PAGE 12 DAILY NEWS
LIFESTYLE
THURSDAY OCTOBER 17 2013
Energy shift
for summer:
how to get
healthy
THE health and wellness
explosion is exciting.
People are talking about
lifestyle modification and
getting ready for summer.
From healthy wraps
and protein shakes, to
counting carbs and
wrestling with sugar
cravings, people want to
look and feel good, and
minimise their risk of
lifestyle disease,
including hypertension,
diabetes, cholesterol
issues and gout.
Here are Dr Darren’s
10 tips to kickstart your
wellness:
1. Don’t skip breakfast.
2. Limit your refined
sugar intake.
3. Drink plenty of water.
4. Concentrate on low-GI
carbs.
5. Sleep at least seven
hours a night.
6. Try to incorporate
30 minutes of raised
physical activity into your
busy day.
7. Park further away from
entrances to walk.
8. Take the stairs.
9. Avoid heavy meals
three hours before
sleeping.
10. Find 15 minutes a day
to reflect and be mindful
of your blessings – focus
on the things you can
change and stop worrying
about the things you
can’t.
WHILE anaemia is usually
seen as just an iron deficiency
problem that can be controlled
with supplements, it can
prove fatal for people living
with HIV.
According to Graeme
Meintjies, associate professor
in the Department of
Medicine, University of Cape
Town, and member of the
university’s Institute of
Infectious Disease and
Molecular Medicine, chronic
infections like tuberculosis
(TB) in the body can result in
anaemia.
Meintjies said the
inflammation caused by
chronic infections results in
high levels of cytokines
(messenger molecules) in the
blood that suppress bone
marrow function.
“Reduced bone marrow
function leads to fewer red
blood cells being made and the
result is anaemia,” he
explained.
Dr Darren Green is a
Pietermaritzburg-born
doctor who practises in
Cape Town. He is a
regular guest on SABC3
and the Expresso show
and was a finalist on SA
Idols. E-mail questions
to dr@darren
green.co.za or
contact him on
Twitter
@drdarrengreen
How do I end
infection in
my bladder?
Q
I am 67 and have an
ongoing bladder
infection, regardless of which
antibiotic I take. I had a
cystoscopy two years ago and
was told I have a neurogenic
bladder and have to do selfcatheterisation twice a day.
Tablets do fix the infection,
but this only lasts for a
month, and then I have to go
to the doctor for another dose
of antibiotics.
Dr Darren
Give me
a hand
of hope
Q
I HAVE sought
help, but have had
no success with
my problem.
I developed dry, hard hands
from the age of seven, and
this condition is becoming
unbearable as I reach puberty.
I have applied numerous
moisturising hand creams
which claim to deal with dry
cracked hands, with no
success.
This is becoming an
embarrassment and is
affecting my self-esteem.
I don’t wish to greet people
with a handshake any more
and most of the time, keep my
hands in my pockets.
I am a type 1 diabetic and
use pediRelax cream for my
feet, which I also apply to my
hands, but with no results. I
am fast losing all hope.
YOUR complaint is
not easy to
diagnose without a
concise history and
examination. Having dry,
scaly and cracked hands is
well known in many parts of
the world – especially in older
A
TREATMENT: Moisturisers formulated for sensitive skin can help with dry and chapped hands.
people where the most
common triggers are
environmental.
Cold weather and hard
water can contribute, and
chemical irritation, secondary
to disinfectants and cleaning
agents, can cause contact
dermatitis.
One of the most common
ones missed are shampoos
and soaps used in the home.
The interesting feature is
the young age of onset, and
skin conditions associated
with diabetes must be
considered.
Children frequently
develop severely-chapped
hands in the winter months,
when dry air and artificial
heat can dry out the skin.
In most cases, chapped
hands are a temporary
setback and do not indicate a
serious underlying problem.
Home remedies include:
l Moisturisers for
sensitive skin.
l Oatmeal baths may help
relieve the pain and itching
associated with eczema.
l Petroleum jelly and
cocoa butter are effective
moisturisers to rub on
children’s hands prior
to bed.
l Encourage your child to
drink plenty of water.
l Sweetened drinks and
dehydration cause dry skin.
l Consider a humidifier in
your child’s bedroom during
dry winter months
If the hands get worse or
home treatment does not
work, consult a paediatrician.
Eczema and psoriasis must
also be ruled out and the
improvement of medical
treatment for these conditions
has been good.
I am sure you can be
helped.
l Additional information
from www.livestrong.com
Iron deficiency could prove to be dangerous
When a person with HIV infection develops TB, it can result in very significant anaemia, writes Mpume Madlala
“TB is a cause of anaemia
through this mechanism.”
Meintjies said
disseminated TB (that had
spread) can also result in
anaemia because of the
infiltration of the bone
marrow which affects the
bone marrow function, saying
that the TB actually invades
the bone marrow.
“HIV itself has direct
effects on the bone marrow as
it infects certain precursor
and immune cells in the bone
marrow (but not the red blood
cells), and suppresses its
function.
“This can also result in
mild anaemia,” he said.
When someone with HIV
infection develops TB, it can
result in very significant
anaemia, Meintjies said.
“Thus TB is a major cause
of anaemia in patients with
HIV. Anaemia is also a marker
of more disseminated and
severe TB. Patients with HIV,
TB and severe anaemia are
more likely to die,” he said.
Meintjies said that
anaemia was also a marker of
more severe disease and a
worse prognosis.
Cause
“If the underlying cause of
anaemia is TB and it is
not diagnosed, it can have
life-threatening consequences.
Untreated TB in a
patient with HIV can
progress rapidly with
RECURRENT bladder
infections can be
frustrating and are more
common in females. In males,
prostatism or an enlarged,
inflamed prostate often
accompany bladder infections.
The mechanisms of
infection and re-infection
from stagnating urine in the
bladder, as well as incomplete
voiding, are well described.
For anyone with recurrent
bladder infections these vital
points hold true:
l Does the bladder empty
completely?
l Do you hold it in too long?
l Do you drink enough fluids?
l Is your hygiene excellent?
l Are there any underlying
skin conditions on the
genitals?
l If you are sexually active, is
your partner treated too?
l Have your doctors done a
urine culture to isolate the
cause of the problem?
l Is the bug resistant and are
you on the right antibiotic?
A catheter is a foreign body
and increases the risk of
infection. Your situation
requires management by a
urologist.
A
clinical deterioration and
death if untreated,” he said.
However, Meintjies said
that it was important to note
that TB was not the only
cause of anaemia in patients
with HIV, saying that other
causes included nutritional
deficiencies like iron or folic
acid.
“Certain drugs, like
Zidovudine, in a minority of
patients, and certain other
infections like the parvovirus,
can also cause anaemia,
though TB is probably the
commonest cause of anaemia
in patients with HIV in South
Africa,” he said.
HIV activist and founder of
Siphila Ngomusa, a non-profit
organisation that helps people
living with HIV, Nomvula
Shale, said anaemia in an HIV
positive person was very
dangerous if left untreated.
She said to avoid many
problems and complications of
living with HIV, they should
ensure that they see a doctor
every three to six months.
“When you are HIV
positive, you are at risk of
getting over 30 opportunistic
diseases which is why you
have to go for regular checkups,” she said.
Dr Nondumiso Khumalo
said that there were many
causes of anaemia in HIV and
Aids patients.
She explained that as a
result of the inflammation
associated with the condition,
one may not be able to
produce enough red blood
cells.
“Less common causes for
HIV-associated anaemia
include vitamin B12
deficiency and the
autoimmune destruction of
red blood cells. Some of the
early drugs used to treat HIV
and Aids, such as AZT, were
shown to be a possible cause
of anaemia,” she said.
Khumalo, however, said the
newer Highly Active
Antiretroviral Therapy drugs
were less likely to cause
anaemia.
“That is why it is
important to do basic bloods
on patients – including HB
levels – so that we can get a
baseline. Before starting
treatment, we have to treat the
anaemia first because the
drugs can make it worse,” she
said.
Anaemia can have many
causes, including:
ll Dietary deficiency – lack
of iron, vitamin B12 or
folic acid in the diet.
ll Malabsorption – where
the body is not able to use
the nutrients in the diet,
caused by conditions such
as coeliac disease.
ll Inherited disorders –
such as thalassaemia or
sickle cell disease.
ll Autoimmune disorders –
such as autoimmune
haemolytic anaemia, where
the immune cells attack the
red blood cells and decrease
their life span.
ll Chronic diseases – such
as rheumatoid arthritis and
tuberculosis.
ll Hormone disorders –
such as hypothyroidism.
ll Bone marrow disorders –
such as cancer or infection.
ll Blood loss – because of
trauma, surgery, cancer,
peptic ulcer, heavy
menstruation, bowel cancer
or frequent blood
donations.
ll Drugs and medications –
including alcohol,
antibiotics, antiinflammatory drugs or
anti-coagulant medications.
ll Infection – such as
malaria and septicaemia,
which reduce the life span
of red blood cells.
ll Periods of rapid growth
or high energy
requirements – such as
puberty or pregnancy.