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The world’s first dengue vaccine is now commercially available in the Philippines.

Watsons, the international healthcare and beauty care chain, will be holding a three-part series of dengue vaccinations in 108 stores starting April 30. It supports the World Health Organization’s goal of reducing the rate of dengue by 25 percent, and deaths by 50 percent by 2020.

Endemic in the tropics, dengue is a fever caused by a virus from the bite of a striped Aedes aegypti mosquito that has bitten an infected person. Since there is no specific medication for this fever, the remedies are rest, fluid intake and doctor-prescribed pain relievers and anti-inflammatory drugs.

In worse cases, patients are hospitalized and receive intravenous fluids.

Sanofi Pasteur, the vaccine division of the international healthcare company, Sanofi, has created a preventive intervention. The dengue vaccine is classified as a live recombitant tetravalent. It is a preparation of killed viruses, used to protect against organisms that were injected, explains Dr. Gene Solante, expert on infectious diseases. “It took 19 years of research. Scientists harvest components of the virus while they are still alive, but take out the virulence which causes the disease.”

Antibody

“The same components of dengue virus have been inactivated, and can then simulate an actual infection to produce an antibody that will grow, and protect you against actual dengue virus infection,” says Solante.

Tetravalent means that its formula can obstruct the four variations of the dengue virus.
In a clinical study on the vaccine efficiency, conducted in Latin America, the dengue vaccine prevented hospitalizations and serious dengue for up to four years of the dosage, compared with study group that was given a placebo.

“The first benefit of the vaccine is that it reduces symptomatic dengue,” says Solante. “If you get bitten, you won’t get the symptoms— headache, fever, decrease in platelet count and abdominal pain. If you have a mild type of dengue, the fever will disappear in three or four days. The platelet count will not be too low. Third, it can prevent severe dengue or thrombocytopenia, the lowest platelet count of under 50,000…”

He adds that another benefit of the vaccine is that chances of transmission can be decreased.

Solante points out that the Philippines ranks no. 7 worldwide in number of dengue cases. The country experienced a surge by 35 percent in 2016 compared 2015 statistics.

In the Philippines, dengue is one of the top 10 killer diseases. Most of the patients who die are under 9 years old.

The Department of Health (DOH) has been conducting vaccinations in public schools in three regions where the incidence of dengue is high.

Every time a patient perishes due to severe dengue at San Lazaro Hospital, Solante, who heads the adult infectious diseases department, becomes circumspect. “It could have been avoided if there was a vaccine readily available,” he says.

Breeding places

“Before the vaccine was introduced, we thought dengue could be prevented by cleaning the breeding places of the mosquitoes,” Solante adds. “It’s not possible in an urban environment filled with garbage where mosquitos thrive.”

Danilo Chiong, Watsons health business director, says the chain is the first retailer to make the dengue vaccine available to the public. A doctor will be on hand to administer the vaccines at selected branches.

Recipients will be reminded every six months of their next dosage. Each vaccine costs P4,000 or a total of P12,000 for the full cycle.

To make it affordable, Chiong explains that Watsons has a partnership with BDO and BDO credit card companies where people can pay by installment with no interest.

“Since dengue is a public health concern, it’s our way of helping. Doc says that the more vaccinations, the less chances people will get them,” says Chiong.

Solante adds: “This vaccine is important in places where dengue is highly endemic, like the Philippines. DOH can’t afford to vaccinate everyone, so we need the help of the private sector. In other countries, vaccination is an important health program. Prevention reflects the health of a community.”

Balance is the most sought-after commodity of the 21st century. And while the rat race continues, people become so caught up in the frenzy that there isn’t enough time to catch one’s breath.

There are ways to adjust to life and its demands while still maintaining a semblance of peace and quiet. Thus, above the din and chatter, the noise and clutter, there is balance and order.

One can manage it by taking concrete measures for coping.
Beyond just surviving, there is hopeful living.

Perhaps this is one of the strongest arguments for taking a vacation—an urgent need to take a break from stress. But did it ever occur to you that vacations can be stressful? This, because after the so-called adventure, one requires a vacation from the vacation!

Whether you’re on the road this summer or not, there are strategies to preserve one’s sense of calm even amidst chaos.

The 3-minute awareness. This is all you need for starters. Practice the art of focusing on one sensation at the moment.

Take a walk and pick any of your senses—sight, hearing, smell, touch, taste. For example, if it is the sense of sight, see whatever you are looking at with the eyes of your body, mind and heart—whether it be a tree, a flower, etc.

Heighten your sense of awareness. This has a calming effect. As you get the hang of it, increase this to five minutes of quiet focus.

Pray and meditate. Devote sufficient time for prayer and meditation—15-20 minutes a day. Devotional prayer is enough to quiet the mind and calm the spirit.

And with mindful breathing exercises, you can achieve greater calm. You will emerge strong enough to weather the day’s many challenges.

Inhale in five counts, hold two counts, then exhale five counts. Repeat 30 times. This is a proven exercise for calming a restless mind.

Lie down or sit back comfortably. Keep still and use your mind to search for the weariness of your body. Once you find tightness, release the tension by keeping still. Stay focused on the sore spot. Relax your muscle.

Warm and cold compress. If it’s a mild headache, apply cold compress on your head. Close your eyes. Be still for 10 minutes.

If there is tightness in your lower back, apply a warm compress on it for 15 minutes.

Tune up. Choose the melody and tune into your favorite music. Sing out loud to release steam.

Move it. Any form of exercise helps to destress. It fights depression.

Laugh it off. Life can be serious enough, don’t add to its heaviness. Learn how to smile before you laugh out loud. Laughing helps you relieve stress. It releases feel-good hormones and relaxes the muscles instantaneously.

Replace a frown with a smile. Look at yourself in the mirror. Practice smiling. You need more muscles to frown than to smile. A smiling face is so much more agreeable to see than a frowning one.

Each time you feel that you are getting irritable, intercept your mind immediately. Order yourself to stop it. Tell yourself, “Don’t go there.” This is an effective mind interceptor. You can influence your thoughts by just anticipating them.

Water therapy. Splash your face and body with water. If at times you believe that you are not in control, take immediate action by using water therapy as a means to stay cool, physically and mentally.

In fact, shock therapy using an ice-cold water splash on the face and neck is enough to make you snap out of it. A dull mood requires the ice-cold treatment.

Jump for joy. In order to simulate joy, be a kid again by jumping like you did as a child. Jump from your bed or a rebounder or trampoline. Jump 10 times as a beginner, then advance to 100 jumps a day.

Practice generosity. Give something to someone today, whether it’s your time, attention or cheerfulness. Do something nice for somebody in need.

Soothing beverages

There are also soothing drinks that can lower your stress levels. Stay away from high-energy beverages if you want to calm down.

Relaxing teas—chamomile, valerian root, lemon balm, passion flower

Decaffeinated green tea —minus the caffeine, green tea has thiamine, which has a calming benefit.

Warm milk—tryptophan in milk has relaxing power.

Its summer once again and with school out, the temperature rising, and kids wanting to go outside and play, it should be more fun than ever with games, crafts, and activities indoors and outdoors.  That’s what makes summer unforgettable not only for kids but for adults as well.  But this also puts not only children but adults, too, at risk for summertime dermatitis and possible life-threatening situations.  We must be able to distinguish between innocent skin eruptions and potentially life-threatening disorders, and counsel children and adults on skin protection during this season.

Insect bites

 When conditions are more favorable for insect activity and opportunities for exposure increase the prevalence of insect bites, the diseases they carry also start to peak. Insect bites result in papular urticaria, those itchy, often grouped, pink urticarial papules (pantal pantal na maliliit). Excoriations occur, resulting in superimposed infection, most often with the bacteria Staphylococcus epidermidis or S. aureus.  It mostly affects younger children. Fleas and bedbugs are the most common. Treatment should be directed at limitation of exposure. Insect repellant use recommendations: Not for children under two months of age. Application is only once a day. Repellants, in combination with sunscreen, are not recommended. Do not use over cuts, wounds or irritated skin. After returning indoors, wash treated skin with soap and water. Wash treated clothing before wearing again. When using sprays, do not apply in enclosed areas or near food. If applying to face, do not spray directly; spray first on hands and then rub on the face. 

Dermatitis and poisoning from plants

When hiking or mountain climbing, one is at risk of getting dermatitis or possible poisoning from plants.  Colorful flowers and plants are no doubt amazing! We all have been informed since way back when we were graders about the merits from the many uses of flowers and plants. But beware, there are some plants you ought to watch out for, or risk death. Such as:

Talumpunay tree/Cachubong. This tree is legendary because of its hallucinogenic properties. No wonder, it has become a weapon of sorts in many an enterprising criminal’s arsenal.

Rosary Pea. Native to India, Sri Lanka, Thailand and the Philippines, the Rosary Pea is a cold-blooded killer, a slender perennial climber that finds its way through trees and shrubs. One can easily identify it via its seeds, which are bright red with a single black spot. It is so lethal that a mere three micrograms have killed a person.

Castor plants. A lot of these plants grow in the wild.  Native to the Mediterranean region, Eastern Africa, and India, they are now widespread in the tropics.  On the good side, the plant has been the source of healing via the widely used Castor oil. But beware because this plant is so toxic it takes only four to five seeds to kill a full-grown adult. This is because of the toxin called ricin found throughout the plant.

Once the seed is ingested, you feel a burning sensation in the throat and mouth, followed by diarrhea and vomiting. Once the symptoms have set in, the process is unstoppable and the final cause of death is dehydration.

English Yew. If you are out to redecorate your garden, chances are your decorator may suggest using the English Yew bush as a foundation plant for hedges. Don’t be fooled by its aesthetic value. This tree has soft, bright-red berries that are palatable, enjoyed by a lot of birds. But the fruit is the only part that is non-toxic, 50g is enough to kill a human.

Belladonna. How ironic that this plant is useful as an antipyretic, antiseptic, antispasmodic, among many other uses. However, ingestion of the fruit, especially of a young plant, is toxic. Symptoms include: loss of voice, dry mouth, headaches, breathing difficulty, convulsions. The whole of the plant is poisonous but it’s the berries that are most dangerous as they are naturally sweet and attractive to children. Ten to 20 berries can kill a fully-grown adult, but as small as one leaf — where the poison is more concentrated — can kill a man.

Trompeta. Behind this plant’s charm lies a killer. Traditionally, the plant is utilized as a hallucinogen and intoxicant. The Trompeta is home to dangerous alkaloids.

Overdose of any of these alkaloids can lead to poisoning. This enchanting plant can be deadly as it can accelerate the heart rate and cause cardiac rhythmic disturbances, which can be fatal. As little as four grams of the trompeta leaves can be fatal to a young child.

Pong-pong. Because of its notoriety, this plant has been dubbed the Suicide Tree. And not without good reason as it  yields a potent poison, so potent it has been used for suicide.

Sunburn

Despite warnings to avoid excessive UV exposure, sunburn is still prevalent during the summer months. Its long-ranging effects include increased risk of skin cancer, photoaging, and immunosuppression. It has been estimated that if sun-protective clothing and sunscreens are used from early childhood, the incidence of non-melanoma skin cancer (basal cell carcinoma and squamous cell carcinoma) would decrease by 75 to 80 percent. Reactions can range from mild redness to severe blistering, but all forms represent the body’s response to DNA damage and the subsequent release of inflammatory mediators. The best treatment for sunburn is prevention, however cool compresses, nonsteroidal anti-inflammatory drugs (NSAIDs), and topical corticosteroids (Class III to VI) for short periods can be soothing.  Treatment is best when given within the first 24 hours of a sunburn.

Sun protection requires a multi-pronged approach incorporating avoidance of intense exposure, as well as protective clothing and hats, along with sunscreens. The risks of skin cancer and photoaging have both been tied to UV exposure in the first two decades of life. In general, children six months and older should use products with SPF 30 or higher with broad-spectrum (UVA/UVB) protection. Sunscreens are not tested in children under six months of age, and should not be needed at this age, since shade and sun-protective clothing should be provided for this non-ambulatory group. But if necessary, physical blockers are a safe, non-irritating option.

source: Philippine Star
http://www.philstar.com/health-and-family/2017/04/18/1691176/skin-disorders-watch-out-summer

Have you ever seen a doctor for a checkup and he tells you that you a “serious” condition? It could be heart problem, lung disease or a lump somewhere. Whatever the diagnosis he gives you, how do you process such an information?

The questions that probably pop up in your mind are: “Why me? Why did I have this condition? Why should I be burdened by this disease? What have I done to deserve this?”

Your doctor may say the cause of your problem is hereditary (blame the parents), a viral infection (blame the virus) or oftentimes, there is no cause at all.

 

What’s the next step?

After a period of asking the whys, you find out that blaming the heavens, other people, including your doctors, will not help. Instead, we should move on to the better question, which is: What do we do next? This is the most proactive and positive thing you can do with your medical condition. Even if it’s a serious illness, even if it’s cancer, you should continue to ask, “What do I do next?”

What’s the next step, the next test, and the next doctor to see? What can we do to treat this condition? If we can’t treat it, what can we do to lessen the symptoms and the risks? Always look forward to the next step.

Maybe we think it’s “serious” when it’s actually a commonplace disease. A lot of people have it. Serious is a relative thing. A lump in the foot that needs an operation looks serious. But when you compare this with people with no legs going on with their lives and working hard, then you get to think twice. Your condition may not be as bad as you — or your doctor — think.

Get a second or third opinion

It often helps to get a second opinion on the matter. Maybe you were not ready to receive the news at the time. Try to seek another opinion to make sure you get the correct diagnosis and the proper treatment.

Laboratory tests can sometimes go wrong. Do another test to be sure. Find a doctor you have faith in and who will support you as you go through the process of healing.

No matter how bad the news is, your doctor (or a kind relative) can explain it in such a way as to make it more tolerable. For example, the doctor can say, “Yes, you have a medical illness. It’s not a mild disease and we just can’t let it go without treating it. But, on the other hand, it’s not very bad and there are many people out there who have more serious ailments than you.”

You can ask your doctor to enumerate the many things you can do to alleviate your condition. Even if there’s no hard scientific evidence, there’s no harm in using common sense and employing a healthy lifestyle. For example, what food should we eat or avoid? What activities are allowed and what should be minimized? What medicines should you take and how much follow-up is needed?

And as a patient, learning about all these things and studying your body’s reaction to these lifestyle changes can be fruitful and empowering. No matter what the disease, there are many things you can still do. Don’t believe anyone who says it’s hopeless. Keep a balanced mind on what medical treatments, even alternative treatments can be of help to you.

God has given us both prayers and doctors. Use both strategies to get well. Do not forget the scientific part of healing.

Focus on what you can still do

Reframe your thinking. Even if your doctor says you can’t do such and such, then just focus on the things you can still do. You can still work even for a shorter time, you can still write, communicate, and enjoy the company of friends. At least, until you get better, adjust to your new situation.

Continue to fill your mind with inspirational books and uplifting articles. Keep positive people around you. Continue to inspire yourself with stories of triumph over challenges, and success after defeat. There are so many beautiful stories on the Internet and YouTube. Never accept defeat. There will always be a right path to take.

Be positive, things will get better

When diagnosed with an illness, it’s normal to feel afraid. Yes, any disease can possibly have complications. Any medicine can potentially have a side effect. But how do we keep things real?

Positive thinker Norman Vincent Peale writes that in his experience, many of the negative things one anticipates do not occur anyway. In his survey, 92 percent of all negative things we fear will not come to pass. And for the eight percent of things that do happen, we will be ready to face these challenges if they come.

Therefore, think positive and try to keep your fears at bay. According to Peale, fear is a very common emotion that nags a lot of people. But there is one emotion stronger than fear. It is faith. “Only faith conquers fear,” says Peale in his many inspirational books.

I know you may have been given by your doctor a shocking diagnosis. I hope it never happens to you. (That is why I believe you should rejoice when you receive a normal laboratory test. Just think what the opposite result would entail.)

There are lessons to be learned from an illness. I have learned this lesson again and again. Your spouse and children will look even more beautiful and lovely. Some of the nurses and doctors will look like angels. Plans are changed and wounds are healed, probably for the better. And you see life in a different and better perspective.

I pray that you continue to stay positive and do well with what could be bothering you. There is light at the end of the tunnel. There is a purpose for each of our lives.

For today, my purpose is to send you a simple prayer. I hope that you and your family stay happy and reasonably healthy whatever age you may be. Keep on learning. Keep on living. God bless you.

source: Philippine Star
http://www.philstar.com/health-and-family/2017/04/18/1691178/your-medical-condition-serious

A major problem in breast cancer management in the Philippines is that a majority of Filipino breasts are very dense.  This means that the standard routine breast screening that includes digital mammography and ultrasound miss a high percentage of early breast cancer.  This means that a significant number of breast cancers in very dense breasts are not diagnosed for over one year.  When followed up using our usual tests, the cancer very often is far more advanced.  Higher stage leads to more total mastectomies and need for more adjuvant chemotherapy and worse prognosis.  Even the latest 3D Tomosynthesis mammogram picks up only 1.7 times more than the regular 2D mammogram.  

Women with dense breasts as rated by mammography and ultrasound have to understand that they could not be complacent with just annual screening mammography and ultrasound.  Mammograms may not detect as much as 20 percent of all breast cancers and as much as 40 percent of Filipino women under the age of 50 years old with very dense breasts.  To improve their chances of more accurate early detection, these women should also do monthly breast self-examination and annual examination by a breast surgeon.  With or without any abnormal findings on breast exam, if the patient is at high risk of breast cancer or has very dense breasts, she should have either an MRI or MBI.0.18

 As a background, Breast Magnetic Resonance Imaging (MRI)  is an expensive high-tech diagnostic test used specifically as a problem-solving test when you have equivocal findings in your digital mammography and breast ultrasound. To get the best result, you need to use intravenously a contrast called Gadolinium.  Breast MRI is not routinely used because it is very expensive and although it has a very high sensitivity, it has a low specificity. Consequently, getting this test leads to more false positives, resulting in unnecessary recall, more tests, and biopsies. Furthermore, in a stunning development, a European body, on March 10, 2017, recommended that Gadolinium-based contrast (or dye) agents for MRI scans be pulled off the market due to concerns that the dye remains in the body, particularly the brain, for many years after the scan occurs.

Now comes the latest diagnostic equipment:  Molecular Breast Imaging (MBI) is a new nuclear medicine technique that utilizes small semiconductor-based-cameras in a mammographic configuration to provide high-resolution functional images of the breast. Current studies with MBI have used Tc-99m sestamibi, which is an approved agent for breast imaging.

Benefits: MBI, performed with a low-radiation-dose protocol, detects an additional seven to eight cancers per thousand women screened, compared to mammography alone, and is being used at the Mayo Clinic in screening research trials and, now, in usual clinical practice.  One recent study from a community practice showed similar added cancer detection rate from MBI.

MBI can be helpful for some women who need but cannot tolerate MRI for reasons such as kidney failure, claustrophobia or who have pacemakers or some other metallic implants. MBI can be used in women with dense breast tissue who have a suspicious area on a mammogram which cannot be identified on ultrasound.

The Philippines is very fortunate to have the first MBI available at the Asian Breast Center (ABC). The ABC is the first free-standing comprehensive cancer center dedicated to one disease, breast diseases, affiliated with a major medical institution in the United States, Morristown Medical Center in NJ, rated as one of top 50 hospitals by US News and World Report and among the top 5 in the NY Metropolitan Area, whose mission is to donate most of its profits to charity breast clinics in the Philippines to provide the same quality care to indigent patients with breast cancer.  The center is located on the 8th floor of the Centuria Medical Makati in Century City.  Most of the physicians, led by Dr. Norman San Agustin, a dedicated oncoplastic breast surgeon, are US- and European-trained. They plan to have their soft opening soon. They will be strictly following evidence-based international guidelines in breast cancer management so that patients no longer need to go abroad to get the best care.

source: Philippine Star
http://www.philstar.com/health-and-family/2017/04/18/1691177/and-now-latest-breast-cancer-diagnostic-equipment