Articles Archive Section

Lebanon’s mountains, summer haven & winter ski!

On the eastern Mediterranean coast, Lebanon is known for its range of mountains that are close to the seashore. In the summer, the mountain villages and towns become summer retreats, sought for their cool weather and green scenery. In the winter, other mountain areas flourish as ski destinations, because of their peaks, slopes and undisturbed snow. Lebanon through out history has been an integral part of the Middle East region; The Phoenicians initially established coastal city states all along the eastern Mediterranean coast, over the succeeding millennia the region continuously evolved, due to different influences and migration of people and their interaction, resulting in the present day multicultural Lebanon. Arabic is the official language, French and English are spoken & understood.
Lebanon is rebuilding and the country is an interesting destination to visit and explore, "taking in to consideration, the social and infrastructure shortage that accompanies the rebuilding process". A valid passport and a visa is required to visit, which can be obtained at the airport for most nationalities, check details with any Lebanese diplomatic mission.

              
Coffee protects the Brain?  
     
Patients with Parkinson's disease (a Brain disease that causes tremors-shaking, stiffness, slowness and instability-loss of balance in older people) according to a study from Germany's Otto-von-Guericke University, drink less Coffee than people without the disease. The article published in the Neurology Journal, talks about Diet and specific Nutrients role, in the disease which can cause death years later, if not managed adequately.

Parkinson's may have hereditary, environmental and infectious causes leading to a decrease in the brain chemical Dopamine and others. People with Parkinson's may live as long as other people with treatment and care.



Reference
· Diet and Parkinson's disease. II A possible role for the past intake of specific nutrients. Results from a self-administered food frequency questionnaire in a case control study[see comments]. Hellenbrand W-
Neurology-1996 Sep; 47(3): 644-50. From NIH/NLM MEDLINE, HealthSTAR.

Cold...Influenza Vaccine & Treatment?

In the Cold season the recommendation is for the Vaccine against the Influenza Virus, for people at high risk: the elderly, the pregnant, adults and children with chronic diseases, children and teenagers who are receiving long-term aspirin. Vaccination being a preventive measure that is cheaper than treatment.

Influenza virus causes a respiratory infection that can range from no symptoms to the typical cold to pneumonia to even death in high risk people. For the treatment  of the virus, Glaxo-Wellcome had introduced Relenza: Zanamivir an inhaled medication (similar to Tamiflu: Oseltamivir  by Hoffmann La Roche). Some studies have shown that it may also prevent transmission of the virus to others, in general with mild side effects.
Reference
 · Stamboulian D - Infect Dis Clin North Am - 2000 Mar; 14(1): 141-66
From NIH/NLM MEDLINE, HealthSTAR 
 ·  Neuraminidase inhibitors for treatment of influenza A and B infections [published erratum appears in MMWR Morb Mortal Wkly Rep 1999 Dec 17;48(49):1139]

The Abortion Pill …..RU- 486

The "Abortion Pill" also known as RU- 486 (or mifepristone and Mifeprex ® ), and its follow up medication misoprostol, can terminate unwanted pregnancy earlier than most surgical procedures. Among the complications reported by women were excessive bleeding, cramping, nausea and diarrhea; Patients with bleeding disorders and those who smoke are among the patients that should avoid RU-486. A rare reported complication was toxic epidermal necrolysis after mifepristone/gemeprost-induced abortion.

The "Pill" may require three office visits. The first visit is to confirm that the pregnancy is in the uterus, and that it is within the time period allowed by law to take the pill. The second visit is to take the follow-up drug, which triggers contraction of the uterus and expulsion of fetal tissue. The third visit is to confirm that the abortion was successful. The patients will have 35 days from the date of their first missed period to make the necessary arrangements.

According to the conclusion of "one" study from India, China and Cuba, the "Pill" failure rate although low, exceeds surgical procedures, and the "Pill" may be safe efficacious and acceptable in developing countries.
Reference
· Safety, efficacy, and acceptability of medical abortion in China, Cuba, and India: a comparative trial of mifepristone-misoprostol versus surgical abortion. Winikoff B et al. - Am J Obstet Gynecol - 1997 Feb; 176(2): 431-7
From NIH/NLM MEDLINE, HealthSTAR
· Toxic epidermal necrolysis after mifepristone/gemeprost-induced abortion
C. Lecorvaisier-Pieto MD et al. Journal of the American Academy of Dermatology
Volume 35 • Number 1 • July 1996, Copyright © 1996 American Academy of Dermatology, Inc.

Stress worsens Heart disease and decreases Immunity
 
How someone deals with stress affects their health and work. Prolonged stress showing up in continuous anxiety, fear, sadness and anger leads to feeling tired and having difficulty working effectively, this may contribute to illness, and some have suggested that stress may affect the immune system. Stress such as caring for a spouse with dementia, and experiencing marital discord, and grieving have been shown to affect the immune function. There is some evidence that chronic anger and hostility are risk factors for heart disease.

One study in patients with heart disease having "balloon opening of heart arteries" (Angioplasty), looked at levels of hostility (anger/hate) in these patients and found that the ones who were most hostile, were more likely to undergo a repeat balloon procedure (Angioplasty) than those who were less hostile. This may suggest that people with hostile/angry personalities may be at higher risk for heart disease.

Another study showed similar results, stressed individuals showed sharp and significant increases in blood pressure, heart rate and blood thickness (viscosity). These studies suggest that stress and anger may contribute to heart disease, but the relationship is not clearly established.
Reference
·  Irwin M, Lacher U, Caldwell C: Depression and reduced natural killer cytotoxicity: A longitudinal study of depressed patients and control subjects. Psychol Med 22(4):1045-1050, 1992
·  Kiecolt-Glaser J, Dura JR, Speicher CE, et al: Spousal caregivers of dementia victims: Longitudinal changes in immunity and health. Psychosom Med 53(4):345-362, 1991
·  Kiecolt-Glaser JK, Fisher LK, Ogrocki P, et al: Marital quality, marital disruption, and immune function. Psychosom Med. 49(1):13-34, 1987
·  Calabrese JR, Kling MA, Gold PW: Alterations in immunocompetence during stress, bereavement, and depression: Focus on neuroendocrine regulation. Am J Psychiatry. 144(9):1123-1134, 1987
·  Irwin M, Daniels M, Risch SC, et al: Plasma cortisol and natural killer cell activity during bereavement. Biol Psychiatry 24(2): 173-178, 1988
·  Zisook S, Shuchter SR, Sledge PA, et al: The spectrum of depressive phenomena after spousal bereavement. J Clin Psychiatry. 55:29-36, 1994
·  Goodman M, Quigley J, Moran G, et al: Hostility predicts restenosis after percutaneous transluminal coronary angioplasty. Mayo Clinic Proc 71(8):729-734, 1996
·  Muldoon MF, Herbert TB, Patterson SM, et al: Effects of acute psychological stress on serum lipid levels, hemoconcentration, and blood viscosity. Arch Intern Med. 155(6):615-620, 1995

Women & Testosterone.....

Women who had their uterus and both ovaries removed and were given a combination of estrogen and testosterone therapy, report higher rates of sexual desire, arousal and number of fantasies, than those who were untreated or given estrogen alone. It’s proposed that testosterone may be important for the maintenance of sexual function in women after menopause. Women after menopause who were treated with estrogen plus testosterone have lower rates of bone loss over a 3-month treatment period than those treated with estrogen alone.

Normally, the ovaries secrete on average 150 µg of testosterone each day in women before menopause; However, the role of testosterone in women remains unclear. Most of the studies in women after menopause have used relatively large doses of testosterone, so it is not known, if the addition of "normal" doses of testosterone to estrogen replacement can improve muscle strength, sexual function, and bone density in women after menopause without resulting in excessive masculine effects.
Reference
· Shalender B. et al., Emerging Issues in Androgen Replacement Therapy. CLINICAL REVIEW 85.  Journal of Clinical Endocrinology and Metabolism. Volume 82 • Number 1 • January 1, 1997.
· Sherwin BB,et al: Exp Gerontol 1994 May-Aug;29(3-4):423-30
· Sherwin BB, et al., Effects of parenteral administration of estrogen and androgen on plasma hormone levels and hot flushes in surgical menopause. 1984. Am J Obstet Gynecol. 148:552-557.
· Sherwin BB et al., Pharmacology, Biology, and Clinical Applications of Androgens. 1996 Androgen use in women. New York: Wiley-Liss; 319-324.

What Men consider their Personal Health Resources?

It is a good idea to ask Men what they consider their Personal Health Resources and use these identified resources to help men mobilize these resources and support to achieve a beneficial approach. According to a study published in Family Practice Journal, conducted by the Public Health Departments of the University of Copenhagen, Denmark and University of Bergen, Norway.

The Men in the study considered that the following were personal health resources: optimism, good self-esteem, job satisfaction, ability to cope with stress at work, leisure activities and relaxation with friends producing energy, and fitness and lifestyle activities.
The study states that asking people about their ideas shows that coping is more complex than prevailing research indicates and this contrasts with the tendency of medicine now a days to focus on risk.
Reference
·  Hollnagel H et al. Fam Pract 2000 Dec;17(6):529-534

2001 Crash Testing Results for Safe Cars & SUVs

Crash testing of the year 2001 of Cars, Sport Utility Vehicles, Vans & Trucks is underway at the National Highway Traffic Safety Administration (NHTSA) which is under the U.S. Department of Transportation. The results are reported in a range of one to five stars. Five stars indicate the best protection for vehicles within the same weight class. The ratings represent a vehicle's relative level of crash protection in a head-on collision & this rating system has been extended to the lateral impact. As for Sport Utility Vehicles (SUVs), they are more prone to roll over than other vehicle types as they generally have higher ground clearance and narrow width which on the other hand gives them an advantage when driving off roads.  No Mercedes or BMW vehicles were tested. Some of the results are incomplete, or are due later on in the year, however, taking that in to consideration, the following were some of the results

News Archive Section

Hajj : Health  & Vaccination Requirements
SUMMARY of the requirements as it applies to the individual, for FULL details see the Reference "Center for Disease Prevention and Control"
I. YELLOW FEVER:
A. All travelers arriving from countries known to be infected with yellow fever (as shown in the World Health Organization [WHO] Weekly Epidemiological Record and in the biweekly Summary of Health Information for International Travel [the “Blue Sheet”] document #220022) must present a valid yellow fever vaccination certificate in accordance with the International Health Regulations. In the absence of such a certificate, the person will be vaccinated upon arrival and placed under strict surveillance for 6 days from the day of vaccination or the last date of potential exposure to infection—whichever is earlier.
II. MENINGOCOCCAL MENINGITIS:
A. For all arrivals.  Visitors from all over the world arriving for the purpose of “Umra” or pilgrimage or for seasonal work are requested to produce a certificate of vaccination against meningitis issued not more than 3 years and not less than 10 days before arrival in Saudi Arabia. The responsible authorities in the country from where the visitor comes must ensure that vaccination has been carried out as follows:
Adults and children over the age of  2 years must be given one dose of the A/C vaccine. Children between 3 months and 2 years of age must be given two doses of the A vaccine with a 3-month interval between the two doses.
B. Arrivals from countries in the African meningitis belt (see map). It must be ensured that all visitors from these countries have been vaccinated in their countries, not more than 3 years and not less than 10 days before arrival. This should be documented on the vaccination certificate. Visitors from these countries will be checked at entry points to ensure that they are vaccinated.  Suspect cases, shall be isolated and preventive measures will be taken in respect of their direct contacts. If the authenticity of the vaccination certificate is felt to be questionable, revaccination is to be carried out.  Chemoprophylaxis will be administered to all visitors from these countries to lower the carrier rate among them.
III. EPIDEMIOLOGICAL SURVEILLANCE:
Tight control is exercised on entry points in respect of pilgrims and “Umra” visitors, and thorough surveillance shall be made in respect of visitors coming from countries infected with diseases subject to the International Health Regulations, in addition to isolation of suspect cases and surveillance of their contacts.
IV. FOODS:
Foods carried by visitors and pilgrims are banned and not allowed into the country.

Reference
·Saudi Arabia Hajj Requirements: Center for Disease Control & Prevention

A resort harbor town in Tunis

North of the Tunisian city of Sousse (called Hadrumetum during Hannibal's time, renamed Susa by the Arabs in the 7^th century), lies the resort harbor town of Port el Kantaoui, with its stylish marina, and the appeal of ancient Andalusian design, white buildings, arches, extending balconies, flat roofs combined with modern conveniences and comforts. The harbor provides mooring for yachts from Europe and elsewhere.
A nice paved & cobble stone promenade runs around the marina, from which pleasure boats & floating restaurants run trips regularly. Leading off the promenade through meandering streets are shops, restaurants, cafes and apartment buildings. Water sports & riding are available from the sandy beach north of the harbor and behind the beach are the stretch of hotels. On the side of a hill lies the town’s prominent golf course, on a 250 acre property, with 4 nine hole courses.
North west lies several unspoiled traditional Tunisian villages: Akouda, Hergla & Takrouna, charming & different from the resort port and are worth a trip to explore.

Tunis... the Heart & Vitamin E
              
In patients with Coronary Heart disease from Tunis, an association was found between Vitamin E and Coronary disease. The level of Vitamin E was significantly lower in the plasma of patients compared to others that did not have Coronary Heart disease. Vitamin E prevents a chemical reaction called oxidation, that can have harmful effects in the body.

Some diets, diseases and surgery can increase the need of the body for Vitamin E. Good sources of Vitamin E include vegetable oils, wheat, whole grain cereals and green leafy vegetables. Processing foods can destroy vitamin E. The study was done at the Laboratoire de Biochimie Clinique and Service des Explorations Cardiologiques, Hopital La Rabta, Tunis, Tunisia.
                         
Reference
·  Feki M, et al Clin Chem 2000 Sep;46(9):1401-5

Cellular Phones don't cause Brain Cancer...?

The safety of cellular phones in terms of the electromagnetic radiation they emit, as being a cause of brain cancer, has been a question in the public mind for a while.

In a study in the Journal of the American medical Association (JAMA), looking at patients with brain cancer compared to people (controls) without brain cancer. In terms of the duration of use of the cell phones, there was no association. In terms of the location of the brain cancer, in relation to the side of the head where the cell phone was used, brain tumors occurred more frequently on the same side of the head where cell phones had been used.

The conclusion was that there is no association between brain cancer and cellular phone use, but further studies are needed especially as it relates to slower growing brain tumors.
                 
Reference
·  Muskat JE et al.: JAMA 2000 Dec 20;284(23):3001-7
·  Cellular Phone Antennas (Base Stations) and Human Health

Facial Hair Treatment.....Vaniqa!

Vaniqa ® Cream (eflornithine hydrochloride), a topical prescription treatment for women with facial hair was approved by the U.S. Food & Drug Administration (FDA) according to Bristol-Myers Squibb & Gillette. It comes in a form of a gel and works by blocking an enzyme required for facial hair growth.

Side effects include minor skin irritations, redness, stinging, burning, tingling, acne & rash. The side effects generally resolved without treatment.

Facial hair is mostly caused by hereditary factors and less frequently by medical conditions, excess androgens, polycystic ovarian disease and other causes. In clinical trials more than half the users of Vaniqa showed improvement after 24 weeks of treatment. It took 2 months for Vaniqa to work.

Reference
·  FDA Approves Vaniqa™ As Treatment For Women With Unwanted Facial Hair
· Vaniqa web site

Influenza in the Middle East, Germany & Belgium in October to December, 2000

Belgium (25 November 2000). Sporadic cases of influenza A and B have been reported since the last week of October.

Germany (2 December 2000). Another case of influenza A(H1N1) was confirmed in Berlin, the second influenza virus identified for this season.

Iran Islamic Republic (8 December 2000). Since the third week of November, local outbreaks of influenza have been reported, primarily among school children. The first virus isolate was of subtype A(H1N1). 

Israel (2 December 2000). An additional 2 cases of influenza A were diagnosed, one of which was a 1-year-old child hospitalized for respiratory infection. The viruses were identified to be of subtype A(H1N1).
        
Reference
· WHO: Epidemiologic Record: 15 Dec, 2000 Vol 75, 50 (pp409-416)

Fever in Yemen

In September & October 2000, Rift Valley fever (RVF) was reported in Yemen & Saudi Arabia. In humans the disease manifests as an acute fever, headaches, hemorrhagic disease, jaundice, retinitis, and unexplained neurological disease (encephalitis).

Rift Valley fever is caused by a virus first described in Kenya in 1930s, a similar outbreak occurred in Egypt in 1970’s. The disease may have been transmitted through infected animals from Africa.

Control of the disease involves education of the population to avoid handling infected animals and tissues, insect control such as mosquitoes, and correct treatment of patients in health facilities.

       
                
Reference
· WHO: Epidemiologic Record: 1 Dec 2000, Vol 75, 48 (pp 385-396)