SPECIAL SUPPLEMENT TUESDAY 30 JUNE 2020

PAGE | 2 PAGES | 4-5

Public HealthSPONSORS

Exercising during

the summer heat

ACTING MANAGING EDITORMohammed Salim Mohamed

EDITORIAL CONTRIBUTOR Fazeena Saleem

EDITOR-IN-CHIEFDr. Khalid Mubarak Al-Shafi

SUPPLEMENT COORDINATORAhmed Eltigani Idris

DESIGNAbraham Augusthy

Women receiving highest level of care at Al-Ahli Hospital during COVID-19 pandemic

FAZEENA SALEEM THE PENINSULA

The size and speed of events brought about by COVID-19 this year have been diz-zying. The COVID-19

pandemic has brought changes that seemed unthinkable just a few months ago. In January 2020, it seemed unthinkable that the entire white-collar workforce of many countries would soon be working remotely from home. It seemed unthinkable air travel would plummet drastically. Even con-sulting a physician via video call was unthinkable.

The changes have come so thick and fast that it’s hard to remember just how radical some of them are.

In Qatar too, people are heading towards a new normal where they have to live with the COVID-19 restrictions and con-tinue to take precautions.

The COVID-19 Qatar National Response Plan has set clear conditions through the evidence-based, gradual and controlled lifting of restrictions imposed in response to the COVID-19 pandemic. The plan to gradually lift COVID-19

restrictions aims to restore normal life while continuing to protect people, society and economy of the country. Restrictions will be lifted in four phases in accordance with a set timetable.

The Ministry of Public Health continues to track and trace every COVID-19 case in the community.

As the country is going through a phased of lifting COVID-19 restrictions, health care officials emphasize it is important that people stay vig-ilant and take precautions against the spread of virus.

“The weekly (COVID-19) infection rate is declining. Though this indicator is reas-suring, it does not mean the end of the epidemic as the virus is still present in society,” warned Dr. Abdullatif Al Khal, Co-Chair of the National Pandemic Prep-aration Committee, while speaking at a press conference recently.

“It is essential that people follow all the preventive measures as the restrictions are lifted,” he added.

Health sector officials have also reminded the public to take responsibility at a personal level and adhere to preventive

measures during the phased lifting of COVID-19 restrictions.

“We all have a role to play, everyone should take respon-sibility,” Dr Yousef Al Maslamani, Medical Director, Hamad General Hospital (HGH), told The Peninsula.

He also emphasised that it is every individuals’ right that the places they visit apply COVID-19 preventive measures including checking visitors’ health status on the virus-tracing mobile app, Ehteraz; checking body temperature; use of face masks; and adhering to social distancing.

“Protect yourself, protect the family and protect the com-munity from COVID-19,” said Dr Al Maslamani.

Physicians also emphasize that is the time to be cautious and protect those most at risk.

“In order to successfully go through the phased lifting of COVID-19 restrictions we should be fully committed to all instructions given by National Pandemic Preparation Com-mittee,” said Dr Ibtism Al Jalahma, Consultant, Family Medicine at Primary Health Care Corporation.

“While going out, especially to crowded places such as

shopping malls, people should follow all preventive measures. In case if the body temperature is high, people should abide by the rules and return from the place.

“The mask should cover both mouth and nose, keep dis-tance and avoid crowded shops. If the shop is crowded it is advisable to leave and go back on another day,” Dr Al Jalahma told The Peninsula.

The first phase of easing COVID-19 restrictions began on June 15 and the second phase will start from tomorrow.

Meanwhile, the World Health Organization (WHO) has reminded the public to remain vigilant through Mr Bean’s Essential COVID-19 Checklist.

WHO, Project Everyone and Tiger Aspect Productions have partnered to launch a Public Service Announcement (PSA) using global comedy cartoon star, Mr Bean.

“Mr Bean’s Essential COVID-19 Checklist” is a reminder to people about the importance of washing hands, physical distancing and dem-onstrating kindness to their neighbours. The PSA features a cartoon sketch of Mr Bean

comically tackling a pesky roller blind to finally reveal a number of essential tips to protect people against COVID-19.

“COVID-19 affects every walk of human life, and we need to use all tools and avenues at our disposal to share life-saving information with all people around the world. I am grateful for the support of the team behind Mr Bean for lending your voice and talents to spread vital advice on physical distancing, hygiene and knowing the symptoms,” Dr Tedros Adhanom Ghe-breyesus, Director-General of the World Health Organization, said recently.

The PSA is voiced by Mr Bean star, Rowan Atkinson, who created the Mr Bean char-acter to be “a child in a grown man’s body” when he was at Oxford University along with filmmaker and Sustainable Development Goal advocate Richard Curtis. Mr Bean, which was originally broadcast in the 1990s before transforming into an animated series, has since expanded on a global scale with 96 million Facebook fol-lowers globally and major fan-bases across India, Brazil and

Indonesia. Mr Bean also cele-brates his 30th anniversary in 2020.

The PSA was coordinated by Project Everyone, a not-for-profit agency devised by Richard Curtis working to put the power of communications behind the UN’s Sustainable Development Goals.

“We are delighted to work with the WHO on this Mr Bean sketch and to support health messaging around COVID-19. In 2015, 193 world leaders committed to 17 Global Goals to end poverty, inequality and climate change by 2030. Good Health and Wellbeing is Goal 3 and central to achieving all of the Global Goals.

"It’s key that we work with creative partners - and that all sectors come together to con-tinue to get messages out about how we can tackle COVID-19 and build back a better world where the Global Goals remain the guiding plan to be achieved by 2030. I’m not QUITE sure which sector Mr Bean belongs too - but we’re delighted to have him on board,” Richard Curtis said in a WHO newsletter pub-lished recently.

Time to be

cautious

It is every individuals’ right that the places they visit apply COVID-19 preventive measures including checking visitors’ health status on the virus-tracing mobile app, Ehteraz; checking body temperature; use of face masks; and adhering to social distancing.

Mr Bean’s Essential COVID-19 Checklist” is a reminder to people about the importance of washing hands, physical distancing and demonstrating kindness to their neighbours.

Public Health

TUESDAY 30 JUNE 2020

2

Some people tend to rest and stay away from any physical activity during the heat, while others prefer to lose weight by increasing activities and exercises to

maintain good health, specifically those who suffer from or are at risk of chronic diseases.

Dr. Anees Al Yafei, Wellness Officer, Leabaib Health Center, PHCC, says it is important to follow the physical exer-cises or nutritional tips to maintain good health during summer, use our time effi-ciently, and deal with the accompanying climate conditions properly.

Safeguard health

To safeguard health, Dr. Al Yafei advised to drink enough water and fluids regularly to compensate for any loss of water and salts, include a variety of exercises, including cardio exercises that increase heart rate and resistance exercises that depend on weights, have a meal two hours maximum before exercising, and avoid exercising with an empty stomach.

It is important to include variety of foods to balance basic food ingredients, so that half of the dish consists of fresh or boiled vegetables, a quarter consists of protein, such as meat, chicken, fish, and the other quarter consists of

carbohydrates, and avoid eating too many carbohydrates and sugars grad-ually. In addition to eating five servings of fruits and vegetables per day, where one serving means one piece of fruits or vegetables, eating some water-rich foods, such as dried fruits, cantaloupe melon, watermelon, and bananas, avoiding eating too much fried and salty foods, such as salted cheeses and pickles.

Dr. Al Yafei also advised to have enough sleep, 6 to 8 hours a day, reduce naps for less than 30 minutes, stay away from stress, follow new hobbies, and use time to read or learn new skills.

Essential summer foods

As summer is a hot and humid season, it is accompanied by the loss of many fluids and salts, as well as body and muscles stress due to heat and humidity, and as exposure to cold air conditioning is higher in the summer, it is very important to balance outdoor temperature and avoid being exposed to sunlight.

Exposure to high temperature can lead to many complications, such as sunstroke, stress, and even dehydration in severe cases.

On the essential summer foods and drinks, Dr. Al Yafei recommended to drink water as mentioned earlier and provided some tips to encourage

drinking water, such as putting water bottles in the car, room or office, while those who do not like drinking water can add some flavors or fruits to it, such as lemon, strawberry, orange pieces, and others. Citrus fruits, such as oranges, lemons, and others are very effective in content and salts, he added.

Dr. Al Yafei added that eating a salad with various ingredients helps to compensate for salts, vitamins and antioxidants lost during summer due to heat exposure. In addition, milk is very important and rich in salts, espe-cially in the morning or at dinner, and most fresh and fluid-rich drinks are effective in compensating for body’s requirements for vital elements.

The best food options

As explained previously, Dr. Al Yafei said that eating healthy is the best option. It is very important here to focus on reducing carbohydrates in general and choosing healthy cooking methods, such as grilling, steaming or using thermal cooking devices without oil. He also recommended to eat

protein found in meat, fish and chicken, and protein found in yogurt and legumes, such as broad beans, chickpeas and lentils, in addition to some ready-made protein fingers available in the markets.

Foods that should be avoided

As for what we should stay away from, Dr. Al Yafei advised to completely avoid eating fast food high in fat and sodium, whether in summer or the rest of the year, and avoid eating fried meals with oils due to their harmful effects on the body, as well as to reduce pastries and fatty foods. He also advised to completely avoid soft and energy drinks and replace them with natural drinks, milk and home-made juices, stressing that overeating stimulants, such as tea, coffee, karak, chocolate, cola drinks, is not recommended. He added that having a cup of coffee or tea after 5 pm is also not recommended.

Exercise at home

Dr. Al-Yafei said that it is very pos-sible to exercise using a treadmill or a

bicycle; however, walking is the pre-ferred option if there is a space inside the house. He generally recommended to walk or use the treadmill and set the speed to 5 and above for half an hour three days a week as a minimum, resulting in a total of 150 minutes per week for adults who do not suffer from obesity or chronic diseases. For those suffering from obesity or any chronic diseases, duration recommended is 60 minutes a day, three times a week for a total of 300 minutes.

There are other options for those who do not have a space in the house or a treadmill, such as the stair exer-cises like going up and down stairs from ground to first floor continuously, which are very useful before repeating the exercise, then to gradually repeat this exercise to 10-20 times a day. This exercise is effective for improving lower muscles fitness and heart fitness, does not require speed at the beginning, and focuses on areas where fat accumulates in general, in the center of the body. There are also options of jumping rope or jumping jacks, or high knee running in place exercises, as they speed up heart rate and contribute to burning too much fat, in addition to pilates exercises to stretch muscles, which are very easy and can be accessed from accredited websites for online exercises.

Sunlight effects

With regard to working out directly under the sun, Dr. Al Yafei said that sunlight is very important because it converts cholesterol under the skin to vitamin D, which in turn is very important for calcium absorption and related metabolism. Sun exposure is recommended between 9 and 3 pm, as sunlight waves are more effective for converting vitamin D. Nevertheless, he warned to be careful during summer, especially with the high tem-peratures that may lead to sunstroke and the subsequent harmful health effects. With that in mind, he advised to take precautions, drink liquids, and choose the right time.

Exercising during the summer heat

Dr. Anees Al Yafei, Wellness Officer, Leabaib Health Center, Primary Health Care Corporation (PHCC)

PHCC taking precautions in health centres to protect staff and patients

Dr Hanadi al-Hail

The Primary Health Care Corporation (PHCC) is keen on providing con-tinuous guidance and health awareness in an

effort to reduce the spread of dis-eases, especially during the summer.

Dr. Al Jundi Abdulsalam, Family Physician, Abu Baker Al Siddiq Health Center, PHCC, stresses that the extreme heat during the summer leads to fungal infections and many skin diseases.

Skin pigmentationand sunburn

Dr. Al Jundi says that there is an increased risk of getting infections and diseases as a result of rising tem-peratures and the spread of viruses, the best known of which are skin pig-mentation and sunburn. This happens as result of prolonged exposure to sunlight during the summer, resulting in severe skin burns, and thus peeling the skin off. He, therefore, recom-mended avoiding sitting under direct sunlight after 10am to 4pm, where the sun’s ultraviolet (UV) rays are the strongest, and advised looking for shaded areas.

Tinea versicolor

Dr. Al Jundi defines tinea versi-color as a fungal skin infection caused by excessive sweating in high tem-peratures, and causes small white, light brown or pink patches of skin. To prevent this infection, he recom-mended wearing cotton clothing as synthetic materials do not absorb perspiration. Another type of tinea versicolor appears between thighs and occurs due to sea or pool water with high chlorine levels. To prevent transmission of this type of infection, he recommended bathing as soon as you get out of the water.

Bacterial skin infection

Dr. Al Jundi explained that the risk of getting bacterial skin infections increase in large crowds of people in recreational areas, particularly for those with a sensitive skin and children. To prevent this type of infection, he advised to use clean per-sonal items and take a daily bath,

especially while traveling.

Heat rash

Heat rash, also called miliaria, is a type of skin rash that causes small red bumps and develops due to increased heat and perspiration, and can some-times produce itching, said Dr. Al Jundi. To prevent heat rash, he advised to wear light and cotton clothing, ensure good ventilation at home, avoid high temperatures, and take a cold bath to moisturize your body.

Dr. Al Jundi advised not to neglect this disease as it may develop into a skin infection. He also stressed on the importance of treating it using a spe-cific cream after the doctor’s consul-tation. However, if it develops into a skin inflammation, then it may require an antibiotic.

Eczema and skin rash

The same reasons mentioned above: perspiration, temperature and water lead to eczema, which spreads

most commonly on elbows, hands and skin folds, explained Dr. Al Jundi. Eczema is often accompanied by itching, and therefore requires an anti-itch cream, as rubbing the affected areas can worsen the rash and can even leave marks that are difficult to remove.

When it comes to skin rash, he recommended to wash the affected areas with lukewarm water, avoid rubbing them, dry them thoroughly, and use necessary drugs. He also rec-ommended to eat foods that contain vitamin C, as it prevents the release of histamine in the body and contains antioxidants that reduce skin rash, as well as receiving treatment pre-scribed by the doctor.

Boils

Dr. Al Jundi defines boils as severe infections of hair follicles and sur-rounding areas. There is a higher risk of getting infected with boils with increased sweating, and there are factors that increase bacterial activity leading to these boils, which are dia-betes and overweight.

Melasma, freckles and acne

Dr. Al Jundi said that among skin problems appearing during the summer are melasma and freckles that cause dark patches to appear on the skin in areas directly exposed to the sun, especially on the face. The ideal solution for preventing melasma and freckles is using sunscreen half an hour before exposure to harmful rays, he advised.

Furthermore, Dr. Al-Jundi said that some people suffer from the increased acne during the summer, especially those with oily skin, where the release of sebaceous glands increase with open pores, thus making it easier for the dirt to stick on your skin and form acne.

He recommended to avoid touching or pressing on acne to avoid leaving marks on the skin. He added that treatment includes antibiotics, indeed, after dermatologist’s consul-tation. For those whose skin tends to dry out quickly, he recommended to use a moisturizing cream when going out, especially on the dry parts of the body especially the limbs, whenever needed.

PHCC providing advice to prevent skin diseases and infections caused by heat

Dr. Al Jundi Abdulsalam, Family Physician, Abu Baker Al Siddiq Health Center, PHCC

The Primary Health Care Cor-poration (PHCC) has confirmed that it is taking the utmost care to protect patients and medical

personnel from the risks of trans-mission of the coronavirus (COVID-19).

The Head of Al Thumama Health Center at PHCC Dr Hanadi al-Hail, said in press statements that PHCC has developed a comprehensive plan for health centre patients that includes the presence of medical staff at the gates to take the pathological history of each patient and measure temperature and separate suspected cases by directing them to emergency department which prevents them from mixing with other patients, as well as organising waiting and reception areas and marking and tips for social distancing to ensure eve-ryone’s safety.

She explained that among the measures, medical consultations were activated remotely over the phone to communicate with patients in most services, such as family and speciality medicine clinics, dentistry, nutrition, psy-chological and health education, while the health centres continue to receive emergency cases. In addition, medicines are dispensed to patients through home delivery services in co-operation with Qatar Post, especially for the elderly who are more susceptible to the disease, in order to reduce the frequency of visitors to health centres for routine cases in order to preserve their safety and to reduce crowding and infection risks.

As for the precautions taken to protect the medical staff, Dr Hanadi al-Hail pointed out that the medical teams in health centres constantly wear medical face masks, wash hands and use sanitisers, while ensuring dis-tancing, especially since they are con-sidered models for patients.

On quarantine, Dr Hanadi explained that the quarantine is usually applied when an infectious disease spreads, whereby those who are exposed to infection are required to remain at home or in a place designated for

quarantine in order to prevent the spread of the disease to others and as an attempt to control disease conditions.

She added that during quarantine, people are followed up in terms of the appearance of any pathological symptoms such as high body temper-ature and others, while the quarantine period is determined based on the incu-bation period of the disease.

With regard to tests for COVID-19 virus, Dr Hanadi al-Hail said that the PHCC first assesses cases by a doctor, and in the event that a person is suspected to be infected, a patient's swab shall be made according to the protocol, where the results appear within 12 to 24 hours from the time of taking the samples, then a specialised team will inform the patient of the result and give the appropriate instructions in both cases, whether the result is negative or positive.

She called on all people, especially patients with chronic diseases, to see the doctor immediately when any sudden symptoms appear to them, as symptoms differ from one person to another, which is high body temper-ature or inflammation in the upper part

Public Health

TUESDAY 30 JUNE 2020

3

Public Health4

Public Health5

TUESDAY 30 JUNE 2020 TUESDAY 30 JUNE 2020

Pregnancy is a joyful event mixed with fear and stress and being prepared for a natural and healthy child birth is a real challenge for the new parents.

During the Antenatal Class sessions, parents are informed and educated about healthy and special life style, physical, breathing and yoga exercises, signs and symptoms of labor together with the right measures of a natural induction of labor, breastfeeding and baby care and breastfeeding and birth plan, according to Ms. Faten Jabnouni, a registered midwife, and Breastfeeding Counselor at Al-Ahli Hospital.

“During the Antenatal Class session, the physical presence of the midwife with the parents is important. The direct (Face to Face) contact during the sessions is the right way to convey the needful information. During this exceptional time of COVID-19 pandemic, many important measures were taken to ensure the safety of our guests,” said Ms. Faten.

The precautionary measures include, Ehteraz appli-cation should show green before each session, masks are mandatory during the whole session, and physical distancing of a minimum of 1.5 meters should be main-tained all times.

Ms. Faten, has more than 20 years of experience in the field of midwifery, she is also a birth doula and a certified breastfeeding counselor.

“Breastfeeding impacts positively on maternal and child survival, health, wellbeing and the environment.

Ongoing health emergencies such as COVID-19 pose challenges that affect infant feeding,” said Ms. Faten.

Some measures have been taken to encourage breastfeeding during this time.

This includes involving the father and other members of the family to sustain an exclusive breastfeeding, inform, educate and counsel the parents about the ben-efits (antibodies) of breastfeeding against COVID-19 and the measures of safety which should be maintained and educate mothers to continue breastfeeding while applying all the necessary precautions.

To mention, since the beginning of the COVID-19 pandemic, Al-Ahli Hospital has taken several strate-gical measures to ensure the safety of its guests and staff. Several precautionary measures complying with the guidelines of the World Health Organization (WHO) and Ministry of Public Health (MoPH) are in place to curb the spread of the COVID 19 virus in the community.

As part of the Al-Ahli Hospital’s heightened infection control measures, in response to limit the spread of COVID-19, a committee has been formed to implement strategical measures.

FAZEENA SALEEMTHE PENINSULA

Obstetrics and Gyne-cology Department at Al-Ahli Hospital has seen an increase in

number of women seeking for laparoscopic surgeries in the past year, due to the high standard of service and care provided.

“We have seen a significant increase in number of laparo-scopic surgeries in Al-Ahli Hos-pital. We serve our guests in the same standards as the world’s leading hospitals and almost all gynecological surgeries are done safely and successfully in our Obstetrics and Gynecology Department,” said Dr Derya Cirik, Consultant of Obstetrics and Gynecology at Al-Ahli Hospital.

“Guests at our hospital has access to safe gynecological surgery in any time they need. In case of any emergency, even in nights, our gynecological laparoscopy team are with them,” she added.

Clinics at Obstetrics and Gynecology Department are staffed with gynecologists, qual-ified and experienced in per-forming laparoscopical surgeries.

Laparoscopical surgery has several advantages compared to laparotomy (open surgery)

including small incision scars, decreased adhesion formation, less pain, quick recovery, shorter hospital stay and quick return to normal activities.

“One of the most common reason that we do laparoscopic surgery is gynecological emer-gencies. In case of ectopic preg-nancy (pregnancy outside uterus) and ruptured or tor-sioned ovarian cyst, we do urgent laparoscopy to stop bleeding in the abdomen and remove the ectopic pregnancy or revert the ovary to save the women’s life. And almost for all cases, one day after surgery we discharge them form hospital and let them go their home and meet with the loved ones,” said

Dr Derya. “Second common reason we

do laparoscopy is removal of ovarian cysts. It can be a huge cyst suspicions for malignancy or endometriosis that lead to pain or infertility. Nowadays, we can remove most of the ovarian cysts with laparoscopy without rupture by using advanced laparoscopical techniques and instruments,” said Dr Derya.

“With laparoscopy, we check if the tubes are open or working properly, remove the adhesions between the tube and the ovary to increase the chance for natural pregnancy, remove the ovarian cyst if it leads to severe pain or has any suspicion for malignancy. In case of infertility, we also use laparoscopical surgery to search if there is a problem that can interfere natural conceiving and if we detect a major malfunctioning tube, we might remove this tube to increase the success in IVF (in vitro fertilization: Artificial Reproductive Techniques),” said Dr Derya.

Another common use for laparoscopy is removal of fibroids or uterus (womb) itself. All over the world, one fourth of the ladies aged more than 35 years of age has fibroid. This fibroids are usually small and asymptomatic. But if the fibroids are big in size or originates from the inner lining of the uterus

(womb), they might cause heavy vaginal bleeding or pain. Like in most developed countries, we can also remove the big fibroids easily by laparoscopy in our hos-pital. But if the fibroids are mul-tiple and distorted the uterus so much, women might need to remove the uterus.

“Women with abnormal vaginal bleeding unresponsive to the medical treatment, endometrial hyperplasia (suspi-cious proliferation of the cells in the inner lining of uterus) or uterine prolapse (abnormal movable uterus) might be also treated with hysterectomy (removal of the uterus) done by laparoscopy. Removal of the uterus by laparoscopical approach is accepted as the best option for removal of the uterus and has many advantages over open surgery,” said Dr Derya.

Laparocopical surgery is also safe procedure during preg-nancy in case of any emergency. It is the preferred surgery to stop bleeding in the abdomen (batın) or remove any ovarian cysts or appendix.

According to Dr Derya, all fertile aged women need annual gynecological checkups but during especially amid COVID -19, most of them avoid this routine checkups and even sometimes ignored their gyne-cological symptoms. She empha-sized that it is very essential that

women stay cautious about any abnormal symptoms.

“In case of pregnancy or any new symptom like abnormal bleeding or pain or abnormal brownish discharge that are sus-picious for any gynecological malignancy, ladies should see their gynecologists. Emergency services are available 24 hour/7 days and our Obstetrics and Gynecology at Al-Ahli Hospital clinics are working with obeying the instructions of Ministry of Public Health.

At Al-Ahli Hospital, women are being reassured that they will still receive the highest level of care during the COVID-19 pan-

demic. Be pregnant or have a gynecology related condition such as fibroids, cysts or endometriosis, the Obstetrics and Gynecology Department at Al-Ahli Hos-pital provide services and utmost care.

Pregnant women experience changes in their bodies that may increase their risk of some infections. But it is not cur-rently known if pregnant women have a greater chance of getting sick from COVID-19 than the general public nor whether they are more likely to have serious illness as a result.

“Since the beginning of the pandemic, Al Ahli Hospital was a COVID-19 free hos-pital, which means we don’t treat people infected with the virus, or suspected to be infected, according to guidelines issued by the Ministry of Public Health,” Dr Mazen Bishtawi, Consultant Obste-trician and Gynecologist Head of Department at Al-Ahli Hospital.

He also said that it was evident that many pregnant women had chosen Al- Ahli Hospital service for antenatal services and delivery as the public hospitals were busy dealing COVID-19 patients.

“We had a significant increase in number of pregnant women seeking our services, as we are a COVID-19 free hos-pital, antenatal clinics continued to function for one on one consultation with implementing preventive measures,” said Dr Bishtawi.

He also said that pregnant women considered as vulnerable to COVID-19 because, if a pregnant woman get respi-ratory infection in the last three months of the pregnancy, it can cause them difficulties.

Pregnant women seeking services at the Al-Ahli Hospital are advised to follow their appointments at antenatal clinics.

“Pregnant women need to get the essential consultations and scanning done. At Al-Ahli Hospital we encourage pregnant women to attend their ante-natal clinic appointments, but we strongly advice to follow all COVID-19 preventive measures,” said Dr Bishtawi.

Although elective surgeries have been stopped at private hospitals, in case of pregnant women and those with gyne-cology related emergencies it will be con-

sidered as exceptional. “We have seen several women

coming to the Emergency Department with a serious gynecological condition. Therefore it was a necessary to take them for a surgery. We have conducted many such complexed surgeries in the recent weeks,” said Dr Bishtawi.

The Obstetrics and Gynecology Department is one of the busiest clinics in Al-Ahli Hospital which Offers services on a 24/7 basis. In normal conditions, the Obstetrics and Gynecology Department performs procedures at a rate of 7-8

deliveries per day and 100 gynecological surgeries per month.

With doctors holding post-graduate degrees, close antenatal supervision has been given high importance for the best outcome of pregnancy. To ensure the best condition of the expectant moms and their babies, an antenatal clinic is available for high-risk cases like diabetes with pregnancy, anemia, high blood pressure, previous pregnancy loss, pre-vious Caesarian section, multiple preg-nancies, breech presentation, growth restriction babies and premature labors.

Obstetrics and Gynecology Department at Al-Ahli Hospital sees rise in laparoscopic surgeries

Guests at our hospital has access to safe gynecological surgery in any time they need. In case of any emergency, even in nights, our gynecological laparoscopy team are with them

Since the beginning of the pandemic, Al-Ahli Hospital was a COVID-19-free hospital, which means we don’t treat people infected with the virus, or suspected to be infected, according to guidelines issued by the Ministry of Public Health.

We have seen a significant increase in number of laparoscopic surgeries in Al-Ahli Hospital. We serve our guests in the same standards as the world’s leading hospitals and almost all gynecological surgeries are done safely and successfully in our Obstetrics and Gynecology Department Safety of pregnant

women top priority at Al-Ahli Hospital

Women receiving highest level of care at Al-Ahli Hospital during COVID-19 pandemic

Dr Mazen Bishtawi, Consultant Obstetrician and Gynecologist Head of Department at Al-Ahli Hospital.

During the Antenatal Class session, the physical presence of the midwife with the parents is important. The direct (Face to Face) contact during the sessions is the right way to convey the needful information. During this exceptional time of COVID-19 pandemic, many important measures were taken to ensure the safety of our guests

Dr Derya Cirik, Consultant of Obstetrics and Gynecology at Al-Ahli Hospital.

Ms. Faten Jabnouni

Public Health

TUESDAY 30 JUNE 2020

6

Depression affects nearly one in six people at some point in their lives, so folk remedies and half-truths about this common illness abound. One such idea: Throw yourself into work and you'll feel

better. For a mild case of the blues, this may indeed help, but depression is a different animal. Overworking can actually be a sign of clinical depression, especially in men.

Myth: It's Not a Real IllnessDepression is a serious medical condition —

and the top cause of disability in American adults. But it's still confused with ordinary sadness. Bio-logical evidence of the illness comes from studies of genetics, hormones, nerve cell receptors, and brain functioning. Nerve circuits in brain areas that regulate mood appear to function abnor-mally in depression.

Fact: Men Fly Under the RadarA depressed man, his loved ones, and even

his doctor may not recognize depression. That's because men are less likely than women to talk about their feelings — and some depressed men don't appear sad or down. Instead, men may be irritable, angry, or restless. They may even lash out at others. Some men try to cope with depression through reckless behaviour, or drugs.

Myth: Depression Is Just Self-PityOur culture admires will power and mental

toughness and is quick to label anyone who falls back as a whiner. But people who have clinical depression are not lazy or simply feeling sorry for themselves. Nor can they "will" depression to go away. Depression is a medical illness — a health problem related to changes in the brain. Like other illnesses, it usually improves with appropriate treatment.

Fact: Anyone Can Get DepressedPoet or linebacker, shy or outgoing, anyone

from any ethnic background can develop depression. The illness is twice as common in women as in men, but it may be that women are more likely to seek help. It's often first noticed in the late teens or 20s, but an episode can develop at any age. Tough personal experiences can some-times trigger depression in people who are at risk for the illness. Or it may develop out of the blue.

Fact: It Can Sneak Up SlowlyDepression can creep up gradually, which

makes it harder to identify than a sudden illness. A bad day turns into a rut and you start skipping work, school, or social occasions. One type, called dys-thymia, can last for years as a chronic, low-level illness – a malaise that silently undermines your career and relationships. Or depression can become a severe, disabling condition. With treatment, many feel substantial relief in 4-6 weeks.

Myth: Help Means Drugs for LifeMedication is only one of the tools used to lift

depression. Asking for help doesn't necessarily mean your doctor will advise medications, although medicines can often be very helpful for significant forms of depression. Studies suggest, though, that "talk" therapy works as well as drugs for mild to moderate depression. Even if you do use antidepressants, it probably won’t be for life. Your doctor will help you determine the right time to stop your medication.

Myth: Depressed People Cry a LotNot always. Some people don't cry or even

act terribly sad when they're depressed. Instead they are emotionally "blank" and may feel worthless or useless. Even without dramatic symptoms, untreated depression prevents people

from living life to its fullest — and takes a toll on families.

Fact: Family History Is Not DestinyIf depression appears in your family tree,

you're more likely to get it too. But chances are you won't. People with a family history can watch for early symptoms of depression and take pos-itive action promptly — whether that means reducing stress, getting more exercise, counseling, or other professional treatment.

Myth: Depression Is Part of AgeingMost people navigate the challenges of ageing

without becoming depressed. But when it does occur, it may be overlooked. Older people may hide their sadness or have different, vague symptoms: food just doesn't taste good anymore, aches and pains worsen, or sleep patterns change. Medical problems can trigger depression in seniors — and depression can slow recovery from a heart attack or surgery.

Fact: Depression Imitates DementiaIn seniors, depression can be the root cause

of memory problems, confusion, and in some cases, delusions. Caregivers and doctors may mistake these problems for signs of dementia, or an age-related decline in memory. Getting treatment lifts the cloud for the majority of older people with depression. Psychotherapy can also be a useful part of treatment for older adults with depression who may be coping with loss, medical illnesses, or other life changes.

Myth: Talking Makes Things Worse

People were once advised not to "dwell on" problems by talking about them. Today, there's evidence that guided discussions with a profes-sional can make things much better. Different types of psychotherapy help treat depression by addressing negative thought patterns, uncon-scious feelings, or relationship troubles. The first step is to talk to a mental health professional.

Fact: Positive Thinking May HelpThe old advice to "accentuate the positive"

has advanced into a practice that can ease depression. It’s called cognitive behavioral therapy (CBT). People learn new ways of thinking and behaving. Distorted negative self-talk and behaviour is identified and replaced with more accurate and balanced ways of thinking about yourself and the world. Used alone or with med-ication, CBT works for many people.

Myth: Teens Are Unhappy by NatureAlthough many teens are moody, argumen-

tative, and intrigued by "the dark side", pro-longued sadness or irritability is not normal for teens. When unhappiness lasts more than two weeks, it may be a sign of depression — which develops in about one in 11 teens. Other signs a teen may need help include: being constantly sad or irritable even with friends, taking no pleasure in favourite activities, or a sudden drop in grades.

Fact: Exercise Is Good MedicineVery good studies now show that regular,

moderately intense exercise can improve symptoms of depression and work as well as some

medicines for people with mild to moderate depression. Exercising with a group or a good friend adds social support, another mood booster.

Myth: Depression Is Tough to TreatThe reality is most people who take action to

lift their depression do get better. In a large study by the National Institute of Mental Health, 70% of people became symptom-free through med-ications — though not always with the first med-icine. Studies show that the best treatment is often a combination of medication and talk therapy.

Fact: It's Not Always DepressionSome life events cause sadness or disap-

pointment, but do not become clinical depression. Grief is normal after a death, divorce, loss of a job, or diagnosis with a serious health problem. One clue of a need for treatment: the sadness is constant every day, most of the day. When people are weathering difficult times appropriately, they can usually be distracted or cheered up for short periods of time.

Fact: Hope for Better Days Is RealIn the depths of depression, people may think

there's no hope for a better life. This hopelessness is part of the illness, not a reality. With treatment, positive thinking gradually replaces negative thoughts. Sleep and appetite improve as the depressed mood lifts. And people who've seen a counselor for talk therapy are equipped with better coping skills to deal with the stresses in life that can get you down.

www.medicinenet.com

Vitamin D is a fat-soluble vitamin that regulates the absorption of calcium and phos-phorus as well as facil-itates normal immune

system function. This vitamin is an essential nutrient important for strong bones. Vitamin D has 2 forms: D2 (obtained from foods you eat) and D3 (obtained from sun exposure). Vitamin D is produced by the body when your skin is exposed to sunlight. You can also get vitamin D through certain foods and supplements. It's important to get enough of this vital nutrient so you don't end up with a vitamin D deficiency.

Vitamin D can boost your immune system, support muscle function, keep your heart healthy, and aid in brain development. Vitamin D may also reduce your risk of multiple sclerosis and depression.

VITAMIN D BOOSTS BONE HEALTH: Your body needs vitamin D to help absorb the calcium and phos-phorus in your diet that makes for strong bones. Vitamin D deficiency can cause bone loss, low bone density, and increase your chances of breaking bones. Vitamin D deficiency can also cause rickets in children and a con-dition called osteomalacia in adults. Symptoms may include weakness and bone pain.

VITAMIN D AND DIABETES: Type 2 diabetes is a condition in which the body does not use insulin properly and blood sugar levels can rise above normal. Researchers are looking into whether vitamin D can help regulate blood sugar levels. In addition, vitamin D helps with the absorption of calcium, and calcium helps manage sugar in the blood. Studies have found people with vitamin D deficiency have a higher risk of developing type 2

diabetes later in life, but the link is not conclusive.

VITAMIN D AND WEIGHT LOSS: Obesity is a risk factor for low vitamin D levels because the more weight you carry, the more vitamin D your body requires. Studies have also shown vitamin D deficiency may increase your risk of becoming obese later in life. One small study found women with low levels of vitamin D might be more prone to gain weight. Vitamin D

and calcium may act as an appetite suppressant as well.

VITAMIN D DEFICIENCY AND DEPRESSION: There may be an asso-ciation between low levels of vitamin D and depression, but studies show mixed results and further research is needed. Vitamin D receptors in the brain have been linked to the devel-opment of depression. Vitamin D itself may not ward off depression, but patients who are taking

antidepressants along with vitamin D may help reduce symptoms of depression.

SUNLIGHT AND VITAMIN D: The easiest way to get vitamin D is by exposing your skin to direct sun-light, specifically, ultraviolet B (UVB) rays. The more you expose your skin, the more vitamin D your body pro-duces. The darker your skin, the more time you need in the sun to produce vitamin D.

VITAMIN D FOODS: Generally, sun exposure is the best way to get the vitamin D your body needs. Most foods that contain vitamin D only contain small amounts and won't give you the total amount your body needs. Foods high in Vitamin D are fatty fish such as salmon or mackerel, beef liver, egg yolks, milk, orange juice fortified with vitamin D, for-tified cereals and infant formulas

VITAMIN D SUPPLEMENTS: If you don't get enough sun exposure, food is unlikely to give you the amount of vitamin D your body needs. In this case, your doctor may recommend you take vitamin D supplements. There are two forms of vitamin D: D2 (ergocal-ciferol), found in food, and D3 (chole-calciferol), produced by your body from exposure to sunlight. Most over-the-counter vitamin D supplements contain vitamin D3, which is not usually vegetarian. If you have con-cerns about this, your doctor may pre-scribe vitamin D2 supplements.

VITAMIN D DEFICIENCY: People may be at risk for vitamin D deficiency if they dislike the sun, suffer from milk allergies, or stick to a vegan diet. People with dark skin may also be at risk for developing vitamin D deficiency. This is because the pigment melanin reduces their skin’s ability to make vitamin D after sun exposure.

VITAMIN D DEFICIENCY SYMPTOMS: Vitamin D deficiency symptoms may be very general. You might have aches, pains and fatigue or you may have no symptoms at all. If your vitamin D deficiency is severe, you may suffer from bone pain and reduced mobility. In adults, severe vitamin D deficiency is called osteomalacia, and in children a severe deficiency can lead to softening and weakening of bones. www.medicinenet.com

Depression: Some myths and facts

Vitamin D: Is it a wonder pill?

Public Health

TUESDAY 30 JUNE 2020

7

The kidneys are two organs located on either side in the back of the abdominal cavity. The kidney has many roles. An essential job of the kidney is to reg-

ulate the body's fluid balance. It does this by adjusting the amount of urine that is excreted on a daily basis. On hot days, the body sweats more. Thus, less water needs to be excreted through the kidneys. On cold days, the body sweats less. Thus, urine output needs to be greater in order to maintain the proper balance within the body. It is the kid-ney's job to regulate fluid balance by adjusting urine output.

Another major duty of the kidney is to remove the waste products that the body produces throughout the day. As the body functions, cells use energy. The operation of the cells produces waste products that must be removed from the body. When these waste products are not removed adequately, they build up in the body.

An elevation of waste products, as measured in the blood, is called "azo-temia". When waste products accu-mulate they cause a sick feeling throughout the body called "uremia", which is due to urea and other nitrog-enous waste compounds.

When the kidneys fail to filter the blood effectively, and fluid and waste products build up in the body to a critical level a person may need to start dialysis. The two main causes of kidney failure and need for dialysis treatment are diabetes and high blood pressure.

When a person’s levels of waste products in their body become so high they start to become sick from them, he or she may need dialysis. The level of the waste products usually builds up slowly. Doctors that specialize in diseases and conditions of the kidneys are called nephrologists.

To help nephrologists decide when dialysis is necessary for a patient, he or she will order tests that measure several blood chemical levels in the patient’s body. The two major blood chemical levels that are measured are the "creatinine level" and the "blood urea nitrogen" (BUN) level. As these two levels rise, they are indicators of the decreasing ability of the kidneys to cleanse the body of waste products.

Doctors use a urine test, the "cre-atinine clearance", to measure the level of kidney function. The patient saves urine in a special container for one full day. The waste products in the urine and in the blood are estimated by measuring the creatinine.

By comparing the blood and urine level of this substance, the doctor has an accurate idea of how well the kidneys are working. This result is called the creatinine clearance. Usually, when the creatinine clearance falls to 1 below 10 cc/minute, the patient needs dialysis.

The doctor also uses other indi-cators of the patient's status to decide about the need for dialysis. If the patient is experiencing a major ina-bility to rid the body of excess water, or is complaining of problems with the heart, lungs, or stomach, or difficulties with taste or sensation in their legs, dialysis may be indicated even though the creatinine clearance has not fallen to the 10 cc/minute level.

Types of dialysis

There are two main types of dialysis, hemodialysis and peritoneal dialysis.

How hemodialysis works

Hemodialysis uses an external machine and a special type of filter to remove excess waste products and water from the blood.

During hemodialysis, blood passes from the patient's body to the dialysis machine through sterile tubing and into a filter, called a dialysis membrane. For this procedure, the patient has a spe-cialized vascular tube placed between an artery and a vein in the arm or leg (called a gortex graft). Sometimes, a direct connection is made between an artery and a vein in the arm. This pro-cedure is called a Cimino fistula. Needles are then placed in the graft or fistula, and blood passes to the dialysis machine, through the filter, and back to the patient. If the patient requires dialysis before a graft or a fistula is placed, a large diameter catheter (hemodialysis catheter) is placed directly into a large vein in the neck or leg in order to perform dialysis. In the dialysis machine, a solution on the other side of the filter receives the waste products from the patient.

How peritoneal dialysis worksPeritoneal dialysis uses a fluid that

is placed into the patient's abdominal cavity through a plastic tube (peri-toneal dialysis catheter) to remove excess waste products and fluid from the body.

Peritoneal dialysis uses the patients own body tissues inside of the belly (abdominal cavity) to act as the filter. The abdominal cavity is lined with a special membrane called the peritoneal membrane. A plastic tube called a peri-toneal dialysis catheter is placed through the abdominal wall into the abdominal cavity. A special fluid called dialysate is then flushed into the abdominal cavity and washes around the intestines. The peritoneal membrane acts as a filter between this fluid and the blood stream. By using different types of solutions, waste products and excess water can be removed from the body through this process.

Where do I get treatment?

How long does it take?

HEMODIALYSIS: Treatment for hemodialysis usually takes place in a hemodialysis unit. This is a special building that is equipped with machines that perform the dialysis treatment. The dialysis unit is also the place where patients can receive dietary counseling and help with social needs.

Patients generally go to the dialysis unit three times a week for treatment. For example, the schedule is either Monday, Wednesday, and Friday or Tuesday, Thursday, and Saturday. Before treatment, patients weigh them-selves so that excess fluid accumulated since the last dialysis session can be measured. Patients then go to assigned chairs that are like lounge chairs.

The area of the graft or fistula (the connection between the artery and vein), is cleaned thoroughly. Two needles are then inserted into the graft or fistula. One takes the blood to the machine where it is cleaned. The other needle allows blood that is returning to the patient to go back into the patient's body.

Treatments last from 2 ½ to 4 ½

hours. During this time, the dialysis staff checks the patient's blood pressure frequently and adjusts the dialysis machine to ensure that the proper amount of fluid is being removed from the patients body. Patients can read, watch television, sleep, or do other work during treatment. On occasion, patients who are very moti-vated may be able to perform dialysis themselves at home in a process called home hemodialysis.

PERITONEAL DIALYSIS: Peri-toneal dialysis requires the patient to play a more active role in their dialysis treatment. Of primary importance is the patient's responsibility for maintaining a clean surface on the abdomen and catheter, where treatment is adminis-tered, in order to prevent infection.

During this process, the patient weighs herself/himself to determine the strength of fluid to be used. The patient then puts on a mask and cleans the peritoneal catheter site. Fluid that has been allowed to stay in the peri-toneal cavity while the peritoneal membrane filters waste into the fluid. The fluid and waste are is then drained back into the plastic bag that originally

contained the fluid. The patient then disconnects this bag containing waste in the fluid and connects a new bag of solution that is allowed to drain into the peritoneal cavity. Once the fluid is in the body, the new bag is rolled up and placed in the patient's underwear until the next treatment. This pro-cedure usually takes 30 minutes to accomplish and must be done four to five times a day.

As an alternative to this treatment, some patients on peritoneal dialysis use a machine called a "cycler". This cycler is used every night. Five to six bags of dialysis fluid are used on the cycler and the machine automatically changes the fluid while the patient sleeps.

What are the advantages

of the different types of

dialysis?Each of the two types of dialysis,

hemodialysis and peritoneal dialysis, has advantages and disadvantages. It is up to the patient and their kidney doctor to decide which of these procedures is best by considering her/his life style, other medical conditions, support systems, and how much responsibility and participation in the treatment program he/she desires.

The patient must realize that because of their specific medical condition, they may not be a candidate for one or the other type of dialysis. Each patient must view the two types of dialysis procedures from her/his own perspective.

Regardless of which type of dialysis is chosen, patients have certain respon-sibilities such as following a diet program, watching their fluid intake, taking special vitamins, and other med-icines to control blood pressure and calcium and phosphorus balance.

For many patients, the major advantage of hemodialysis is minimal participation in the treatment. However, patients are required to adhere to a specific schedule and travel to the dialysis unit three times a week. Hemodialysis also requires stricter diet control and fluid control than peri-toneal dialysis.

For those patients preferring more independence, peritoneal dialysis allows for more flexible scheduling and can be performed at home. The patient must undergo a certain amount of dialysis each day, but can alter the exact timing of the dialysis procedure.

A major problem with peritoneal dialysis is infection. The patient has a plastic tube that goes from the peritoneal cavity to the outside of the body and this is a potential site for the entry of bac-teria into the body. Great emphasis is placed on cleanliness and technique during the training sessions.

What is the life expectancy

for someone on dialysis?

The expected lifespan of a patient receiving dialysis is dependent on many factors such as: age of patient, quality of dialysis treatment, other medical issues in the patient (comorbidities), quality of pre-dialysis treatment, control of potassium levels, and overall com-pliance of the patient. Some patients do dialysis as a bridge (time to locate an appropriate donor kidney) to getting a kidney transplant (renal transplant). If a patient is successful in getting a trans-plant and is able to stop dialysis, their survival prognosis increases greatly.

www.medicinenet.com

The kidneys maintain the blood creatinine in a normal range. Creatinine has been found to be a fairly reliable indicator of kidney function. Elevated

creatinine level signifies impaired kidney function or kidney disease.

As the kidneys become impaired for any reason, the creatinine level in the blood will rise due to poor clearance of creatinine by the kidneys. Abnormally high levels of creatinine thus warn of possible malfunction or failure of the kidneys. It is for this reason that standard blood tests rou-tinely check the amount of creatinine in the blood.

A more precise measure of the kidney function can be estimated by calculating how much creatinine is cleared from the body by the kidneys. This is referred to as creatinine clearance and it estimates the rate of filtration by kidneys (glomerular fil-tration rate, or GFR).

The creatinine clearance can be measured in two ways. It can be

calculated (estimated) by a formula using serum (blood) creatinine level, patient's weight, and age. The formula is 140 minus the patient's age in years times their weight in kilograms (times 0.85 for women), divided by 72 times the serum creatinine level in mg/dL.

Creatinine clearance can also be more directly measured by collecting a 24-hour urine sample and then drawing a blood sample. The creat-inine levels in both urine and blood are determined and compared. Normal creatinine clearance for healthy women is 88-128 mL/min. and 97 to 137 mL/min. in males (normal levels may vary slightly between labs).

Blood urea nitrogen (BUN) level is another indicator of kidney function. Urea is also a metabolic byproduct which can build up if kidney function is impaired. The BUN-to-creatinine ratio generally provides more precise information about kidney function and its possible underlying cause com-pared with creatinine level alone. BUN also increases with dehydration.

Recently, elevated creatinine levels

in infants were associated with bac-teremia while elevated levels in adult males have been linked to incresed risk of prostate cancer.

What are normal blood creatinine levels?

Normal levels of creatinine in the blood are approximately 0.6 to 1.2 mil-ligrams (mg) per deciliter (dL) in adult males and 0.5 to 1.1 milligrams per deciliter in adult females. (In the metric system, a milligram is a unit of weight equal to one-thousandth of a gram, and a deciliter is a unit of volume equal to one-tenth of a liter.)

What are the symptoms associated with highcreatinine levels?

The symptoms of kidney dys-function (renal insufficiency) vary widely. They generally do not correlate with the level of creatinine in the blood.

Some people may have an

incidental finding of severe kidney disease and elevated creatinine on routine blood work without having any symptoms.

In others, depending on the cause of the problem, different symptoms of kidney failure may be present including: feeling dehydrated, fatigue, swelling (edema), shortness of breath, confusion, or many other nonspecific symptoms (for example, nausea, vom-iting, neuropathy, and dry skin). Dia-betes and and high blood pressure are the most common causes of long-standing chronic kidney disease.

What causes elevated (high) creatinine levelsin the blood?

Any condition that impairs the function of the kidneys is likely to raise the creatinine level in the blood. It is important to recognize whether the process leading to kidney dysfunction (kidney failure, azotemia) is long-standing or recent. Recent elevations may be more easily treated and reversed.

The most common causes of long-standing (chronic) kidney disease in adults are high blood pressure and

diabetes. Other causes of elevated blood creatinine levels are: Certain drugs can sometimes cause abnor-mally elevated creatinine levels.

Serum creatinine can also tran-siently increase after ingestion of a large amount of dietary meat; thus,nutrition can sometimes play a role in creatinine measurement. Kidney infections, abnormal muscle breakdown and urinary tract obstruction may also elevate creatinine levels.

Who has low or high blood creatinine levels?

Muscular young or middle-aged adults may have more creatinine in their blood than the norm for the general population. Elderly persons may have less creatinine in their blood than the norm. Infants have normal levels of about 0.2 or more, depending on their muscle development. In people with malnutrition, severe weight loss, and long standing ill-nesses, the muscle mass tends to diminish over time and, therefore, their creatinine level may be lower than expected for their age.

www.medicinenet.com

Why are blood creatinine levels checked?

Dialysis: When do patients require it

Public Health

TUESDAY 30 JUNE 2020

8

Our brains change as we age. There’s a bit of good news and a bit of bad news for ageing adults when it comes to mental work. Let’s

start with the bad. After your 30s, your ability to process information usually declines. So does your capacity to remember things. Maybe there’s some truth to the old saying that “the first thing to go is your memory”. Your brain also becomes more “set” as you age, particularly after age 70, making it harder to produce novel ideas. If all of this seems depressing, keep in mind that for a healthy adult, these changes are small on average.

There is an upside to ageing, however, when it comes to your brain. Older people get better and better at a variety of tasks that psychologists lump into a category called crystallized intel-ligence. Crystallized intelligence refers to the accumulation of knowledge, skills, and abilities that have been prac-ticed again and again. Your vocabulary resists decline, and continues to improve at least through middle age. Other well-practiced skills such as arithmetic improve through middle age as well, and are also unlikely to decline as you grow older.

Taste changesThe way you taste your food can

change as you age. Why? It could be medications. Another culprit is illness. Respiratory diseases, allergies, and gum disease can affect your sense of taste and that other sense so crucial to the way food tastes — smell. So as the way food tastes changes for you, you may find yourself changing your diet accordingly.

This can be good news if you choose to flavour your food with more herbs and spices. But it could also be a problem if you find yourself reaching for the salt shaker time after time. High sodium has been linked with a greater risk of cardi-ovascular problems, so finding healthier ways to intensify the flavours you enjoy could improve your health.

Hair pops up in new placesAgeing means finding hairs in new

places around your body. This happens to both men and women, but it impacts both genders differently. This is because the changes are largely affected by hormones. For men, nose and ear hair start to become more sen-sitive to testosterone. These follicles are already there, but testosterone causes these hairs to become longer and more coarse.

So while they may have been more or less invisible before, at a certain age you will likely find them standing out in ways they never had before. To the disappointment of many men, the same isn’t true of the hair on the scalp, which tend to get smaller and grow less fre-quently, which explains male pattern baldness.

Hormonal changes in women can sometimes lead to a growth in facial hair. As women near menopause, their bodies produce less estrogen. That means testosterone holds greater sway. And it’s this new balance of hormones

that can cause the hair on your face to grow coarser and darker.

Sleep changes and ageingIf you never thought of yourself as

a morning person, that could change as you grow older. Older adults typi-cally find their sleep habits change in several ways, and one of these is a ten-dency to rise earlier.

As you age, you may sleep the same number of hours, or see that time slightly decrease. But you may also spend more time in bed, as seniors tend to have more trouble falling asleep and may wake up more often in the middle of the night — three to four times a night on average. You also dream less as you age, as less of your sleep time is devoted to REM sleep. The combi-nation of these factors could make you feel like you’ve had less sleep, even if your total sleep time hasn’t changed.

When It's Unhealthy: Not all sleep changes are healthy or normal. Chronic pain can intensify the tendency to sleep lighter and wake up more frequently. Medications can keep you up at night, too. Problems can also come from depression (which is more common in seniors), frequent urination, and various diseases such as heart failure. As older people tend to be less active, this can affect sleep too — exercise helps when it comes to getting a full night’s sleep.

What seniors can do about sleep problems

Sleep problems are frustrating at any age, but even if you’re an older adult there are ways to relieve many of these problems. Here are some tips:

� Do not nap.� Keep a regular sleep schedule,

and avoid deviations.� When you find you can’t sleep,

get out of bed and find a quiet activity to keep you occupied until you feel more tired. Reserve bedtime for sleep.

� Cut caffeine and other stimulants from your afternoons.

� Don’t eat too big a meal before bed, which can make it harder to sleep.

� Get some exercise earlier in the day. Many senior-friendly exercises are available. If you’re not sure how to put together a workout routine, discuss the matter with your doctor.

Many people who are frustrated by sleep problems will turn to sleeping pills. While these can occasionally offer some of the rest you need, avoid relying on them. Sleeping pills can be habit-forming, and they can make sleep problems worse if they aren’t used properly. If you feel you need sleeping pills, discuss them with a doctor who can guide you to pills that are safer, and give you tips on the proper way to take them.

Seniors and migrainesDo you suffer from migraines?

These distracting and typically painful headaches can ruin a good day. But there’s a bright spot for migraine-suf-ferers after their 60s — you may be one of the lucky ones who experiences fewer headaches with age. One study found that for seniors, migraines are less

frequent, less intense, and less likely to induce nausea and vomiting.

For some, they seem to disappear completely. It’s possible that the same number of seniors still get migraines technically, but because those head-aches are milder, they get diagnosed as tension headaches. While many migraine symptoms become less likely, some symptoms become more common as you age, such as dry mouth, paleness, and loss of appetite.

Love what you do

Many think a carefree, easy-going attitude will help sustain them to a ripe, old age. But a major survey studied 1,500 people, throughout their lives, to learn what leads to a healthier, longer life. Some of the results were surprising. For instance, having a relaxed attitude toward work was associated with an earlier grave, while those who were most dedicated to their jobs lived longer. The study, which began in 1921, had other surprises as well. Researchers observed that opti-mistic children more prone to joking lived shorter lives than their more serious, but persistent, peers. It also found that married men lived much longer on average than divorced men, but divorced women lived about as long as their married counterparts.

Falling and fear itselfFalls are scary things. More than a

quarter of all Americans over age 65 fall each year, and each fall has roughly a one-in-five chance of causing serious injury. These include head injuries and broken bones.

It’s easy to become scared of falling, whether you’ve ever experienced a bad fall or not. But fear of falling actually makes people more vulnerable to falls. Why? It makes sense when you stop to think about it: A person who is afraid of falling is likely to be more timid and cautious about physical activity. Because fear of falling can limit your physical activity, it can also make you weaker. And weaker people are more prone to fall.

In other words, it’s sensible to be cautious about falls, but letting a fear

of falls slow you down has conse-quences, too. Here are some fear-free ways to reduce your risk:

� Visit your eye doctor. Regular eye exams ensure you’re getting the right eyeglass prescription, which can help keep you more stable while walking. If you have bifocals, you might want to ask for a pair of glasses to use strictly for seeing at a distance.

� Stay active. Maintain an exercise routine that focuses on leg strength and balance. These two factors can help you stay steady on the ground.

� Talk to your doctor. Ask how much of a risk falling poses to you. Find out if any of your medications contribute to sleepiness or dizziness. Make sure you’re getting the right amount of vitamin D — both too little and too much vitamin D have been linked to a higher risk of falling.

Make your home safer from falls. Keep your floors free of clutter. Make sure all stairs have handrails on both sides. Add more or brighter lights inside your home to make sure you can see clearly as you move around. Have grab bars installed in the bathroom for both the tub and toilet

Self confidenceThroughout our lives our self-

confidence continues to increase until we hit retirement age. At this point many see a swift, sharp drop in con-fidence. Experts debate the reasons for this. Some say it’s because retirement threatens the stability of our working life. Others suggest that by leaving the workforce, retired seniors may feel that they aren’t con-tributing to family and society as they once did.

Not everyone is affected by retirement in the same way. The study these findings are based on found that wealth and good health seem to protect against the self-confidence dip in retirement. When people enjoy relationships that are supportive and satisfying, this also leads to better self-esteem than average over time. But even people in good relationships experience a similar dip after retirement.

Living with less stressStress poses serious consequences,

whether it’s from work (or a lack of work), family pressures, bad habits, or nearly anything else. Higher levels of stress make your body less capable of fighting off illness, and it’s been connected with heart disease and other health problems that could lead to a shorter, less healthy life. That being the case, seniors have cause for celebration when it comes to stress: A major stress survey in America keeps showing that older generations live with less stress than younger people.

While a few more birthdays may put us at greater ease in life, those of us who do have intense or chronic stress may have fewer birthdays to look forward to. Studies have shown that high levels of stress can age your body’s cells prematurely, and that can lead to an earlier death.

Age and heightDo you know how tall you are? Are

you sure? Researchers asked more than 8,500 women over 60 their height, and then measured. On average the women overestimated their height by an inch, and had become two inches shorter than their highest recorded height. Almost everyone shrinks as they age. The reason has to do with your spine. The cushion surrounding your spine dehydrates as you age. The spine can also curve or collapse, which can lead to stooping, and even the arches of your feet may flatten, causing a shorter stature. Every decade after age 40, the average person loses ½ an inch in height. This speeds up after age 70.

There are ways to slow this process down, though. Eating a healthier diet helps. Specifically, eating a diet filled with fruits, vegetables, whole grains, and not too much healthy fat has been associated with less shrinking as you age. Avoiding tobacco and limiting drinks helps, too, as does getting plenty of exercise on a regular basis.

Happiness and ageingThink getting older is all doom and

gloom? Nonsense! Older people report being happier than the young. And that’s true despite any age-related dis-abilities or other health concerns. What’s more, that may be more and more true every year, as rates of depression among the elderly have declined for about a decade.

This is based on a survey of about 1,500 people ages 21 to 99. It suggests as we get older, we may indeed become wiser. Mental health seems to improve as you continue to meet the many demands and surprises life throws your way. So if you are one of the many people who fear the advancement of time, cheer up — life gets better with age.

Fewer coldsIf you hate sniffling, sneezing, and

coughing, pay attention. Older people are better protected against colds than the young. Your body remembers every cold virus you ever had to fight off — and there are more than 200 out there. When you encounter the same virus again, your body’s infection fighters — known as T cells — are primed and ready to stop a familiar infection before it starts.

Studies show this immunity super-power is strongest from your 40s to your early 70s. However after a certain point your body’s immune system has a harder time keeping up, and you may become more susceptible to colds once again. That can be tough, because these colds tend to hang on longer and wreak more havoc as you age.

Less sensitive teethIf you’re someone who winces at

the thought of ice water, you may be delighted to learn that as you age, your teeth become less sensitive. The reason for this involves dentin, the hard, inner tissue of teeth. When you’re young, you have less dentin built up in your teeth with more microscopic cracks. We’ve known about this since the 1930s, but are only beginning to understand why teeth age the way they do. It seems the buildup of dentin, which fills in the tiny cracks and helps prevent tooth pain, does come with a side effect. It results in older teeth being more vulnerable to cracking.

Less sweatingOlder people sweat less. That’s

because sweat glands shrink as you age, and they become less sensitive as well. This is particularly true for women, who sweat less than men to begin with. Though it’s nice to stay dry, there are a couple of health implica-tions to consider along with this. For one, the sweat ducts play an important role in delivering fresh cells to the skin to repair wounds, and this effect is hampered as you age. For another, sweating keeps us cool, so older people should be especially vigilant against heat exhaustion.

Older adults have a surprising superpower when it comes to memory, and it seems to relate to their ability to focus their attention — or rather, their inability to do so. Studies have found that older people are more easily dis-tracted by irrelevant information. While this may cause some problems with mental tasks, there’s an upside. Because older adults are less likely to filter out information that seems useless at first glance, they retain that information more easily than younger adults. It means older adults remember more associations between things than younger folks. And that has consequences that can improve decision-making.

www.medicinenet.com

Ageing: The surprises of

getting older

Stress poses serious consequences, whether it’s from work (or a lack of work), family pressures, bad habits, or nearly anything else. Higher levels of stress make your body less capable of fighting off illness, and it’s been connected with heart disease and other health problems that could lead to a shorter, less healthy life.