Tag Archives: Health

8 Causes of Dry Skin & Solutions

Hands

Photo credit:  photostock/freedigitalphotos.net

Amazingly, medical journals only look at skin diseases, but have always overlooked the humble dry skin. It is however an extremely common problem that patients have. I was so happy when I found this article written by Dr Anneke Andriessen, a Consultant at UMC, St Radboud Nijmegen, Netherlands at the British Journal of Nursing, published in January 2013. That is an extremely comprehensive article, unfortunately not for public assess. So here are the causes:

1. Dry weather.

2. Central heating and air-conditioning.

3. Tight clothing.

4. Detergents, deodorant, soaps (especially anti-bacterial ones) that strip away the lipids and water from the skin.

5. Sun exposure.

6. Aging.

7. Zinc, essential fatty acid and vitamin D deficiency.

8. Diseases such as hypothyroidism (low thyroid levels), kidney failure, diabetes, HIV, skin diseases and nerve problems that decrease sweating.

Here are the solutions:

1. Consider an air humidifier indoor.

2. Use gentle washers such as those that are suitable for babies.

3. Use moisturizers generously.

4. Take a healthy and balanced diet. Zinc is available in many food. Essential fatty acids are the omega-3 and omega-6 that are rich in fish, nuts and oil olive, amongst others. A study done last year found that low vitamin D levels is associated with dry skin, and using a moisturizer enriched with vitamin D improves the situation. Milk and salmon are rich sources of vitamin D, and we can also make our own under sunlight. However, lack of vitamin D is common, 90% in winter in Switzerland (expected), but is actually worse in Singapore, a country in the equator. Singaporeans mostly work indoor and avoid the hot sun whenever possible.

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Avoid Glibenclamide for patients who are elderly or have renal failure

Finger prick meter

Photo credit:  Gualberto107/freedigitalphotos.net

Glibenclamdie (glyburide in America) is a common and useful drug for type 2 diabetes. It is effective and the blood sugar lowering effect long-lasting. However, the strength is also a weakness: it can sometimes be so powerful that the patient can suffer prolonged hypoglycemia (low blood sugar level).

The Health Sciences Authority of Singapore had looked at the data and found that in Singapore, patients who are above 60 or those with kidney failure have a much increased risk of severe and protracted hypoglycemia. They have now advised all doctors to avoid using glibenclamide in those patients.

There are many other alternative drugs in the same class such as gliclazide and they are also generics, available at a low price at our clinics.

If you are taking glibenclamide and had recently turned 60 or have renal failure, please do not stop your medicine immediately, but talk to your doctor about it.

3 Scientifically Proven Way to Prevent Diabetes: sleep, move, eat

Tsunami

Photocredit: Danilo Rizzuti/freedigitalphotos.net

My article on the Coming Tsunami of Diabetes: how to dodge it has just been published.

Diabetes is an extremely serious problem in Singapore. 1 in 9 adults have it and by 2030, 1 in 5 adults are going to get it.

I personally love the first scientifically proven way: sleeping. Not sleeping enough increases our stress hormones (adrenalin and cortisol) which raises our sugar, and increases our hunger hormone so we want to eat more.

The second is what all doctors say: exercise. I had previously written about the power of exercise.

The third is to eat healthy. Avoid artificially processed starch such as white bread,  white rice and juices. Whole grains should be taken instead. Yes even Michelle Obama supported it.

Remember: sleep, move, eat.

World Diabetes Day Singapore 2013

WDD 2013

Mark the day – 10 November 2013. As diabetes affects 11.3% of Singaporeans, the number of families with one or more members are becoming very high. This year the Diabetes Society of Singapore is going to have an event packed with activities at the Suntec Convention Centre. There are tons of free stuff there:

Free Hba1c test (cost $30)

Free eye photos (cost $30)

Free feet check (cost from $25 at least)

Free consultation with diabetic nurse educators, pharmacists, dieticians (cost from $25 each)

Total free stuff: $160 plus the goodie bag!

In fact since every year the DSS celebrates the World Diabetes Day, you can just get your eyes and feet checked free of charge over there, as they are supposed to be screened yearly as well.

Pravin, a patient with type 1 diabetes will also be there to share his experience. He was diagnosed to have type 1 diabetes at age 7, but had learnt to live with the illness, and is now an engineer. He also runs marathons, climb mountains and volunteers overseas to help other people with diabetes.

So just go to Suntec this Sunday!

Urine Spills in Factories Making Generic Drugs

capsulesPhoto credit: antpkr

I love the US Food and Drug Administration (FDA). They set the standards for generic drug safety, allowing small countries like Singapore to save a lot of time and money to check on the quality of generic drug manufacturing. Unfortunately, what they found in the Wockhardt factory was not pretty: urine on the floor, dirty uniform, moldy storage areas.

Yikes! I would not give my patients these drugs, no matter how cheap they are!

On the other hand, this piece of news creates a problem for doctors and patients. Generic drugs are much cheaper than the originals and allow governments to treat a lot more patients. While the rich patients would of course demand genuine medication, it is not feasible to treat everyone with expensive branded medication. We need the generics and we need to make sure that their standard of quality is good.

The best way to ensure quality compliance is spot checks. Keep up the good work, FDA!

Problem of Slimming Drugs sold as “Supplements”

ImagePhoto Courtesy: Health Sciences Authority Singapore

If you are taking Oxylite Pro now, stop taking them immediately. The Health Sciences Authority of Singapore had issued an alert after Oxylite Pro had been found to cause liver injuries. An analysis of the ingredients found the potent chemicals 1,3-dimethylamylamine (DMAA) and yohimbine. Those chemicals have caused liver injuries.

Oxylite Pro is marketed as a magic weight loss supplement. Looking at the ingredient from its website, it probably works to some extent, as it contains DMAA and yohimbine which are stimulants and caffeine that increases the metabolic rate, and certain plant extracts that increases thyroid hormone which in turn increases the metabolic rate.

Mainstream Western medication can be toxic if taken inappropriately. That is why even paracetamol (Panadol) in overdoses can harm the liver. That is the reason only doctors can prescribe registered medication as we need to carefully weigh the potential pros and cons of any single medication. We must help, not harm patients.

A healthy diet (low in saturated fat and refined carbohydrates, high in good protein and fibre) and regular exercise is the best way of weight loss. Please discuss with your doctor before you want to take any of the over-the-counter supplements that promise quick fixes for weight loss.

Counterfeit Drugs a problem in Indonesia

fake drugsPhoto courtesy:  Victor Habbick,

I am sometimes asked about the huge price difference of drugs between Indonesia and Singapore. Rent, labor, the strong Singapore dollar, and differential pricing are all factors. However, there is one very important factor – fake or counterfeit drugs. Counterfeit drugs have become a huge problem in Indonesia. The pharmacies used to buy drugs from “independent medication sellers”, but are now buying them simply online.

I had come across instances when I simply switched medication from overseas to Singapore ones, and saw huge differences in the effect of lowering blood pressure and blood sugar. I can only surmise that the “strengths” of the medications are different.

Part of the problem reported was that the pharmacies find it difficult to differentiate between genuine and fake medication. I totally agree. There is no way for even pharmacists and doctors like us to differentiate between the fake and real thing, since boxes, logoes can all be faked. The only way to ensure that the drugs are genuine is to buy direct from the Big Pharmaceutical Companies themselves.

Pharmacists and doctors must realize that fake drugs may not contain any active ingredients, and can also contain harmful ingredients. They must make a stand to sell the real thing to their patients. Patients must also buy medication from registered pharmacies and not from dodgy ones.