Pharmacy News

These are congenital defects (defects present at birth). During development of the foetus, there is incomplete closure of the lip or the roof of the mouth, forming an open cleft. Each can occur separately, but they often occur together, sometimes in association with other malformations. Usually only soft tissues are affected, but occasionally bone can be involved, causing deformity of the nose as well. Cleft lip alone is more common, occurring in about 1 out of every 1000 births; cleft palate occurs in about 1 out of every 2500 births.

Cause

The exact cause is unknown. Genetic influences are believed to be largely responsible.

Clinical features

The defect varies in severity, from a small notch in the upper lip, to a gaping defect of the lip and palate, and sometimes the nose. Aside from the obvious appearance of the lips and mouth, a baby with cleft lip and/or cleft palate will have significant difficulty with feeding. This is because they find it difficult or impossible to suck, even though they have no problems with swallowing. They are usually otherwise very normal children.

Treatment

Initially the baby is fed with a special spout or elongated teat that delivers milk to the back of the throat. Surgery is always necessary, and the type and extent depends on the degree of deformity. The lip is usually repaired at 2-3 months of age, and the palate at around 1 year, before the baby starts to speak. Occasionally minor corrections are made before the child starts school. The cosmetic results with cleft lip alone are usually excellent. Speech therapy can help enormously in correcting nasal-sounding speech in the case of a cleft palate. Regular follow-up with your doctor is essential, as these children are more prone to develop ear infections and subsequent problems. Specialised dental care may also be necessary.

Prevention

Cleft lip and palate cannot be prevented.

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Most premature babies require specialised care, usually within a newborn intensive care nursery, for up to several weeks after birth. The baby is nursed in a humidicrib and, depending on his condition, may require oxygen, intravenous infusion, tube feeding and careful monitoring. If your baby does need intensive care, your doctor will explain exactly what is going on.

Most premature babies have an excellent outcome. The smaller the baby and the more premature or ill he is around the time of birth, the higher the risks of him developing problems later. Careful follow-up is necessary until the child starts school. All neonatal intensive care units have follow-up programs for premature babies.

Having a premature baby can be very stressful for parents. Mixed with the joy of having a new child comes the fear of whether or not he will be all right. Seeing your newborn in a humidicrib, hooked up to tubes, can be a distressing experience.

Mothers who have had a Caesarian section may find it especially difficult to move around and visit their baby initially. It is important for parents to spend as much time as possible with their newborn, in order not to feel too distant from him. Talk to staff, who are experienced in these matters. They are generally sympathetic and encourage you to be involved in what is going on, and to touch your child as much as is practicable. Make sure that the staff do not overlook the central role you as parents play in the care of your child.

Treatment of premature babies is often a highly complex and specialised field, and you may at times feel overwhelmed by all the technology surrounding you and your baby. This is understandable, but remember also that there are human beings behind all this sophisticated gadgetry, and they are there to talk to you if you reach out to them also.

Apnoea is the term used when a newborn baby stops breathing for a short period of time, usually for more than 20 seconds. The baby may turn blue (cyanosis), and go limp, but usually starts breathing again as soon as he is stimulated by touch.

Apnoea occurs usually within the first 10 days and more often in premature babies. It is due to immaturity of the centre in the brain that controls breathing. Babies born at less than 34 weeks gestation are at risk of having at least one apnoeic spell within the first two weeks of life, and therefore require careful monitoring in a special care nursery.

Apnoeic attacks can also occur in babies who have a heart or lung problem, or who have an infection. Once the underlying condition is treated, the apnoeic attacks usually stop.

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“I am deathly afraid that he is having an affair. He just doesn’t want that much sex anymore. Is he?”

ANSWER: Frequency of and interest in sex is not a symptom. It does not “mean” anything if medical problems are ruled out. It is a means of sharing and expression that stands in and of itself. Looking for outside affairs only avoids the real issue of strengthening the marriage. Even if an affair were taking place, the issue would still be to strengthen the intimacy of the marital relationship. To enhance the intimacy of your relationship, particularly at times of outside stress on the relationship, devote for a period of time almost all of your mental and emotional energy to this, relationship and suspend other relationships, even friendships and family ties. This doesn’t mean give them up; it means announcing that for a few weeks you are giving your full attention to your marriage. After that, you will be back in all relationships you value, even more ready to be close to others because of your new trust in the closeness of your marriage. I have found that there is little interest in returning to relationships that are only approximations of what super marital sex can be. If after these few weeks there is still a trust problem or other difficulties, look inside, at the marriage, for the cause, not outside at other factors.

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Even if you do not plan to change anything else in your diet, for social, business or other reasons, improve the quality of the water you drink. Drink at least 2 or 3 litres of it every day.

The latest research indicates, that it is not only the purity of water that is important, but also its molecular structure. To be particular, a 20 molecule liquid crystal water structure, first predicted by a Nobel Prize laureate Linus Pauling in his famous book The Hydrogen Bond seems to be very important. Such structures are formed by a phenomenon known as “hydrophobic hydration” and cause changes in the surface tension, heat capacity and other properties of the water. Water liquid crystals occur naturally in some spring water high in the mountains, and are also formed in the water inside living cells. Water impurities practically eliminate any trace of water liquid crystals.

Note, that nearly every civilisation in the past had tales, related to “living water”, which was to be found only in inaccessible locations high in the mountains. In view of the current scientific research (Flanagans) it is quite possible, that such tales were based on real experiences.

Seek fresh air as much as possible. Even if you live in the city, and you are forced to breathe polluted air, make an effort to go to the country, forest or at least to a park as often as possible. Trees and other plants purify the air for us there. Use an ozone generating lamp to purify the air in your home, if the air outside is worse than inside. You can leave the lamp on when you are away.

With regard to other ingredients of the diet, again there is remarkable agreement found in wisdom of many civilisations. They all agree, that we should eat PURE FRESH FOOD. Note for example, that “kosher” means “pure” in Hebrew. (Be careful here: the modern definition of “kosher” food should be carefully examined, because it most likely has lost its exact meaning over the centuries, similarly to fasting in other cultures)

Again, the emphasis should be on purity. The best foods from such a point of view are fresh fruits and vegetables. Even if grown in quite polluted environment, fruits accumulate very little pollutants- They are created from simple inorganic compounds with the aid of photosynthesis. Their content is mostly water.

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In the condition known as hiatus hernia, there is reflux of the acid contents of the stomach up into the lower part of the gullet and this may produce indigestion.

If this symptom of indigestion is of recent onset then it may be safely treated without further investigation. If it is severe or persistent or recurrent, then it is necessary to investigate the person further to determine if a condition such as an ulcer is present.

Usually an X-ray is necessary and the stomach can be outlined in the procedure known as barium meal X-ray where a radio opaque salt of barium outlines the hollow organ of the stomach and can reveal abnormalities in its structure.

Sometimes, to differentiate the symptoms from the stomach or gallbladder, it is necessary to carry out an X-ray procedure on the gallbladder. Here a radio opaque dye containing an iodine salt is taken. This substance passes through the liver into the bile and so outlines the gallbladder.

There are available many proprietary preparations which patients can obtain directly from the chemist without a doctor’s prescription … all designed to relieve indigestion. These usually work well.

As well, attention to the diet is helpful. The taking of small meals frequently rather than large meals infrequently so that there is always some food in the stomach to neutralise the acid is most helpful.

Antacid mixtures, tablets or powders all can give relief.

Prevention, of course, is usually better than cure and if one is certain of the cause of indigestion, such as over-indulgence, then a little more prudence next time may prevent the development of this disorder.

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Penicillin was first isolated from a mould by Fleming in 1929 but it was Chaim and the Australian, Florey, who first brought it into clinical use in 1940.

Originally, penicillin had to be given by injection but now derivatives are available which can be taken by mouth. This drug is bacteriocidal and has such a low toxicity that massive doses can be given without risk to the person.

However, allergy to penicillin is probably the commonest of the drug allergies. Some may show an allergy when first they take this drug, having previously been sensitised by minute quantities in milk. This gets in the milk because the antibiotic may be given to cows to prevent or treat mastitis.

Others can develop an allergy after having taken penicillin for years without trouble.

Some of the newer derivatives of penicillin, such as ampicillin, are more effective against a wider range of organisms than penicillin itself.

Ampicillin may cause a fine rash which is not due to allergy, although anyone allergic to penicillin will also be allergic to its derivatives.

Amoxycillin, a derivative of ampicillin, has now supplanted it. It has all the benefits of ampicillin but is absorbed in the presence of food and gives higher blood levels.

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Psychologists and psychiatrists have been examining the effects of Stress on the immune system. How do we cope with stress? Do we fed reasonably able to deal effectively with the world and maintain a positive sense of self, or do we feel helpless, as if no effort can make a difference? What if endometriosis is the outcome of the immune system’s collapse of effort?

In a study measuring the correlation between the psychological symptoms of stress to natural killer cell activity. Dr. Steven E. Locke at Beth Israel hospital in Boston reported in Psychoiomatxc Medicine that “symptoms such as anxiety and depression may negatively affect immunity.” Those who were good at coping with life’s vicissitudes tended to have “significantly higher natural killer cell activity” than those who felt a greater lack of control over the environment.

Transcendental meditation, hypnosis, biofeedback (wherein one literally learns to control the calming alpha waves produced by the brain), guided imaging, and other mind-control techniques have been studied extensively in laboratories and hospitals. Cancer patients have used many of these techniques to reduce pain and, in some cases, to fire immune system regeneration—in effect, curing themselves, or Creating an environment where cure is more possible. Stress, as such, is not a fixed quantity: what is negatively stressful for one person may be of little consequence to another. For now, much of the data indicates that stress cm contribute to the onset of disease.

Women with endometriosis tend to lead stressful lives - this tact cannot be denied. A persuasive enough argument has been made, in my estimation, for sufferers of this disease to consider making changes in their lives as a means of controlling the disease.

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This is a superficial, contagious infection of the skin sometimes known as ’school sores’. As this name suggests, it is more common amongst school-age children. It usually affects more than one person in the family or group, and seems to be more common in the summer months. Most commonly it occurs on the face, particularly about the nose and mouth. The common infective organisms is either the Staphylococcus or the streptococcus. If untreated, new lesions may continue to erupt for months.

Adequate treatment requires the administration of appropriate antibiotics by mouth. It is not sufficient to treat impetigo with applications of antiseptics or antibiotics alone. The only local treatment necessary is the washing of the skin with an antiseptic soap, and the gentle lifting off of crusts. Penicillin or Erythromycin are usually the most appropriate antibiotics, and will also help prevent possible complications of impetigo, such as infection of the kidneys.

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There is considerable scientific backing for the health benefits of a diet with a high proportion of starches. National health targets suggest that carbohydrates should provide about 55-60 per cent of daily energy. Unfortunately, carbohydrate intake in most Western countries has declined this century with the increased consumption of fat. Fibre intake in most Western countries averages only about half the national target of an achievable 30g per day.

The first idea that fibre could protect against certain diseases appeared in I960, when researchers observed that the degenerative illnesses common in affluent societies were rare in rural Africa where diets were high in unrefined plant foods. Subsequent studies confirmed the health properties of fibre and it is now considered to have a role in protection against chronic diseases such as cardiovascular disease, colorectal cancer, and the management of constipation and diabetes. The specific benefits depend on the type of fibre. Foods high in insoluble fibre reduce transit time (i.e. shorten the time for food to pass through the GIT), soften stools by holding water and increase stool volume. In contrast, foods high in soluble fibre have little effect on bowel transit but appear to slow the rate of carbohydrate absorption due to their gel-forming ability. This helps to reduce rapid fluctuations in blood glucose and insulin among people with diabetes.

The combination of the effects of different fibres (including resistant starch), the SCFAs produced and a diet low in fat are all thought to protect health, so it has been difficult to credit any one factor. Nutritionists therefore recommend a diet low in fat with a variety of foods containing all types of starch and fibre.

A low intake of carbohydrate in any form appears to be linked to obesity on a population level because, by default, it is a high-fat diet. The claim that carbohydrates, whether as sugars or starches, are fattening’ is a myth. However, it is prudent for some individuals who are obese and who consume large quantities of sugars, to moderate their intake as a second level of priority after decreasing fat.

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Just because you have endometriosis does not necessarily mean that it is the only cause of your inability to conceive.

Most doctors will want to do a number of tests to check that everything else is as it should be.

First, you will be asked to have your hormone levels assessed. This is usually done as a blood test where the levels of progesterone will be measured. If these are abnormal, oestrogen, prolactin, testosterone, follicle stimulating hormone (FSH) and luteinising hormone (LH) levels will be measured as well.

The results of the test can take up to four weeks. Your doctor will tell you at what stage in your cycle the test should be done. Usually, it will be collected one week after your expected ovulation (for example, if you usually ovulate on day 14 then your blood test will be done on day 21).

The next test most women have to undergo is the tedious process to establish a basal body temperature chart. Once told to do this test your morning cannot possibly start without sticking the thermometer under your tongue — do not drink, go to the toilet, get out of bed or even talk before doing this!

Once the temperature has been noted it is then marked on the chart at the appropriate day in your cycle and the pattern is observed.

Like playing dots and dashes, you then draw a line joining the dots and this should indicate when ovulation is due. Intercourse is then timed to coincide with ovulation.

If ovulation has occurred your temperature will normally rise by about one degree. If your temperature remains high after the due date of your period this may be the first indication that you are pregnant.

If your basal body temperature chart shows that you are ovulating but still have not conceived your doctor may want to perform other tests. These may include:

Hysterosalpinogram

An hysterosalpinogram is an X-ray where dye is injected through the cervix to check that both tubes are functioning and that the internal structure of the uterus is normal. The procedure lasts approximately ten minutes.

Your doctor may say that this test will be a little uncomfortable. It is, but thankfully most hospitals will inject you with a sedative before the test is carried out and you should experience little more than some ‘cramping’ pains.

This test is becoming less frequent as most doctors feel that a laparoscopy provides a more accurate picture.

Post-coital test

A post-coital test allows your doctor to observe sperm within the cervical mucus after intercourse. You will be asked to have intercourse (at home) four to twelve hours before the test and this is usually done mid-cycle as the mucus is then clear.

It is similar to a smear test and carried out to make sure that the live sperm are penetrating the mucus and that the mucus is not ‘hostile’. Do not panic if your doctor says your mucus is ‘hostile’. IVF-related procedures mean that the sperm and egg can be fertilised outside the womb and transferred back into the fallopian tube, by-passing the cervix.

The Kremer test

The Kremer test is similar to the post-coital test except that you are not asked to have intercourse. Instead, specimens of mucus and sperm are collected and tested together at regular intervals over six hours. This test will help pinpoint if the problem lies with the sperm or the mucus.

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