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How to Manage Morning Stiffness?

Rheumatoid Arthritis

The most common and prominent symptom of rheumatoid arthritis (RA) is morning stiffness. Rheumatologists consider morning stiffness that lasts at least an hour a key sign of RA. Although the stiffness usually loosens and goes away, it can take some time.

Here are eight things you can do to gently ease morning stiffness:

1- Take pain or anti-inflammatory medications an hour before getting out of bed in the morning. Keep a small snack by your bedside so that you don’t take the medication on an empty stomach.

2. Exercise in bed:
By the time your alarm rings, the pain medication should be working. But don’t get up quite yet. Stretch gently and do some range-of-motion exercises. It will help warm up your sleepy muscles and loosen those creaky joints.
While you’re still under the covers, lie on your back. Stretch your upper body first, moving your joints gently through a comfortable range of motion. First, turn your head from side to side, loosening your neck. Then stretch the following joints, first on one side and then the other:
·    hands
·    wrists
·    elbows
·    shoulders
Then do the same with the joints in your lower body:
·    toes
·    ankles
·    knees
·    hips
Stretch and move your joints as much as you can, slowly and gently. When your joints feel less stiff and painful, you should get up.

3. Hit the showers

Taking a warm bath or shower is one of the best ways to help relieve morning stiffness. Heat causes the blood to move to the surface of the skin. A warm bath or shower will flush and warm your joints along the way.
4. Put the dryer to work

Before you get dressed for the day, pop your clothes into the dryer for five minutes. Use the highest heat setting. Then go make your coffee, pour your cereal, or put an egg on to boil.
When the dryer beeps, get your heated clothes out and put them on. The warmth from the dryer is soothing and will help to loosen up your stiff, achy joints.
5. Eat a good breakfast
Morning is here and you’re running on empty. Your body needs fuel!
Eating a light but nutritious breakfast can help to ease morning stiffness. An egg or yogurt with whole-grain toast, or a bowl of hot or cold whole-grain cereal with milk or soymilk. Any one of these choices will give your body the energy it needs to get started.
6. Bring the heat
Warming salves or lotions can help to ease stiff, sore joints. Massaged into the skin over the joint, the warmth is penetrating and can last for quite a while.
7. Move your body every day
Walking for 15 or 20 minutes a day strengthens the muscles that support your joints. Stretching and moving your joints through simple, gentle, range-of-motion exercises helps to keep them from getting stiff and weak.

 8-Make time for yourself every morning, every day, and consider learning to meditate as a way to reduce stress. Rheumatoid arthritis is a serious, painful disease. To lessen the stress of coping, stop and focus on breathing every now and then.

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Fasting and Irritable Bowel Syndrome

Fasting and Irritable Bowel Syndrome


 A healthy diet is important for all of us. However, some people with IBS find certain foods of a normal healthy diet can trigger symptoms or make symptoms worse. Evidence is emerging that using the FODMAP diet may improve IBS bowel symptoms (see reference below). Current national guidelines about IBS include the following points about diet, which may help to minimise symptoms:
·    Have regular meals and take time to eat at a leisurely pace.
·    Avoid missing meals or leaving long gaps between eating.
·    Drink at least eight cups of fluid per day, especially water or other non-caffeinated drinks such as herbal teas.
·    Restrict tea and coffee to three cups per day (as caffeine may be a factor in some people).
·    Restrict the amount of fizzy drinks that you have to a minimum.
·    Don't drink too much alcohol. (Some people report an improvement in symptoms when they cut down from drinking a lot of alcohol, or stop smoking if they smoke.)
·    Consider limiting intake of high-fibre food (but see the section above where an increase may help in some cases).
·    Limit fresh fruit to three portions (of 80 g each) per day.
·    If you have diarrhoea, avoid sorbitol, an artificial sweetener found in sugar-free sweets (including chewing gum) and in drinks, and in some diabetic and slimming products.
·    If you have a lot of wind and bloating, consider increasing your intake of oats (for example, oat-based breakfast cereal or porridge) and linseeds (up to one tablespoon per day). You can buy linseeds from health food shop
·    Maintain good physical fitness to improve bowel function and help reduce stress

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Ramadan & The Medicines you take

Ramadan & The Medicines you take

 

During Ramadan, some alterations take place in the functioning of our body. Changes in the circadian rhythm (internal body clock) of biochemical, physiological and behavioural processes also occur. As a result drug absorption, their bioavailability, toxicity as well as interaction between food and drug may be affected.

The situation may be compounded when medications are taken indiscriminately. It has been found that many patients with chronic illness often insist on fasting and do not take their medications or take all the drugs in one single dose leading to emergency hospitalization.

Patients who take their medicine two or three times a day may switch to slow-release once daily formulations. for example, patients taking drugs for high blood pressure (two or three times a day) may change over to once daily preparations. Similarly, asthmatic patients who are taking theophylline two or three times may change to slow-release once daily formulations.

Again, the absorption of some drugs are also affected by food and the quality of food. for instance, Rifampicin (a drug used in tuberculosis) should be taken in empty stomach and during Ramadan, it should be taken 30 minutes before pre-dawn meal. Moreover, quality of certain food also decrease absorption such as spicy, fatty foods taken during Ramadan decreases the absorption of certain drugs.

Intake of beverages like tea, coffee, orange juices, and smoking at the time of breaking fast can increase gastric acidity resulting in gastro-intestinal side effects. Thus, many medications need readjustment during Ramadan.

For such situations a doctor should be consulted. Fortunately many drugs are available in slow-release once daily formulations for better patient's compliance particularly during Ramadan. Studies have shown that many patients arbitrarily change the dose and timing of their medications without taking medical advices. Moreover, many patients are also not aware of the medications they can take during Ramadan without breaking the fast.

The choice of drugs and the route of administration remain a matter of concern for many patients and doctors. To settle the difference of opinions and to standardise the choice of route of administration a religious-medical seminar was held in Morocco, participated by distinguished Muslim Jurists, Religious experts, medical practitioners and pharmacologists and specialists in other human sciences.

In the seminar entitled "An Islam view of certain contemporary medical issues" the main focus was on the substances and actions that nullify fasting.

In the discussion it was agreed unanimously that the following routes of administration of drugs do not nullify fasting:
1.    Anaesthetic agents.
2.    All substances absorbed into the body through skin such as cream, ointments, medicated plaster etc.
3.    Anal injections.
4.    Eye and ear drops.
5.    Insertion into the vagina of pessaries, vaginal washes, medical ovules etc.
6.    Injection through the skin, muscle and joints or veins (excepting I.V. feeding).
7.    Inhalers for asthma.
8.    Mouth washes, gurgles, oral sprays provided nothing is swallowed.
9.    Nitroglycerine tablets placed under the tongue for treatment of angina (heart pain).
10.    Nasal sprays and drops.
11.    Oxygen.
12.    Surgery involving general anaesthesia.


In conclusion, Ramadan is a period of altered body rhythm and life habits. Accordingly, drug dosing needs to be adjusted. The timing of intake of medicine (before, during or after food) influence the absorption of drugs. Ramadan is further characterized by repeated fasting and breaking of fast and altered circadian rhythm that last four weeks.

These changes influence the chronobiological parameters (i.e, the route of administration/the dosing, absorption, food-drug interaction and bioavailability etc) which can last beyond the end of the Ramadan.

Therefore, return to the pre-Ramadan bodily functions may take some more time. This fact should be kept in mind both by the patients and medical practitioners.

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Healthy Habits to follow in Ramadan

 

Healthy Habits to follow in Ramadan


1.    Drink 8 glasses of water daily from Iftar to Suhour to prevent dehydration and constipation
2.    Sleep for 6-8 hours a day to get sufficient mental and physical rest. Less sleep means you will feel tired during the day which in turns leads to less productivity and activity
3.    Have a balanced varied Iftar which incorporates dates, soup, salad, a main dish, fruits and a small piece of Ramadan sweet
4.    Walk or participate in some kind of physical activity
5.    Have Suhour to fill your body with energy and help regulate your blood sugar

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Hyperacusis

Hyperacusis

Hyperacusis is a condition that arises from a problem in the way the brain’s central auditory processing center perceives noise. It can often lead to pain and discomfort. Individuals with hyperacusis have difficulty tolerating sounds which do not seem loud to others, such as the noise from running faucet water, riding in a car, walking on leaves, dishwasher, fan on the refrigerator, shuffling papers. Although all sounds may be perceived as too loud, high frequency sounds may be particularly troublesome.

 

Causes

There are some diseases or disorders that are linked to hyperacusis, such as: 

  • Bell’s palsy

  • Chronic fatigue syndrome

  • Lyme disease

  • Meniere’s disease

  • Post traumatic stress disorder

  • Depression

  • Autism

Additionally, hyperacusis is seen in patients who have experienced a head trauma, such as an air bag deployment, surgery to the jaw or face, or a viral infection of the inner ear. One major cause of hyperacusis is loud noise exposure. It may be triggered by a single intense noise such as a gunshot, or it may develop gradually from listening to loud noise without hearing protection. People exposed to loud levels of noise through their occupation, whether as a machinist or a musician, should be protective of their hearing to avoid noise-induced hearing loss and other changes in their hearing such as tinnitus or hyperacusis.

Treatment

There are no specific corrective surgical or medical treatments for hyperacusis. However, sound therapy may be used to “retrain” the auditory processing center of the brain to accept everyday sounds. This involves the use of a noise-generating device worn on the affected ear or ears. Those suffering from hyperacusis may be uncomfortable with placing sound directly in their ear, but the device produces a gentle static-like sound (white noise) that is barely audible. Completion of sound therapy may take up to 12 months, and usually improves sound tolerance.Because social situations are often painfully loud for those with hyperacusis, withdrawal, social isolation, and depression are common.

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