availability of adequate resource persons and appropriate treatment options like depot injections and ECT, absence of rehabilitation centers and shortage of standard studies on prevalence, incidence and other variable aspects of mental illness and finally poorly sensitized family members and society.
The impact of schizophrenia / mental illness
The impact of mental illness especially schizophrenia ranges from ostracisation, debts, social drift and shift, issues related to education , marriage, rehabilitation / social reintegration and depression, adjustment problems and burning out of care takers etc…

What can we do?
To make person’s life better is all about improving his quality of life .There is no absolutism in it, rather it is a continuum.30 yr old A.A, a young schizophrenic was found missing in Dubai in July this year, when he came out with his family. A Good Samaritan helped him to reunite with his family. We can do many things to make the life with schizophrenia better. Understand and accept the person with mental illness is the most important. This we can start from the family, then to the society and to the bigger society, our country. Yes all of us should change the attitude towards them. A good empathetic attitude will serve the purpose.
Drafting mental health policies and Act will help a lot to develop sensible and sensitive attitudes towards a biological disorder of the brain – mental illness. This will provide better treatment options and will help those with mental illness to lead a respectable life by enjoying their rights.
Developing or investing on better hospital / rehabilitation / care centers for behaviourally ill clients is the need of the hour. We have only very few such centers for inpatient treatment and rehabilitation. International modern hospital Dubai is one among the few. Government and private investors can look into such areas to ensure better health care delivery to these downtrodden people.
Changing the existing drug policies will help to make available the drugs fairly freely to those, who are in need. Most of the medications used by mental health professionals are Non addictive. Unfortunately most of them are put under controlled medicine group which make these medicine inaccessible to needy patients in the most needed time.
Mental illness is just like any other medical illness, it is a disorder of the brain. Here in UAE most of the treatment is covered under insurance, so it is not a big burden to a person or his family. Unfortunately mentally ill persons are getting the worst lot always. Neither the consultation nor medications are covered under most of the insurance for mental illness. Mental illness affects the performance of an employee in any organization just like any other medical illness. So ignoring these facts or denying the treatment rights for these persons will affect the prospect of the institution so also the prosperity of the country.
Ignorance, stigma, financial burden and inadequate time, all these factors might have contributed to the insensitivity of family members towards people with mental illness. Developing countries where there is better family ties reports better improvement rates with long lasting medical disorders like schizophrenia than developed countries with disintegrated family structure. Good sensible support from the family and society will reduce the burden of these disorders.
Spreading the awareness will help in early screening, early detection and early treatment seeking, which in turn ensures better improvement and lesser disabilities.
R.D. Laing’s words ring in my ears “Schizophrenia cannot be understood without understanding despair.”
Let this world mental health day give us a healthy mind to understand and participate in nation building process by maintaining a sensible empathetic attitudes towards mentally sick individuals like people with schizophrenia.

Dr.Shaju George
Specialist psychiatrist
International modern hospital
Mind Wellness Department
Burdubai,Dubai
Appointments : 971 4 406 3000

Preventive Healthcare for You

Prevention is better than cure. All of us have been taught about this right since our school days and yet when it comes to practice, we seem to forget about it! Basic reason appears to be an inherent belief that “illness is not for me”, till it catches us and then we start repenting the missed opportunities and start doing what is known as secondary prevention. Let us resolve now to systematically approach our lives and start Primary and Primordial Prevention.

Prevention is a habit and has to develop in all spheres of our lives, be it wearing a helmet, fastening car seat belt properly, avoiding tobacco consumption, knowledge of safe limit of alcohol intake, safe sex, preserving proper vision, avoiding osteoporosis etc.

Broadly, ailments are divided into Communicable and Non-communicable diseases. The latter e.g. obesity, diabetes, high blood pressure, coronary heart disease, cancers etc are on the rise. Incidence of obesity and overweight is around 70% in US today! The average American waistline has increased by 3-5 cm. in last 10 years. To prevent all this, one should strictly follow a healthy lifestyle, which essentially means a balanced diet and an increase in physical activity. In a recent survey, thanks to media campaigns, in last 30 years, there has been a significant increase in physical activity from 20% to 40 % among US adults and a similar drop in smoking status! Simple measures like reducing salt intake in diet decreases incidence of strokes by 35% and heart attacks by 20%!

The earlier one starts prevention, the better are the results. It is estimated that a long-term reduction in serum cholesterol concentration of 10% (which is in the range of lifestyle change) lowers the risk of coronary heart disease (CHD) by 50% at age 40, falling to 20% at age 70.

Lots of new and effective vaccines are now available. Our awareness about vaccines is pathetically low. It is unfortunate that we do not have a Global Adult Vaccination Program.

International Modern Hospital, Dubai, has introduced, for the first time, an Adult Vaccination Initiative. It is sincerely hoped that more and more people will use these guidelines to their greatest advantage.

Needless to say, preventive health checkups are very useful in early detection of all types of illnesses and risk factors. In the preventive checkup program at Mayo clinic, 5% people were found to have a life threatening disease and another 30% had a previously undiagnosed severe disease condition.

Lately, large numbers of big corporations are encouraging their employees to undertake Preventive Health Check. There is enough data to show that employees undertaking regular health checks have 45% lesser absenteeism and their medical reimbursements are 20% less. Net return on investment for the organization, purely in financial terms, is
2.3: 1.

To conclude, preventive healthcare is for YOU. The earlier one starts, the better it is for major gains. Follow the global slogan of Sir K George Alberti, Former President of International Diabetes Federation –“EAT LESS, WALK MORE”, and of course GET VACCINATED.
Dr SUSHUM SHARMA
MD(Med),MNAMS,FICP
FIACM,FISE,FIMSA
Specialist-Internal Medicine,
International Modern Hospital, Dubai

 
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