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EDITORIAL

Welcome to this edition ofFamily Health. As always we strive to keep you informed aboutthe latest health issues and how they relate to all of you. Obesity is a word that has

received bad press in recent months. From reading some papers, you would think that thewhole world is becoming obese. At the same time, parts of the world are starving and foodprices are increasing. So what is the real truth?

Not a question that has an easy answer, but we have included in this edition an article onobesity which sets out the basic facts.

The latest gures from the World Health Organisation (WHO) indicate that globally in 2005:

approximately 1.6 billion adults (age 15+) were overweight;

at least 400 million adults were obese.

WHO further projects that by 2015, approximately 2.3 billion adults will be overweight and more than 700 million will be obese.

At least 20 million children under the age of 5 years were overweight globally in 2005.

Obesity is no longer a problem only in high-income countries, overweight and obesity are now on the rise in low andmiddle-income countries, particularly in cities and towns. The even more worrying aspect is that obesity is a major causeof an increase in chronic conditions such as diabetes and cardiovascular disease. The risk of these conditions increasesas Body Mass Index increases.We will continue to provide information in Family Health that we believe is relevant so thatwe can all play our part in improving the outlook for the future.

In this edition we also take a look at a part of our body that we take for granted our feet. They have to last a lifetime andwe cannot just go to a garage and change them when we wish. Shoe shops can help, but at least you can become aninformed buyer and make sure they do last for as long as you need them.

Finally, I have introduced a new feature, a Question and Answer section that I hope you will enjoy. If there are any medical

or dental topics that you would like answered and you think would be helpful for others, please write in.

Regards,

Rob GreyEditor

Fall 2008

Published by:American Mission Hospital

P.O. Box 1, Manama, Kingdom of Bahrain

Tel: 17253447 Fax: 17234194

E-mail: [email protected]

Website: www.amh.org.bh

Printed with kind permission of the Ministry of Information

Registration No. SAMH 444

No part of this publication may be reproduced in printed

or electronic form without the written permission of

American Mission Hospital.

Disclaimer:Although every effort has been made to ensure

accuracy of information in this publication, AMH cannot

be held liable for any errors that may have occurred

whether through type-setting, translation, printing orother processes.

Family Health Editorial and Advertising Team:

Editor: Rob Grey

Anne Al Zayani

Production & Photography

Bahnaz Abbas

Sponsorship & Advertising

Dr. Mohammed Al Khateeb

Arabic Review & Translation

(former Regional Advisor for Health Promotion

for the World Health Organization)

For further details, please contact: 17248136Issue No. 14 - Fall 2008. Next issue January 2009.

Circulation: 20,000 copies

Printed by: Union Printing Press


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Dr. R.P. Sachdevaexplains the differenterrors that can affectyour eye sight.

KNOW YOUR EYES -REFRACTIVE

ERRORS

20 - 2211 - 13

BBK supportsAMHs NewSpecial BabyCare Unit /Riffa ViewssponsorsPediatric Clinic

AMH NEWS

CONTENTS

Rob Grey introduces

the Fall 2008

issue of FamilyHealth Magazine.

EDITORIAL 3 15 - 18

Discover whichdiseases andconditions pose the

greatest health risks towomen. Find out how tominimize your riskas explained byOB/Gyn ConsultantDr. Alka Gupta

WOMANS HEALTH RISKS

HEALTH NEWS 7 - 9


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CONTENTS

37 - 38

OBESITY - Causes andcomplications

24 - 27

TAKING CARE OFYOUR FEET

33 - 35 NEONATOLOGYEnhancing Care forNewborn Babies

WATER a Vital Nutrient 29 - 31

AMH has introduced several packages to help our patients manage chronic illnesses. Packages include

discounted prices or a year o management o chronic diseases such as Hypertension, Diabetes, ele-

vated Cholesterol or serum lipids and respiratory diseases like asthma. Besides being treated by a phy-

sician, package holders are given counseling sessions by our trained, multi-lingual Nurse Counselors.

AMH also has a special discounted Fitness Package whereby the package holder is coun-

seled by both a dietician or inormation about oods and their contents, and a physiothera-

pist who oers guidance about appropriate exercise and ftness programs, all or just BD 10.

Pregnant women can avail themselves o the comprehensive Delivery Packages that

AMH oers which include many delivery options and choices o rooms depending on

your birth-plan. Each package includes antenatal visits, breasteeding and ante-

natal classes and ante and post-natal exercise instruction. Classes are taught

in various languages to suit all nationalities. Women should also

consider the Well Woman Package or com-

prehensive medical check-ups.

AMH oers 5 packages o care or children

based upon their ages rom birth up to 6

years o age. These packages include routine

check-ups and age appropriate immuniza-

tions.

For urther inormation about any o the AMH

packages please call 17 248122/123 or

chronic diseases, 17 248115/116 or the de-

livery package and Well woman package, and

17 253447 ext 333 or Pediatrics.

AMH HEALTH PACKAGES

Obesity is a

problem world-wide asConsultant /Internal MedicineDr. Mathewpoints out.

Consultant

Orthopedic SurgeonDr. Juan Magalongtells us about theways to take careof our feet.

NutritionistChristine Zoleta

explains theimportance ofwater.

Dr. Lourdes Imperial,Neonatologist,tells us about thenew SCBU andhow it works.


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HEALTH NEWS

Having a snack before you go to bed

may not necessarily mean you put

on weight, but your metabolism does

slow down when you are asleep so

you burn fewer calories (60 an hour).

You typically burn between 120 150

calories an hour during the day, just tostay alive. So remember the heavier

the bedtime snack, the more calories

stay with you.

CHAMPIONS LEAGUE FOR WEIGHTBedtimeSnacks

A study by Kleenex has found that the pollen

that attaches itself to grasses in the coun-

tryside now also attaches itself to the heavy

exhaust particles from cars, especially die-

sel. Pollen mixed with diesel has a worse ef-

fect on the respiratory system than pollen in

grass. So hay fever is no longer just a coun-

tryside condition. Also, global warming that

causes warmer climates, is extending the

traditional summer season for hay fever to

all year round. Good news for Kleenex and

bad news for hay fever sufferers.

According to the International Association for the Study of Obesity, the

British are the leaders in the European Overweight League. Almost 60%

of men and women have a BMI (Body Mass Index) which is overweight

25+ or obese 30+.

The table below shows the best and worst countries and Bahrain for

local reference. Figures relate to a BMI of 30+

The World Health Organization (WHO) estimates for the USA in 2015 are that

BMIs will be: Women 54.3 and Men 51.7 and for Bahrain Women 40.7 and 21.2

for Men.

WHO are moving towards implementation of a Global Strategy on Diet, Physi-

cal Activity and Health primarily aimed at obesity - related non-communicable

diseases.

Some facts on Diet

The average Briton eats just over three portions of fruit and vegetables a day,

well under the recommended ve.One in ve people in the UK manages to walk for 20 minutes at a stretch once a year

or less - a statistic described recently by Professor Roger Boyle, the British Govern-

ments leading cardiac expert, as the most disgusting thing I have ever heard.

URBAN

HAY FEVER

Country Males % Females %

Bahrain 21.2 35.2

England 24.9 25.2

Switzerland 12.1 18.2

Cyprus 26.6 23.7

USA 36.5 41.8


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HEALTH NEWS

HEALTHY SLEEP

Researchers at the University of Alabama at Birming-

ham, Alabama have solved why eating garlic can help

keep the heart healthy. Garlic contains allicin which is

broken down into sulphur compounds. These react with

red blood cells and produce hydrogen sulphide which

relaxes the blood vessels and keeps the blood owing.

This helps to reduce blood pressure. The only downsideis the smell of hydrogen sulphide it smells like rotten

eggs. But remember, a balanced diet is the foundation

to good health.

Lack of sleep can be bad for your health. In a recent study, the

University of Pittsburgh School of Medicine team found that a

lack of sleep raised the risk of metabolic syndrome which is

a set of symptoms that include high cholesterol, raised blood

pressure, a large waist measurement and problems control-

ling sugar levels,. The syndrome is considered to be an early

warning of diabetes and heart disease and is rising at an

alarming rate around the world. In the study, those sleeping

less than 6 hours a night were more likely to have metabolic

syndrome.

Most nutrition experts contribute the rise in metabolic syn-

drome to the increased fast food and inactive culture of today.

They recommend that we move towards a healthy balanceddiet with lower fat, sugar and salt, more fruit and vegetables

and an increase in physical activity,

GARLIC -

GOOD FOR

THE HEART

In 2005 there were 400 million people in the world with

a BMI of over 30, so technically obese. There were a

further 1.6 billion who were overweight (with a BMI of

over 25). 2.5 million deaths a year are attributed to over-weight and obesity worldwide, according to the WHO.

As a footnote to the above, a recent Norwegian study

recommended that 90 minutes exercise a day for eve-

ryone would be necessary to solve the worlds obesity

problem.

Obesity and ExerciseBODY FAT

BMI is a crude way of measuring fat accumulation in

the body. It is merely an indication. Everyone needs

fat to survive and reproduce. Men need 2% 5%

and women 10% - 13%. The recommended levels

of fat are higher than these because fat protects the

body as well. These levels will vary for each indi-

vidual.

(Figures from American Council on Exercise)

There is no one test for measuring body fat that is100% accurate but several can give an indication,

for example skinfold, water immersion, X-Ray and

bioelectrical impedance analysis.

Description Women Men

Essential fat 1215% 25%

Athletes 1620% 613%

Fitness 2124% 1417%

Acceptable 2531% 1825%

Obese 32%+ 25%+


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HEALTH NEWS

STAYING COOL - DEHYDRATION

Often, environmental and physical conditions can make it difcult to

stay cool. But being well hydrated may help lower your risk of get-

ting heat-related illnesses.

Q: How much water should I take in a day?

A:, Our bodies are about 2/3rds water and if your water level drops

below that, you become dehydrated. Water needs depend on many

factors like your health condition, how active you are and where

you live. Besides drinking more water and/or beverages, you canalso consume foods that naturally contain water such as oranges,

watermelon and cantaloupe.

A joint convention between US and Canada, Institute of Medicine,

made in February, 2004 suggests the following for healthy seden-

tary adults living in temperate climates:

Men: 125 oz (3.7 liters) of water per day from all dietary sources

Women: 91 oz (2.7 liters) of water per day from all dietary sources

Q: How do I know Im getting dehydrated?

A: Its generally not a good idea to use thirst alone as a guide for

when to drink. To gauge your hydration, you should check how of-

ten you urinate. Ideally you should be going every 2 to 4 hours as

most people do. Another indication is the color of your urine. Ideally

it should be almost clear (slightly yellow), the darker it is the more

dehydrated you are.

Q: Will drinking coffee or alcohol increase my risk of dehy-

dration?

A: Yes, in certain conditions caffeine and alcohol may increase your

risk of dehydration. But it would be best to consult your doctor or

licensed dietician for this.

CHICKEN POX

Q: What is chicken pox? What are its symptoms?

A: Chicken pox is a common viral infection that causes an itchy rash

and red spots or blisters (pox) all over the body.

The rst symptoms of chicken pox are usually fever, headache and

sore throat followed by the typical chicken pox rash after 1-2 days.

The rashes/red spots appear one after another as it goes through

stages of blistering, bursting, drying, and crusting over about 10

days, usually. Some children get the chicken pox rash without hav-ing a fever or the early symptoms.

Q: Should I see a doctor if I think I have chicken pox?

It would always be wiser to see your doctor. He/she will ask you

about these symptoms and examine you. This usually gives your

doctor enough information to nd out if you do have chicken pox.

Q: Is chicken pox a serious illness?

A: Chicken pox is usually not serious in healthy children. But it can

cause problems for pregnant women since the infection may be car-

ried over to the fetus; teens and adults since the blisters may be -

come unwanted scars; and people with immune system problems

as this will make it hard for the body to ght the infection.

Q: Ive had chicken pox in the past. Will I have it again?A: After you have had chicken pox, you are not likely to get the ill -

ness again. But the virus stays dormant in your body long after you

get over the illness. If the virus becomes active again, it causes a

painful viral infection called shingles.

The Readers QandA Corner

New Insurance

Plan for Ladies

Family Health advocates that you lookafter your health and so it is good tosee an initiative that encourages pre-

ventative action to detect illness.

Takaful International and Tasheelat In-surance have introduced the Heya Plandesigned specially for ladies. It providesnancial protection cover for breast andvaginal cancer and more importantlyincludes an annual medical check as

part of the policy. We know from re-search that early detection of cancer

dramatically improves the chances of

a full recovery so we welcome this ini-tiative. We hope that other insurers willencourage check ups and preventativemeasures.

If you over age 50 you should take a simple blood test to check if yourprostate is working normally. The prostate produces protein and by takinga Prostate Specic Antigen Test (PSA) you can nd out if there is anythingabnormal. In your 40s the reading should be 2.5 mg/ml and it will increasewith age.

Nearly 160,000 men in Europe are diagnosed with prostate cancer eachyear. It has become the most common cancer in men overtaking lung can-

cer. With PSA testing on the increase and an ageing population, incidenceis predicted to rise ahead of breast cancer over the next decade.

An abnormal reading by itself does not mean that there is prostate cancer

but it may be an indication. So look after your health and take the test.

Bladder

Semenal Vesicle

Lymph Node

Vas Deferens

Testis

Rectum

Anus

PROSTATE


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AMH NEWS

American Mission Hospital launchedan Increased Acuity Unit on 27thAugust 2008. This launch marks yet one

more step in the varied history of the hos-

pital. The Increased Acuity Unit will en-

sure that some of the patients requiring

extra and special care can remain in the

hospital rather than be moved to anothermedical facility.

This unit is launched with the support of

the 2007 AMH Island Classic sponsors.

Equipment purchased for this unit in-

cludes Ventilators to control the patients

breathing, Patient monitors to monitor

blood pressure, body temperature, pulse

and breathing rhythm and special beds

that are easily adaptable to any patient

position required. The total cost incurred

by the unit is BD 127,000/- including

the upgrading of the central gas system

throughout the hospital.

The sponsors supporting this unit are

Aer Rianta International, ALBA, AMEX, BAPCO, BMI Bank,

Chevron Bahrain, Contax, Deeko Bahrain Ltd, E.K. Kanoo,

JPMorgan Chase Bank, Merrill Lynch Bank, Securities & In-

vestment Company, Standard Chartered Bank, United Gulf

Bank andYateem Oxygen.

Dr. Paul L. Armerding, Chief Medical Ofcer/ CEO of American

Mission Hospital said, We are delighted with this development.

The launch of an Increased Acuity Unit means that we can be

sure that when our patients need extra care, we are in a posi-

tion to control and provide that care. Specialized equipment isemployed to ensure that the patient is closely observed and

given the best conditions for recovery. The unit is located in a

totally separate area immediately adjacent to the nursing sta -

tion. We hope to continue to provide even better healthcare for

the community of Bahrain.

Robert Grey, Director of Communications of American Mission

Hospital said With the launch of this unit we mean to demon -

strate how quality of care can make a difference for our patients.

Many studies have shown that special care and attention mean

that patients recover quicker and make a better recovery than if

they received standard care.

Bahnaz Abbas, Marketing & Development Coordinator added,

I would like to take this opportunity to thank all the sponsors

without whose support the launch of this unit would not have

been possible. The charity golng event supports this by rais -ing funds for much needed medical equipment and development

without adding to the patients cost. Most of last years support

was utilized towards the launch of this unit. We continue to look

forward to support from the sponsors to guarantee quality care

and health service.

American Mission Hospital Launches Increased Acuity UnitAmerican Mission Hospital Launches Increased Acuity Unit

Standing From Left To Right: First row: Dr. Ken Kauffmann, Jonathan Crosse, Talal Kanoo, Maya Baradarie, Ghulam Ahmed,

Ali Yakoob,Jonathan Maurice, Dr. Rana Ammadi, Frank McGarry, Redha Faraj. Second Row: Bahnaz Abbas, Khalid Safa,

Robert Grey, Dr. Paul Armerding, Craig Wilson, Mohammed Azzet, Karl Stumke, Gordon Andrade, Yousuf Haider.


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AMH NEWS

RIFFA VIEWS SUPPORTS PEDIATRIC CLINIC

Riffa Views of-

cially opened the

pediatric clinic ofthe American Mis-

sion Hospital, spon-

soring the clinic as

Platinum Sponsors

for the 2007 AMH

Island Classic char-

ity golf tournament

by donating BD

15,000 towards the

unit. Their spon-

sorship funds were

utilized to give the

clinic a totally newlook and purchase

much needed medi-

cal equipment like

Pediatric Ventilator,

Portable Nebulizer,

Infantometer, Bass-

inettes, Opthalma-

scope, Oroscope

& an Alaris Tri-site

Thermometer.

Dr. Paul Armerding, CEO, American Mission Hospital

said, The staff of American Mission Hospital (AMH)deeply appreciate Riffa Views giving Diamond sponsor-

ship to the AMH Pediatric Clinic. This generous assist-

ance from Riffa Views provides our youngest patients

with up-to-date medical equipment and more attractive

surroundings in which to receive care.

Richard Browning, CEO, Riffa Views said, The continuous

support of initiatives which reach the broader community ispart of the Riffa Views Corporate Culture. There are many

ways in which a company can fund medical support to allow

hospitals to take the next step and provide the best possible

care to those in need. We are pleased that our commitment

in this instance can benet Bahrains youngest generation.

An enthusiastic group of Riffa Views volunteers painted

the reception area of the American Mission Hospital

Pediatric Clinic. The volunteers creatively painted a mu-ral on one of the Clinics walls, depicting the sculpture

which was designed by the pupils of the Umm Salama

Girls Intermediate School that participated in the recent

Riffa Views Eden Challenge. The sculpture won the In-

termediate Category of the event and was also recog-

nized as the overall winning display of the Eden Chal-

lenge Exhibits Stand at the recent Riffa Views Bahrain

International Garden Show 2008.

Bahnaz Abbas, Marketing & Development Coordinator

and Island Classic Organizer said, I was delighted when

I saw the beautiful drawing in the Riffa Views Eden Chal-lenge calendar. When I realized that it was the overall win-

ning entry of the event, I couldnt think of a better theme

for the Pediatric Clinic. The volunteers did a brilliant job

and the clinic looks wonderful.

Featured: Sara Malik, Noor Zainal, Nazli Tawqi, Ameena

Sa, Hanan Shehabi and Abeer Abdul Latif.

RIFFA VIEWS VOLUNTEERS PAINT AMH PEDIATRIC UNIT

Standing from left to right: Bahnaz Abbas, Yousuf Haider, Hugh OShea, Richard Brown-

ing, Dr. Paul Armerding, Robert Grey, Dr. Ken Kaufmann, Tim Gardner.


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10

BBK is actively involved in com-

munity development projects. As

part of this commitment, BBK last

year donated BD10,000 to the

American Mission Hospitals Ob/

Gyn Unit. The support was used

to launch a Special Baby Care

Unit and purchase key medical

equipment. With the launching

of this unit, in the future AMH

will be able to handle emergency

and complicated cases internally

without having to transfer the pa-

tients to other medical facilities.

BBK Chief Executive Ofcer Mr.

Abdulkrim Bucheery said, BBK

is proud to be actively involved

in many projects that benet the

community in a number of ways and we are pleased to support

AMH once again in its endeavors to help meet healthcare needs

in Bahrain.

Dr. Paul Armerding, CEO/ Chief Medical Ofcer, AMH said, For

the last few years, BBK has taken a keen interest in our Ob/Gyn

services and have supported this clinic tremendously. We are

grateful for their continuing support which has helped us launch

the Special Baby Care Unit this year.

Bahnaz Abbas, Marketing & Development Coordinator, AMH

said, We highly appreciate it that BBK has once again support-

ed our main fundraising event of the year. Their continuing sup-

port has helped us to mark improvements and developments inthe ob/gyn unit of AMH without having to add to the costs of the

patients. This has ensured a rise in the number of patients utiliz-

ing these services. With the launch of the Special Baby Care

unit, we are looking forward to providing the best possible medi-

cal care to even more patients.

BBK supports American Mission Hospitals New Special Baby Care Unit

AMH NEWS

(Standing from left to right)Yousuf Haider, Administrative Consultant, AMH, Bahnaz Abbas, Marketing & De-velopment Coordinator, AMH, Abeer Swar, Corporate Communications, BBK, Dr. Paul L. Armerding, CEO/Chief Medical Ofcer, AMH, Abdulkareem Bucheery, Chief Executive Ofcer, BBK, Sister Caroline Black,Charge Nurse, AMH, Reyadh Sater, Deputy General Manager, BBK, Robert Grey, Director-Communications& Development, AMH, Dr. Lourdes Imperial, Neonatologist, AMH.

American Mission Hospital and Citi-

bank conducted 5 community outreach

events at social centers around Bahrainnamely Hamad Town Social Center, Isa

Town Social Center, Ibn Khuldoon So-

cial Center, Jidhafs Social Center and

the Sitra Social Center. This event in-

cluded health screening, educational

lectures and distribution of educational

material.

Mr. Abdulhussain Al Dairi, the Director

of Social Centers, Ministry of Social De-

velopment said, The ve events held by

American Mission Hospital and Citibank

have been very successful. All the cent-ers have returned back with very posi-

tive feedback and we hope to receive

this sort of support in the future also.

Bahnaz Abbas, Marketing & Develop-

ment Coordinator, AMH said, With the

culmination of this event, we have com-

pleted our project with Citibank to cover

5 social centers and provide medical

aid to the patients. We are grateful to

Citibank and the Ministry of Social De-

velopment for all their support and co-

operation in making this event a suc-

cess.

Mayank Malik, CEO, Citibank said,

As an international financial servic-

es company, Citi is committed to help

people improve their lives, business

to grow and communities to prosper

around the world. Therefore Citis

support to the Community Outreach

Event will definitely improve the

general health and wellbeing of the

people.

American Mission Hospital and Citibank conduct Community Outreach Event

Standing from left to right: Bahnaz Abbas, Marketing & Development Coordinator, AMH Robert Grey,

Director of Communications, AMH Yousif Haider, Administrative Consultant, Abdulhussain Al Dairi, Direc -

tor of Social Centers, Ministry of Social Development and Zahra Mohd. Ali, Head of Sitra Center.


11/31

11

Dr. Alka was born in a family of

physicians in the large indus-

trial Indian city of Nagpur. Her

father was a civil surgeon and

her mother a professor of Ob-

stetrics and Gynecology in the

Medical College there. She was

the third child of 4 children, andher elder brother and sister had

taken medicine so it seemed

logical to become a physician.

(Her younger sister is also a

gynecologist and runs a busy

practice)

She graduated with top hon-

ors from the Medical College

in 1985 getting a gold medal in

Obstetrics & Gynecology and

her Post-graduation in 1989.

She subsequently joined the

college as a lecturer for a year.

Her areas of interest are high

risk pregnancies and laparo-

scopic surgery. Juggling be-

tween home and work has be-

come a habit as the pressure of

managing 3 children and hospi-

tal means she has literally two

full time jobs.

Dr. Alka GuptaConsultant Obstetrician

/ Gynecologist, AMH

D o you worry excessively about developing breast orovarian cancer? Your anxiety may be misplaced. Althoughthese cancers can cut your life short, your r isk of having either

one is far lower than your risk of having and dying of

cardiovascular disease.

Thats not to say you should forgo regular mammograms or

ignore symptoms that may suggest ovarian cancer, particularly

if you have a high-risk family history. But it does mean you

might benefit from a realistic appraisal of your true health risks

if only to put your mind at ease. Better still, understanding

your top health risks is the first step toward reducing them.

To that end, the leading causes of death for women in

the United States are listed below, in order of prevalence.

Of course, every woman is unique, so you should alwaysdiscuss your personal risk profile and preventive plan with

your own doctor. These figures serve as a reference for that

discussion.

WOMENS HEALTH RISKS

Discover whichdiseases and

conditions pose

the greatest

health risks

to women.Find out how

to minimize

your risk.

Discover whichdiseases and

conditions pose

the greatest

health risks

to women.Find out how

to minimize

your risk.


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12

The third-lead-

ing cause of cancer

death for women in

the United States is

colorectal cancer.

Like heart disease,

colorectal cancer

is often mistaken-

ly thought of as a

mans disease, but

equal numbers of

men and women die

of colorectal cancer

each year. Manycancer deaths are

related to nutrition

and other controlla-

ble lifestyle factors.

No. 1 Heart disease

Heart disease is responsible for more

deaths in women than all forms of

cancer combined. Heart disease is

the most signif icant health concern

for women in the United States today,

causing nearly 350,000 deaths each

year.

But doesnt heart disease affect most -

ly men? No and thats a dangerous

myth. In reality, more women than

men die of heart disease in the United

States each year.

The good news is that heart disease

is one of the most preventable health

condit ions. You have the power to re-

duce some of your r isks:

Avoid smoking and secondhandsmoke and l imit the amount of alco-

hol you drink.

Eat a diet r ich in fruits, vegetablesand whole-grain products.

Exercise regularly.

Control other health condit ions thatincrease your r isk of heart disease,

such as high blood pressure, diabe-

tes and high cholesterol.

If youre at increased risk of heart dis -

ease, your doctor also may suggest a

daily low dose of aspir in.

No. 2 Cancer

It s easy to believe cancer is a ma -

jor threat to womens health, but the

kinds of cancer women are dying of

might surprise you. According to the

American Cancer Society, the most

All Females, All Ages Percent

1) Heart disease 27.2

2) Cancer 22.0

3) Stroke 7.5

4) Chronic lower respiratory diseases 5.2

5) Alzheimers disease 3.9

6) Unintentional injuries 3.3

7) Diabetes 3.1

8) Inuenza and pneumonia 2.7

9) Kidney disease 1.8

10) Septicemia 1.5

common cause of cancer death in

U.S. women is lung cancer. It s esti -mated that more than 70,000 women

in the United States die of lung cancer

each year, with the majority of these

deaths l inked to cigarette smoking.

Breast cancer is the second-leading

cause of cancer death in U.S. women,

responsible for about 40,000 deaths

each year.

The third-leading cause of cancer

death for women in the United States

is colorectal cancer. Like heart dis-

ease, colorectal cancer is often mis-takenly thought of as a mans disease,

but equal numbers of men and women

die of colorectal cancer each year.

Many cancer deaths are related to nu-

tr it ion and other controllable l i festyle

factors. Do all you can to reduce your

r isk:

Dont smoke or chew tobacco.

Exercise regularly.

Eat a healthy diet.

Avoid excessive sun exposure.

Limit the amount of alcohol youdrink.

Have regular preventive healthscreenings.

Know your family medical historyand review it with your doctor.

No. 3 Stroke

Nearly 160,000 people in the United

States die of stroke each year, and

almost two-thirds of them are women.

Stroke not only is womens No. 3 kil ler,


13/31


14/31

14

driving while sleepy or under the in-

f luence of drugs or alcohol.

Falls. About 8,300 women in theUnited States die f rom falls each year.

Women of any age can fall, but the

r isk increases as you get older. The

majority of falls occur in the home,

so common-sense safety measures,

such as avoiding throw rugs and in-stall ing handrails, can reduce the risk

substantially. Regular eye exams help

too, as does routine exercise, which

maintains your strength and mobil ity

and may improve your balance.

No. 7 Diabetes

Diabetes, a group of diseases that

affect the way your body uses blood

sugar (glucose), is a serious health

condit ion that affects about 18 mil -

l ion Americans, 5 mil l ion of whom areunaware that they have the disease.

Many people learn they have diabetes

only when they develop one of its l i fe-

threatening complications. Advanced

diabetes can cause blindness, kid-

ney failure and severe nerve damage.

People with diabetes are also two to

four t imes more l ikely to die of heart

disease and experience stroke.

The most common type of diabetes

is type 2 diabetes. This type of dia-

betes, generally developing after age40, can often be prevented. Follow

these steps to reduce your r isk:

Maintain a healthy weight.

Eat a healthy diet.

Exercise regularl y.

Get your fasting blood sugar levelchecked periodically.

No. 8 Pneumonia and influenza

Pneumonia and influenza combined

are the eighth-leading cause of death

for women in the United States today.

Together they take the l ives of more

than 36,000 women each year.

When associated with other chronic

health condit ions, pneumonia and in-

f luenza can be l ife-threatening. Peo -

ple with COPD, asthma, heart dis-

ease, diabetes and condit ions that

suppress the immune system are at

high risk. Because both pneumonia

and influenza affect the lungs, smok -

ing increases the danger of these two

diseases.

The risk of both pneumonia and in-

f luenza can be reduced by immuniza-

t ions. A yearly f lu shot can be 70% to

90% effective in preventing influenzain healthy adults. The pneumococcal

vaccine can reduce the risk of gett ing

pneumonia by more than half. Stay

healthy get those shots.

Putting health risks into

perspective

This ranking of health r isks applies to

the entire population of adult women

in the United States all ages in-

cluded. But for specif ic age groups,

the leading cause of death can shift.For instance, it s true that during the

course of your entire l i fetime, heart

disease is your No.1 health threat.

However, in your 20s, your r isk of dy -

ing from an accident is your top health

threat. Likewise, from ages 35 to 64,

your greatest r isk is cancer.

Whenever you read about hea l th

r isks, think about the cited numbers

in real terms. For example, the 2003

total of nearly 350,000 heart disease

deaths in women in the United Statesseems enormous. But if you consider

the total number of women in the Unit -

ed States that year more than 149

mill ion the number represents just

a small fraction of the female popula-

tion as a whole.

The bottom line? Be concerned about

health r isks, but dont panic. Do what -

ever you can to lead a healthy l i festyle

including eating healthy foods,

staying physically active, gett ing reg-

ular checkups and paying attentionto your environment. Such measures

can reduce your r isk factors for these

condit ions and help you lead a long

and healthy l i fe.

Women of any

age can fall, but the

risk increases as you

get older. The ma-

jority of falls occur inthe home, so com-

mon-sense safety

measures, such as

avoiding throw rugs

and installing hand-

rails, can reduce the

risk substantially.

Regular eye examshelp too, as does

rout ine exerc ise ,

wh ich ma in ta ins

your strength and

mobility and may im-

prove your balance.


15/31

15

Dr. R.P. Sachdeva started the

Ophthalmology Unit at AMH in

2003.

After graduating medical Sci-

ence (MBBS), he did his post

graduation in Ophthalmology at

AIIMS, New Delhi, a prestigious

institution of Medical Science in

India. After working as a clini-

cal registrar in a Retina Unit

for 3 years, he settled into a

practice in Delhi with an attach-

ment to private and charitable

hospitals. He has been active

in academic exercises with

ophthalmic organizations. He

has visited Japan and the USA

for clinical surgery. He is a life

member of All India OphthalmicSociety. He is always keen to

keep pace with advances in

Ophthalmology.

Dr. R.P. Sachdeva, MD

Ophthalmologist

AMH

A refractive error is a mismatch be-

tween the power of the eyes opti -

cal system and its length. It gener-

ally results in either blurred vision

or symptoms such as eyestrain and

headaches. The common types of re-

fractive errors are:

1. Myopia Nearsightedness.

2. Hyperopia Farsightedness.

3. Astigmatism.

4. Presbyopia.

We reach our normal vision between the ages

of 5 and 8, so all refractive errors should be

corrected during this period.

MYOPIA

In myopia, light rays are focused in front of

the retina, so that objects in the distance ap-

pear blurry and near objects appear clear.

This is because the eye is too long or there

is excessive focusing power. This condition

is often inherited or associated with prema-

ture birth. It may appear at any age, but most

commonly it is diagnosed in the early years

and progress is gradual and stabilized by the

late teens or early 20s. There is currently no

T

he eye is a complex optical system very similar to a camera.

Vision begins when light enters the eye through the cornea, a

powerful focusing surface. From there, it travels through clear aqueous

uid and passes through a small aperture called the pupil. As muscles

in the iris relax or constrict, the pupil changes size to adjust the amount

of light entering the eye. Light rays are focused through the lens and

proceed through a clear jelly like substance in the center of the eye

called vitreous, which gives it form and shape. The light rays nally

land on the retina, part of the eye similar to lm in a camera, where

they form an upside-down image. The retina converts the image into

an electrical impulse that travels along the optic nerve to the brain,

where it is interpreted as an upright image.


16/31

16

Correction of all

types of refractive

error can generally

be achieved with

spectacles. High in-dex lenses in both

glass and plastic

have a higher re-

fractive index and

lenses are thinner,

flatter and lighter.

It is important that

lenses are f i t tedin the frame with

the correct optical

center.

widely accepted treatment to stop its progres-

sion. Spectacles or contact lenses may be

worn to correct myopia. After 18-21 years, la-

ser surgery may be considered provided the

refractive error is stable. Glasses prescribed

in early age should be checked annually up

to puberty.

HYPEROPIA

Hyperopia is present when light rays focus

behind the retina so that near objects appear

blurry. The eye is either shorter than normal

or there is too little focusing power. A small

amount of Hyperopia is normal in childhood

and correction is typically not required. A

large amount of Hyperopia may require cor-

rection with spectacles especially if there is

crossing or turning of the eyes. Hyperopia

usually increases in early childhood and then

decreases toward preteen to early teenage

years. Contact lenses and laser surgery are

alternatives to spectacles at the appropriateage.

ASTIGMATISM

In astigmatism, light rays are distorted as they

enter the eye. Some rays may be focused

behind the retina and others in front. Usually

the front part of the eye (the cornea) is curved

more in one direction than in the other. The

shape of the eye is more similar to a rugby

ball or American football than a basketball. Vi-

sion is blurred for both near and far objects.

Glasses are prescribed if the astigmatism issignicant. Contact lenses and laser surgery

are alternatives to spectacles at the appro-

priate age. Astigmatism of some degree is

present in approximately 30-40% of individu-

als who wear glasses or contact lenses.

Irregular astigmatism frequently occurs with

such conditions as keratoconus (a degenera-

tive non-inammatory disorder) and corneal

scarring, which need special attention.

PRESBYOPIA

Throughout its life, the lens of the eye gradu-

ally hardens, becomes less pliable, and pro-gressively increases its resistance to changes

in shape. This leads to greater difculty in

focusing close up. By around the age of 45,

most people require reading correction, as-

suming their vision is corrected for distance.

This condition is known as Presbyopia.

Most patients with Presbyopia first notice

difculties while attempting to perform near

distance tasks, such as reading. There may

be blurring of near objects or discomfort and

fatigue with attempted near vision tasks.

Most patients in the presbyopic age range will

opt for a pair of thin glasses or bifocal glasses

though many other options are present, like

multi-focal and progressive glasses. Contact

lens wearers may wear reading glasses when

needed. Many patients who undergo a refrac-

tive surgical procedure such as LASIK will be

offered monovision, i.e., a planned surgical

approach in which one eye is left near sighted

to minimize dependence on reading correc-

tion. Conductive keratoplasty (surgery using

radio waves) may also be used for Presbyo-

pia correction.

What treatment is there for refrac-

tive errors?

Correction of all types of refractive error can

generally be achieved with spectacles. High

index lenses in both glass and plastic have a

higher refractive index and lenses are thinner,

atter and lighter. It is important that lenses

are tted in the frame with the correct optical

center. Contact lenses correct refractive error

and are either hard or gas permeable, which

oat on the surface of the eye on the tear lmor soft lenses that allow oxygen through them

due to the relatively high water content. There

are a number of different types and they are

all applied directly to the surface and mold

to the shape of the eye. They can be used


17/31

17

Parents with

children at school

should have at

least one check-

up to see if a child

needs glasses, es-

pecially if you wear

glasses. If your

child does not copy

properly from the

blackboard, s i ts

very close to the

TV, squeezes orrubs their eyes, or

has frequent water-

ing of the eyes, it is

always better to

see an eye special-

ist to rule out any

refractive errors.

on a disposable daily basis, monthly dispos-

able, extended wear or standard daily lens.

The most important consideration in contact

lens wear is hygiene. Contact lenses must be

sterilized correctly and not handled without

thoroughly washing your hands as corneal in-

fection can be very serious resulting in loss of

vision. Extended wear lenses have a higher

risk of corneal infection and many contact

lens practitioners do not recommend their

use. Contact lenses must always be removedas soon as redness or discomfort occurs and

not worn again until you have seen an eye

specialist.

Refractive errors can be corrected by laser

refractive surgery when the refractive error is

stabilized, usually by the age of 21, by photore-

fractive keratectomy and by LASIK. It is now

a well standardized safe procedure. However,

there is a risk with any form of treatment of

this type and make sure you are fully informed

of the potential risk to your eyesight.

If you have a refractive error, you should have

your lens prescription incorporated in your

sunglasses to gain maximum visual benet

during summer to avoid the harmful effects of

Ultra Violet radiation.

Refractive Errors in Children - Be Alert

Parents with children at school should have

at least one checkup to see if a child needs

glasses, especially if you wear glasses. If

your child does not copy properly from the

blackboard, sits very close to the TV, squeez-

es or rubs their eyes, or has frequent water-

ing of the eyes, it is always better to see an

eye specialist to rule out any refractive errors.

Between 3-5 years of age, their eyes must beexamined or earlier if there is any squinting of

the eyes. If glasses are not given when need-

ed, then amblyopia sets in. This is a condition

where the eye is normal, but vision does not

improve even with glasses. Amblyopia com-

monly occurs when one eye has normal focus

and the other eye has a signicant error, usu-

ally hyperopia or astigmatism. The dominant

eye develops good vision and the second eye

remains poor. If this is identied early enough,

generally by the age of 18 months, and the

error corrected with glasses and a patch (oc-

clusion therapy) this defect can be corrected.Regular monitoring is necessary until the child

is eight years old.

So make sure you care for yours and your

childrens eyes.


18/31

18

Obesity is an excess of body fat that frequently results in a signicantimpairment of health. A normal sized person has between 30 and35 billion fat cells. When a person gains weight, these fat cells increase

in size and later in number. One pound of body fat represents about

3500 calories.

When a person starts losing weight, the cells

decrease in size, but the number of fat cellsgenerally stays the same. This is part of

the reason that once you gain a signicant

amount of weight, it is more difcult to lose it.

A method was developed that closely corre-

lates with body fat and the metabolic compli-

cations of obesity. This is the BODY MASS

INDEX (BMI) and it is calculated as follows:

BMI= Weight (in kg)/Height (in meters)

squared (ht x ht)

For example, a man who is 510 (1.78meters)

tall and weighs 285lbs (~130kgs) would have

a BMI of 130/ (1.78 x 1.78) =~41

CAUSES OF OBESITY

Obesity results when you consume more cal-

ories than you expend in your daily activities.

Weight gained during certain critical periods

in life more commonly lead to an increased

number of fat cells and make obesity more

difcult to treat. These time periods are:

Between 12 and 18 months of age

Between 12 and 16 years of age

Adulthood - when a person gains in excess

of 60% of their ideal body weight

Pregnancy

Age

Metabolism slows down with advancing age.

People frequently state that they eat the same

and do the same activities as they did when

they were 20 years old, but at 40 are gain-

ing weight. Males have a higher resting me-

tabolism rate than females, so males require

more calories to maintain their body weight.

When women enter menopause, their meta-

bolic rates decrease signicantly. That is part

of the reason why women start gaining weight

after menopause.

Activity level

Active individuals require more calories than

less active ones. Physical activity tends to

diminish appetite in obese individuals while

increasing the bodys ability to metabolize fat

as an energy source.

Body Weight

Heavier people require more calories to

maintain their body weights than lighter ones.

For example, a middle aged man weighing

250lbs. doing minimal amounts of physicalactivity may require 2700 calories to main-

tain his body weight. If this person goes on a

2000 calorie per-day diet, he will lose weight.

Eventually, if he stays with a 2000 calorie daily

diet, his weight will stabilize because his met-

Dr. Mathew George studied atChristian Medical College, Lu-dhiana, India where he wenton to achieve his MD in internalmedicine and be Assistant Pro-fessor of Medicine. He joined AMH in 2002 as a Consultantin Internal Medicine, working inthe hospitals busy OverkampClinic. As part of his role, he alsocoordinates the newly-launchedHypertension Clinic.

Dr. Mathew is a dynamic educa-tor, advocating the importance of patients managing their chronicdiseases from home and work-ing closely with their doctor tomaximize their quality of Life.

Dr. Mathew George,

MBBS, MD

Consultant Internal

Medicine, AMH

C A U S E S A N D C O M P L I C AT I O N S


19/31

19

abolic rate will gradually decrease. When this

man reaches approx. 200lbs. he will require

only about 2000 calories per day to maintain

his new weight.

Food preferences

High fat foods are obesity promoting in hu-

mans. The ready availability of high fat foods

(such as fast foods) combined with the de-

creased requirements from decreased physi-

cal activity, is felt to be the major factor in the

sharp rise in the prevalence of obesity. Thus,

the current low carb, high fat diet craze, which

encourages intake of fatty meats instead of

vegetables (carbs) will in the long run result

in an even sharper rise in obesity and prob-

ably heart disease, as well.

Medications

Certain medications prescribed for inamma-

tory conditions, seizures and mental illness

tend to increase appetite and may also de-

crease metabolic rate.

Hereditary factors affect appetite and me-

tabolism.

Obesity is related to metabolic processes in-

herited primarily from the biological mother.

If the biological mother is heavy as an adult

there is approximately a 75% chance that her

children will be heavy.

Psycho-social and other factors

Depression

Depression is not just feeling blue for a day,

but is the result of actual chemical changes

that take place in the brain, causing profound

episodes of sadness, crying and loss of ener-

gy. Depression is commonly associated with

loss of appetite, but in a signicant minority,

it is associated with increased appetite and

weight gain. Medications used to treat de-

pression are generally very effective, but can

lead to an even greater weight gain.

Binge eating disorder (compulsive overeating)

This disorder is characterized by the following

diagnostic criteria:

Eating in a discrete period of time (within

a two hour period) an amount of food that

is larger than what most people would eat

in a similar period of time under similar cir-

cumstances.

A sense of lack of control----that is, a feel-

ing that one cannot stop eating or control

what or how much one is eating.

The binge eating episodes are associated

with three or more of the following:

Eating much more rapidly than normal.

Eating until feeling uncomfortably full.

Eating large amounts when not physi-

cally hungry.

Eating alone because of being embar-

rassed by how much one is eating.

Feeling disgusted, depressed or guilty.

Smoking and obesity

When people smoke, this increases the

High fat foods

are obesity pro-

moting in humans.

The ready avail-

ability of high fat

foods (such as fast

foods) combined

with the decreased

requirements from

decreased physi-

cal activity, is felt

to be the major

factor in the sharprise in the preva-

lence of obesity.

Thus, the current

low carb, high fat

diet craze, which

encourages intake

of fatty meats in-

stead of vegeta-bles (carbs) will in

the long run result

in an even sharper

rise in obesity and

probably heart dis-

ease, as well.


20/31

20

The risk of dia-

betes is increased

over 53 times the

normal rate with se-

vere obesity. 90%

of Type 2 diabetics

generally develop

their diabetes in

their middle years.

This type is almost

always associated

with obesity and ap-

pears to be relatedto hormonal sub-

stances (cytokines)

produced by adi-

pose tissue and

to the increased

amounts of blood li-

pids (fats) that occur

in diabetes. Reduc-ing body weight by

10% can eliminate

or reduce the need

for oral medications

or insulin injections.

caloric requirements by increasing the rest-

ing metabolic rate. If you stop smoking but

maintain constant food intake and exercise,

your body weight will increase 5% to 10%. An

excellent way to help counter this decrease

in metabolic rate is to increase lifestyle activ-

ity. That is, instead of the multiple cigarette

breaks, make use of that time as walking

breaks. These periods of physical activity

have a cumulative effect and will improve

your mood and health while helping to mini-

mize weight gain.

Injuries and obesity

A professional athlete, laborer or ofce clerk

who had been physically very active but sus-

tains an injury and is now no longer able to do

so, will gain weight. When activity decreases,

the body does not automatically reduce calo-

rie intake but one has to take a conscious ef-

fort to monitor food intake. If obesity is estab-

lished, it is very unlikely that the person will

return to the pre-injury weight.

Complications of Obesity

Though obesity affects virtually every organ

system, some of the more commonly seen

obesity conditions are discussed.

Hypertension

Around 30% of individuals who are at least30lbs. overweight, have mildly elevated blood

pressure. The etiology appears to be related

to substances produced by adipose (fat) tis-

sue and to increase in the hormone insulin

that occurs with obesity. A 10% reduction of

body weight and an avoidance of excessive

salt intake can normalize blood pressure and

reduce or eliminate the need for blood pres-

sure medications.

DiabetesThe risk of diabetes is increased over 53

times the normal rate with severe obesity.

90% of Type 2 diabetics generally develop

their diabetes in their middle years. This type

is almost always associated with obesity and

appears to be related to hormonal substances

(cytokines) produced by adipose tissue and

to the increased amounts of blood lipids (fats)

that occur in diabetes. Reducing body weight

by 10% can eliminate or reduce the need for

oral medications or insulin injections.

Elevated cholesterol (hypercholesterolemia)On an average, every 10lbs. of excess fat

produces 10mg of cholesterol per day. Cho-

lesterol levels are determined by both genet-

ics and diet. Most people can successfully

control their cholesterol by reducing both their

fat intake and weight.

Fatty liver (NASH)

Fatty liver disease (Non-Alcoholic Steato-

Hepatitis) is caused by excessive fat deposi-

tion in the liver. Excess calorie consumption

can lead to excess liver fat which results in

silent inammation of liver, usually detected

by abnormal liver function tests. If untreated it

can develop into cirrhosis or liver failure. The

most effective treatment is weight reduction

and increase in physical activity.


21/31


22/31

22

Christine Zoleta works as Nu-

tritionist-Dietician at AMH. She

holds a B.Sc in Foods and Nu-

trition from St. Pauls College of

Manila and nished her Dietetic

Internship at the University of

Sto. Tomas, Manila.

She has extensive experience

in the food service industry, was

active as a government coun-

selor in public health nutrition

in the Philippines and was a di-

etician for a medical center in a

Canadian-owned copper mining

company.

Christine spearheads the Nutri-

tion and Food Services section

and plays an active role by tack-

ling nutrition implementation

of the Diabetic, Hypertension,Cholesterol and OB-Gyne spe-

cial packages. The AMH Get

Fit package is Christines brain-

child, the rst-of-its-kind, 2-in-1

personalized wellness, diet and

exercise regimen ever offered in

the island.

Christine Zoleta

Nutritionist-Dietician

AMH

Water makes up 60% of average bodyweight and every system in the body

needs water to function. This percentagevaries depending on body composition,

age and gender. Lean tissue holds more

water than fat, so the leaner you are, the

higher proportion of water in your body.

Men have a higher percentage of water

in their bodies than women. Young peopleusually have more than adults. A babys

weight is about 75% water and falls to

50% in the elderly.

How much water do we need?

The average adult loses about 2 12 liters of

water daily through perspiration, urination,

bowel movements and breathing. In hot,

humid weather or strenuous physical activ-ity, uid loss is higher. In healthy people,

water intake and water loss balance outso if you drink more than you need, your

kidneys eliminate the excess. When youdont drink enough, you feel thirsty.

Thirst tells you that your body needs more

uids to perform its functions. But thirst

isnt foolproof, especially for elderly peo-

ple, children, during illness, hot weather orstrenuous physical activity, so dont wait

until you feel thirsty, you may already be

dehydrated.

Your water needs depend on the amount

of energy you use: An adult will use 1 to 1

12 milliliters of water per calorie of energy

expended. Thats 1 to 112 liters for every

1,000 calories. As the average adult uses2,000 3,000 calories daily that means 3

4 liters of water. This is affected by:

A VI TAL

NUTRIENT

OF LIFE

Besides oxygen, the other element we cannot live withoutis water. We each use over 100,000 litres of water a yearthrough various activities including washing, cleaning and

drinking, but what does water actually do for our bodies?

Body Tissue % of water

Blood 83%

Lean Muscle tissue 73%

Body Fat 25%

Bones 22%


23/31


24/31

24

In the Middle

East, exposure to

high temperatures

can cause heat

exhaustion or therisk of heat stroke.

To keep your body

functioning nor-

mally and to avoid

dehydration, your

b o d y n e e d s a

steady water sup-

ply. Drinking wa-ter makes you feel

good and makes

you look good! It

moisturizes your

skin by keeping it

hydrated thereby

giv ing you this

f r e s h , y o u n g e r looking skin al l

the time.

Moistens tissuessuch as those inthe mouth, eyes

and nose

Protects bodyorgans and tissues

Helps preventconstipation

Helps dissolveminerals andother nutrientsto make themaccessible to the body

Regulatesbody temperature

Lubricatesjoints

Lessens the burdenon the kidneys andliver by fushing outwaste products

Carries nutrientsand oxygen tocells

fruit essence. If they contain sugar, other

sweeteners and articial avors, theyre

soft drinks .

... oxygen-enhanced drinks? Do they really

offer benets such as a boost in athletic per-

formance? Probably just marketing hype.

4) Soft Drinks

The basic ingredients of a soft drink are

water, sweetener, acid and a avor. Op-

tional ingredients often include fruit and / or

fruit juice, carbon dioxide, preservative and

coloring. They are typically around 90% wa-ter. Seltzer, tonic water and club soda are

considered soft drinks, not sparkling water,

and may contain sugar and calories. Soft

drinks are considered a contributory factor

in increasing obesity in children.

5) Sports & Energy Drinks

Both of these are sources of water but the

two are often confused. Sports drinks aredesigned to meet particular sporting re-

quirements, such as replacing not just liq-uids but also minerals and carbohydrates

whille energy drinks usually contain high

caffeine levels to stimulate alertness.

6) Alcoholic Beverages

These are a source of water but only if con-

sumed in moderation, that is no more than

one drink a day for women and no more

than two drinks daily for men. Evidence

suggests that moderate drinking may lower

the risk for heart disease, but a healthy life-

style is part of the equation too.

The Gulp in the Gulf

In the Middle East, exposure to high tem-

peratures can cause heat exhaustion or the

risk of heat stroke. To keep your body func-

tioning normally and to avoid dehydration,

your body needs a steady water supply.

Drinking water makes you feel good and

makes you look good! It moisturizes your

skin by keeping it hydrated thereby giving

you this fresh, younger looking skin all the

time.

There is no excuse as bottled water is easyto buy and easy to carry whether to the of-

ce, the gym or the shops.

Water is life. Live your life to the fullest by

drinking more of this healthy beverage.

FUNCTIONS OF WATER IN THE BODY


25/31


26/31

26

form on the joint at the base of

your big toe or at the little toe

(bunionettes).

Tight heel cords. Tightening

and shortening of your Achilles

tendon-the strong brous cord

that connects your calf muscle

to your heel bone. Wearing high

heels prevents your heel fromregularly coming in contact with the ground,

and stops your Achilles tendon from fully

stretching. Over time, your Achilles tendons

contract to the point that you no longer feel

comfortable wearing at shoes.

Pump bump (Haglunds deformity) A bony

enlargement on the back of your heel can be-

come aggravated by the rigid backs or straps

of your heels.

Neuromas.

Mortons neuromaor plantar neuro-

ma is an inamed

nerve tissue that

occurs in the ball

of the foot; usually

between your third and fourth toes, as a re-

sult of wearing tight tting shoes. A neuroma

causes a sharp, burning pain in the ball of

your foot accompanied by stinging or numb-

ness in your toes.

Joint pain in the

ball of the foot(Metatarsalgia).

Increased pres-

sure, strain and

pain in your fore-

foot due to weight

shifting to the ball

of the foot.

Stress fracture. Tiny cracks in one of the

bones of your foot. Generally a result of re-

petitive stress.

Heel pain is extremely common.

It often begins without injury and is felt un-

der the heel, often while standing or walking.

Usually worse rst thing in the morning and

inammation on the sole of the foot (plantar

fascia) where it attaches to the heel bone is

the likely cause.

Plantar warts occur on the sole of the foot.

They result from an infection by a specic

virus. They grow inward and are extremely

difcult to treat.

The good news is these problems donthappen overnight, but rather develop over

time. Its not just your feet that are in jeop-

ardy. High heels have also been linked to

overworked or injured leg muscles, osteoar-

thritis of the knee and low back pain. You

vent injury, orthotics can be

used to support the arch and

provide cushioning.

High arch (Pes Cavus) feet

have an elevated arch, causing

the heel and toes to turn slightly

inward. When walking or exer-

cising, shock is disproportion-

ately absorbed by the heel andthe ball-of-the foot leading to repetitive stress

problems, including pain in the knees, hips

and lower back. Foot problems often develop

in the heel and forefoot such as heel pain syn-

drome, arch strain, metatarsalgia and claw

toes. The solution is to provide longitudinal

arch support which lls in the arch cavity.

How old are your feet?

Over time, your feet become wider and

longer and the natural padding under

your heel and forefoot thins. Years of

standing and walking flatten your archesand stiffen your feet and ankles. When

you wear high heels-shoes with a heel 2

inches or higher- your foot slides forward

in your shoe, redistributing your weight,

creating unnatural pressure points and

throwing your bodys natural alignment

out of order.

High heels are one reason why women have

about four times as many foot problems as

men. Following fashion can cause:

Corns and calluses. Thick, hardened layersof skin develop in areas of friction between

your shoe and your

foot.

Toenail problems.

Constant pressure

on your toe and

nail beds from be-

ing forced against

the front of your

shoe by a high

heel can lead

to nail fungus

and ingrowntoenails.

Hammertoe.

A deformity in which

the toe curls at the

middle joint as a re-

sult of tendon imbal-

ance.

Bunions.

Bony bumps that

Over time, your

feet become wider

and longer and the

natural padding

under your heel

and forefoot thins.Years of standing

and walking flat-

ten your arches

and stiffen your

feet and ankles.

When you wear

high heels- shoes

with a heel 2 inch-es or higher- your

foot slides forward

in your shoe, re-

distributing your

weight, creating

unnatural pres-

sure points and

th rowing yoursbody s na tu ra l

alignment out of

order.


27/31

27

also risk ankle injuries if you lose your bal-

ance and fall off your high heels.

So is it time to surrender high heels?

Ladies keep your high heels, but avoid wear-

ing them all day to minimize your risk of de-

veloping foot problems.

Wear more comfortable

shoes, high heels withdress shoe orthotics.

Research has been

shown that the most ef-

fective way to decrease

force on the ball of the

foot and reduce pain

under the ball of the

foot and the heel is to

use specialized custom

orthotics that transfer pressure off of the pain-

ful area of your feet and provides extra cush-

ion under the forefoot.

Wear high heels with comfort, how?

Select shoes with low heels and a wide

heel base.

Put something in the shoe to transfer the

force of the ball of your feet, a product

that incorporates Insolia technology.

Put something in your shoe that provides

cushion with air pads.

Shoe shopping tips to minimize foot prob-

lems

Shop for shoes late in the afternoon or in

the evening. Your feet swell during the

day. A shoe that feels ne when you try it

on in the morning could feel tight later.

Theres no such thing as a break in

period. Shoes should feel comfortable

right away.

Pay attention to materials and style. Se-

lect materials that breathe and allow ex-

ibility, such as leather or nylon mesh.

Try on both shoes before buying. Many

people have one foot larger than the

other. So select shoes that t the larger

foot. Make sure you have at least a

ngers width between your longest toe

and the end of your shoes.

Dont rely on shoe size alone. Gauge

proper t by how the shoes feel when

you try them on. Sizes can vary from one

manufacturer to another and from one style

to another. Dont worry about the

stated size of the shoe. Worry aboutthe t. Dont buy shoe if it feels too

tight. It will not stretch to t your foot.

Check your shoe size. Your feet getlonger and wider as you age. Its a good

idea to recheck your shoe size every

few years or so. Stand up when being

sized because your feet expand when

you step on them.

Other common foot problems

In-grown toenails

Left untreated or un-detected, an ingrown

toenail can infect the

underlying bone and

lead to a serious bone

infection. Even worse

it could become gan-

grenous and lead to

amputation.

Corn and Calluses

Treat only if they cause discomfort.

Nail fungus

These infections usually develop on

nails continually exposed to warm, moist

environments,

such as sweaty

shoes or show-

er oors. See

your doctor at

rst sign of nail

fungus, which

is often a tiny

white or yel-

low spot under the tip of your nail . This maycause permanent damage to your nails.

Diabetic foot

Nervous sys-

tem impairment

(neuropathy) is

a major com-

plication that

may cause you

to lose feeling

in your feet or

hands. This means you wont know right away

if you hurt yourself. The problems affect 60-70% of people with diabetes. It is very impor-

tant for diabetics to take the necessary pre-

cautions to prevent all foot related injuries.

Tips for taking care of your feet

Wash and check your feet everyday

Dont cross your legs for long periods

of time

Be more active

Dont disregard foot pains.

Be kind to your feet, they will return the favor.

Dont let your sense of style cripple your abil-

ity to stand, sit or step pain-free.

Research has

been shown that

the most effective

way to decrease

force on the ball

of the foot andreduce pain un-

der the ball of the

foot and the heel

is to use special-

ized custom or-

thotics that trans-

fer pressure off of

the painful areaof your feet and

prov ides ex t ra

cushion under the

forefoot.


28/31

28

Enhancing Care for newborn babies at the American Mission Hospital

NEONATOLOGY

For over a hundred years, American Mission Hospital has capably

met the needs of expectant mothers with normal pregnancies,and the walls of our Obstetric Unit are lined with framed photographsof healthy, beaming infants and toddlers who rst saw the light ofday in our delivery room. The mothers who deliver their babies hereexperience tender loving care from our staff and, more often thannot, they choose to come back for their succeeding pregnanciesbecause they are condent of receiving the same care.

But not all pregnancies proceed as planned,

and in the past we have had to refer some

high-risk pregnancies, where we identied po-

tential problems, to a larger medical center for

the delivery. Or sometimes we have delivered

babies who are not the normal bouncing kind

but show signs and symptoms of distress. In

these instances, weve had no alternative but

to transfer these sick babies to other institu-

tions because we were not equipped to man-

age such problematic newborns. One can

then imagine the disappointment and anxiety

that strikes the parents when the newest, most

fragile member of their family has to be trans-

ferred to unfamiliar surroundings, away from

the mother, for specialized medical care.

We have delivered increasing numbers of ba-

bies in recent years (over 600 in 2007), andtherefore we expect to encounter more high-

risk pregnancies and deliveries, and we rec-

ognize the necessity of being able to address

the needs of these babies who require more

than routine newborn care. In anticipation of

this, we have added neonatology as one of

the specialized services that the hospital has

to offer. Neonatology is the medical specialty

of taking care of newborns, especially sick or

problematic babies, as well as premature ba-

bies. Neonatology basically means science

of the newborn, coming from the root words

neo = new, natal = birth, and ology = sci-

ence of. Now that the hospital has the most

modern medical equipment for monitoring and

ventilation, we are now able to provide more

comprehensive care to these ailing newborns

in a fully-equipped Special Care Baby Unit

(SCBU).

What is the Special Care Baby Unit?

The SCBU is a special area of the Obstetrics

Ward that is devoted to the care of criticallyill babies. It is staffed round-the clock by the

neonatologist (which is just a fancy techni-

cal term for baby doctor), pediatricians and

nurses who are skilled at neonatal resuscita-

tion and management of newborn problems

Dr. Ma. Lourdes S. Imperial ob-

tained her Bachelor of Science

in Biology degree from the Uni-

versity of the Philippines in Dili-

man. She graduated from theUERMMMC College of Medicine

then proceeded to complete

her Pediatric Residency and

Neonatology Fellowship train-

ing at the Philippine General

Hospital. She is a Fellow of the

Philippine Pediatric Society and

a Diplomate of the Philippine

Society of Newborn Medicine.

She is a certied instructor of

both the Neonatal Resuscitation

Program and the S.T.A.B.L.E.

Program for post-resuscitation/

pre-transport stabilization of

the neonate. She is also an ac-

tive member of the Newborn

Screening Society of the Philip-

pines and the Community Pedi-

atrics Society of the Philippines.

Before joining the AMH family,

she was afliated with several

teaching hospitals as a lecturer,

and was an active consultant

and newborn screening coordi-

nator in numerous private hos-

pitals in different provinces in

the Southern Luzon area in thePhilippines.

Dr. Ma. Lourdes S. Imperial

Neonatologist

AMH

NEONATOLOGY


29/31


30/31

GENERAL PRACTITIONERS (OPD) MANAMA

DR. P. RICHARDSON GENERAL PRACTITIONER 17248110 / 17248121

DR. SUSAN ISAAC GENERAL PRACTITIONER 17248110 / 17248121

DR. CECILIA SOLIVEN-EDROZO GENERAL PRACTITIONER 17248110 / 17248121

DR. SAMUEL ISAAC GENERAL PRACTITIONER 17248110 / 17248121

DR. MOHAMMED AL KHATEEB GENERAL PRACTITIONER 17248110 / 17248121

DR. EDMUND EDROZO GENERAL PRACTITIONER 17248110 / 17248121

DR. MARY JAYA GANAPATHY GENERAL PRACTITIONER 17248110 / 17248121

DR. SOLOMON VINAY KUMAR GENERAL PRACTITIONER 17248110 / 17248121

DR. JOEL SURENDER GENERAL PRACTITIONER 17248110 / 17248121

DR. NATESAN NEHRU GENERAL PRACTITIONER 17248110 / 17248121

DR. WESAM SALEEM MUSTAFA GENERAL PRACTITIONER 17248110 / 17248121

DR. VIRGINIA PAZ BRAGA 17248110 / 17248121

DR. ANITA DAVIS GENERAL PRACTITIONER 17248110 / 17248121

DR. JOBEL LAPINID GENERAL PRACTITIONER 17248110 / 17248121

RESPIRATORY MEDICINE

DR. BABU RAMACHANDRAN 17248110 / 17248121

DR. SUAD AL MUNFARIDI EXTENSION: 374

PAIN CLINIC

DR. KALYAN SUBRAMANYAM EXTENSION: 353

OVERKAMP CLINIC ( INTERNAL MEDICINE )DR. M.D.V.N. NAGESH BABU INTERNIST 17248122 / 17248123

DR. K. MATHEW GEORGE INTERNIST 17248122 / 17248123

DR. ANABETH LIM SAKHRANI INTERNIST 17248122 / 17248123

Sub Speciality

DR. NEIL DE JESUS RANGEL INTERNIST / ENDOCRINOOGIST 17248122 / 17248123

DR. EMERITA CO - DE LEON INTERNIST / CARDIOLOGIST 17248122 / 17248123

OB / GYN CLINIC

DR. BHANU VASUDEVAN OBSTETRICS / GYNECOLOGY 17248142

DR. ALKA GUPTA OBSTETRICS / GYNECOLOGY 17248142

DR. C. S. SHOBHA OBSTETRICS / GYNECOLOGY 17248142

DR. JULIET PREM OBSTETRICS / GYNECOLOGY 17248142

DR. CECILIA PACHECO OBSTETRICS / GYNECOLOGY 17248142

DR. SUSAN QUIJANO OBSTETRICS / GYNECOLOGY 17248142

DR. PAULITA BARETTO-ABASILLAS OBSTETRICS / GYNECOLOGY 17248142

GENERAL SURGERY

DR. SANJAY GUPTA EXTENSION: 351

DR. NANIK SAKHRANI EXTENSION: 351

DR. JENNIFER A. GARCIA GENERAL SURGEON EXTENSION: 351

DERMATOLOGY CLINIC

DR. BHARTENDU MEHTA EXTENSION: 354

NUTRITION & FOOD SERVICES SECTION

CHRISTINE ZOLETA NUTRITIONIST - DIETICIAN 17248145 / 17248146

GENERAL PRACTITIONER /SMOKING CESSATION

GENERAL PRACTITIONER /PULMONOLOGY

GP ANESTHESIOLOGIST /

PAIN MANAGEMENT

GENERAL SURGEON /

ASST. CHIEF OF MED. STAFF

GENERAL SURGEON /

LAPAROSCOPIC SURGEON

DERMATOLOGIST /

VENEREOLGIST

ENT CLINIC

DR. E. KRISHNAN ENT SURGEON 17248148

DR. ELMER ESPINOSA ENT SURGEON 17248148

DR. STANLEY KWIK ENT SURGEON / ALLERGIST 17248148

MS. SHEIK NAZIYA BATUSHAAUDIOLOGIST /

SPEECH THERAPIST17248148

ORTHOPEDIC CLINIC

DR. ABRAHAM GEORGE ORTHOPEDIC SURGEON EXTENSION: 330

DR. BASHEER AHMEDORTHOPEDIC SURGEON/

SPORTS MEDICINEEXTENSION: 330

DR. JUAN MAGALONG ORTHOPEDIC SURGEON EXTENSION: 330

PEDIATRIC CLINIC

DR. KAMLESH RAISINGHANI PEDIATRICIAN 17248113

DR. RAVINDRA E. BHINGARE PEDIATRICIAN 17248113

DR. PREETHA ACHUMON PEDIATRICIAN 17248113

DR. MARIAM KOSHY PEDIATRICIAN 17248113

DR. MA. CRISELDA DIVINA-NAVARRO PEDIATRICIAN 17248113

DR. RENE ALLAM PEDIATRICIAN 17248113

Sub Speciality

DR. MARIA LIZA ESPINOZAPEDIATRICIAN / PEDIATRIC

PULMONOLOGIST17248113

DR. JUDY PIPO DEVEZA PEDIATRICIAN / NEUROLOGY 17248113

DR. LOURDES IMPERIAL PEDIATRICIAN / NEONATOLOGY 17248113

ANESTHESIOLOGY

DR. HEMANGINI RAJU AL MOULA ANESTHESIOLOGIST EXTENSION: 315

DR. KANUBHAI PARMAR ANESTHESIOLOGIST EXTENSION: 315

OPHTHALMOLOGY CLINIC

DR. RAJINDER PARKASH SACHDEVA OPHTHALMOLOGIST EXTENSION: 263

RADIOLOGY DEPARTMENT

DR. BEULAH ISAACS RADIOLOGIST 17248117

DR. V GANESAN RADIOLOGIST 17248117

DR. CHARITO K. MANGUERRA RADIOLOGIST 17248117

PHYSIOTHERAPY DEPARTMENT

MS. ZAITOON MALOO PHYSIOTHERAPIST 17248140

MS. GLENDA BARBACENA PHYSIOTHERAPIST 17248140

MS. JIYA SARAH ITTICHERIA PHYSIOTHERAPIST 17248140

DENTAL DEPARTMENT

DR. ZAHRA MAJEEDGENERAL DENTIST / CHIEF OFDENTAL SERVICES, MANAMA

17248145 / 17248146

DR. HUSSAIN AL WEJDANI GENERAL DENTIST 17248145 / 17248146

DR. NOSHEEN HUSSAIN GENERAL DENTIST 17248145 / 17248146

DR. ANDLIB TARIQUE GENERAL DENTIST 17248145 / 17248146

DR. SAJNI VAIDYAGENERAL/PERIDONTICS/COSMETIC DENTISTRY

17248145 / 17248146

GENERAL PRACTITIONERASSIST. CHIEF MEDICAL STAFF

D O C T O R S , D E N T I S T S & S P E C I A L I T I E S

DR. PAUL ARMERDING - Chief Medical Officer DR. KEN KAUFMANN - Chief of Medical Staff

P.O. BOX 1, Manama, Kingdom of Bahrain Tel: (+973) 17253447 Fax: (+973) 17234194 email: [email protected] website: www.amh.org.bh


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SAAR MEDICALand DENTAL CENTER

General practice, Pediatrics, Obstetrics Gynecology, ENT (Ear, Nose and Throat),

Dermatology, Psychiatry and Physiotherapy. General Dentistry, Implantology,

Endodontics, Orthodontics and Cosmetic Dentistry.

The AMH Saar Medical and Dental Center is a department of the American Mission Hospital. It functions as a satellite clinicwhich provides quality medical and dental services to the community.

The clinic provides general and specialty clinics to ensure that each patient is seen by a competent physician or dentist.In addition, the clinic has a mini laboratory wherein minor tests and phlebotomy service are available. The clinic also has apharmacy which stocks a wide collection of medications for dispensing. There is a furnished childrens play area andspacious car parking area.

AMH 14th Mag Eng No ads

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