RSS

Monthly Archives: June 2015

MERS ALERT RETURNS! – Traveller from the Middle East to South Korea.

12 months ago I blogged an alert about MERS (Middle East Respiratory Syndrome Coronavirus (MERS- CoV)

MERS OUTBREAK – 2014

The BBC have broadcast that there is a further outbreak In South Korea following a businessman travelling from the Middle East to South Korea and a further traveller has been diagnosed following travel to Hong Kong and China. Although there seem to be greater concerns about how this is affecting the economy in South Korea!

The WHO suggest  countries, whether or not MERS cases have been reported in them, should maintain a high level of vigilance, especially those with large numbers of travellers or migrant workers returning from the Middle East.

MERS

Since May 2015, an outbreak of the Middle East respiratory syndrome coronavirus has affected South Korea. The virus, which causes Middle East Respiratory Syndrome (MERS), is a newly emerged betacoronavirus that was first identified in a patient from Saudi Arabia in April 2012.

As of 12 June 2015, there were 126 known infections in/from the country and 11 people have died from this outbreak. 2,208 schools have been temporarily closed, including 20 universities.3,800 people have been placed in isolation at home or at government designated facilities.image

Here are  things you should know about MERS:

as published by World Health Organisation – fact sheet 401 http://www.who.int/csr/disease/coronavirus_infections/en/ – to get any further updates

  • Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by a novel coronavirus (MERS‐CoV) that was first identified in Saudi Arabia in 2012.
  • Coronaviruses are a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS).
  • Typical MERS symptoms include fever, cough and shortness of breath. Pneumonia is common, but not always present. Gastrointestinal symptoms, including diarrhoea, have also been reported.
  • Approximately 36% of reported patients with MERS have died.
  • Although the majority of human cases of MERS have been attributed to human-to-human infections, camels are likely to be a major reservoir host for MERS-CoV and an animal source of MERS infection in humans. However, the exact role of camels in transmission of the virus and the exact route(s) of transmission are unknown.
  • The virus does not seem to pass easily from person to person unless there is close contact, such as occurs when providing unprotected care to a patient.
  • There are no treatments and no vaccine.
Advertisements
 
 

MINDFULNESS FOR EVERYONE

Last year I blogged about mindfulness and recommending this has become an integral part of our practice as we constantly see patients faced with the stress of modern living. For those that are not aware of mindfulness, which involves meditation, is defined as:-

 “the intentional, accepting and non-judgemental focus of one’s attention on the emotions, thoughts and sensations occurring in the present moment”.

image

I was asked to proofread an  article written by Charlie Morgan, yogi and yoga teacher who promotes the slogan:-

                               ‘ Your health is your wealth, the rest is a bonus’

The article was to be published in the section on health and happiness on the blog of deliciouslyella the blogger, foodie, yogi, best-selling author, nut butter addict, Telegraph columnist, app creator & avocado enthusiast.

I was delighted to see it appear on her blog for many  people to view and subsequently read the positive comments.

Click on the link below to read the article:-

image                                     Mindfulness

Thank you Ella and Charlie for collaborating to promote mindfulness and help many people understand it’s value in today’s world.

http://www.charliemorganyoga.com

image

 
2 Comments

Posted by on June 12, 2015 in Training and Advice

 

Tags: , , , , , , , ,

IMPROVING MATERNITY CARE IN NORTHWEST LONDON

One of the most distressing things I had to do as a junior obstretric doctor was to attend the monthly meetings to discuss neonatal and maternity deaths. At that time many of the causes were unavoidable due to lack of medical progress and expertise in monitoring and managing complications of labour. Also, caring for the neonate was limited and often carried out by junior paediatricians without specialist training.  I was one of those junior paediatricians and was often left to resuscitate  and care for a neonate with virtually no training. Some of these precious babies miraculously survived but a significant number died with complications of prematurity and foetal distress which are now treated with success by staff, who are highly trained.

However, we still aware that their are  inconsistencies with regards to facilities and availability of trained staff and although deaths are significantly fewer every neonatal or maternal death is a tradegy for the families expecting to take home a healthy normal baby and every woman having a baby expects to survive. Hence, the overall opinion from the commissioning groups is that each maternity unit should have the most up to date facilities and highly trained staff to be available every minute of the day and night to address and problems should they arise.

I had three births under the care of the  Old  Queen Charlotte Hospital, Goldhawk Road. The first birth was after a difficult, long labour and delivery was using antiquated Keilland’s high rotating forceps and both my condition and the baby’s was ‘touch and go’ but thankfully we both survived. My second birth was a precipitant delivery in the antique bath on the ante-natal ward with late assistance from a passing junior midwife – my idea of having a delivery in a birthing pool which hadn’t been invented at that time – but much more cumbersome to get out of!  My third delivery was in the front seat of the car ( my husband was driving) ‘on the way to Queen Charlotte’s’  as stated on her birth certificate – a natural delivery with no complications even not needing stitches just so hungry afterwards that I ate my breakfast and my husband’s whilst he went home to clean the car! That was the nearest I could have to  a home delivery which were not available at that time!  She now uses the car registration number as her email address and is 29 yrs of age tomorrow! That is the reason why I feel pleased to see a much more consistent approach……

image

Moreover, as Ealing Hospital was unable to meet these requirements the maternity unit will be closing on June 25th and expectant mothers will be directed to another unit in Northwest London.

Uncomplicated pregnancies can be managed in the communitiy with improved support for home deliveries.

All our maternity units offer both consultant-led and midwifery-led care depending on the level of support you need. They all have birthing pools accomadati g families to be part of the event at the same time the most up to date facilities and staff are available if necessary. You can  also choose to give birth at home, where you will be supported by our home birth team.

image

Antenatal care is carried out in our hospitals, in children’s centres and in health centres close to where you live. Most women can choose where they receive antenatal care, although some women with particular medical needs may be advised to attend hospital for appointments. Women can also choose to have their postnatal care either at home, in hospital, or in health and children’s centres near where they live. Recently we have concentrated our staff and resources into six maternity units.

This has enabled us to have more midwives and senior consultants in our units to provide care for women, upgrade our facilities, provide more antenatal (before birth) and postnatal (after birth) care locally and offer greater home birth choice.

Your choices In North West London there are six hospitals where you can give birth:

image

– Chelsea and Westminster

– Hillingdon

– Northwick Park

– Queen Charlotte’s and Chelsea

– St Mary’s

– West Middlesex

further details can be accessed using the following link:-

http://www.ealingccg.nhs.uk/your-services/giving-birth-in-north-west-london.aspx

 
 

Tags: , , , , ,

OFF TO MARKET – ASPARAGUS AND IT’S VALUE……

Last month I had my usual trip to the Friday market at Brantôme, a small picturesque town in the Perigord , a chance to pick up on the local gossip and see what’s in season.

image

The gossip first; Olivier from Café Co’Thé on ‘Rue Victor Hugo’ was on the French version of Mastermind and he did very well but didn’t get through to the third round. Needless to say his questions were on coffee! There have been a few major changes in that the pharmacist has moved over the bridge and their old shop has been taken over by the cafe owners next to the newsagent on Puy Joli and as they have createneated a large terrace( and who gave permission for that!)  the stall selling greengrocerie has had to move opposite the new cafe as the pitch has been taken over by the terrace. Moreover, the fishmonger’s van has had to relocate up the road on the main bridge! Then a few progress reports of new illnesses and deaths in the past month, what events are coming up such as ‘ the Charente Weavers festival’ in Varaignes, the home of the slipper ( Pantoufle) and what concerts or Art exhibitions are coming up at the Abbey or nearby and not forgetting the progress of the garden and the weather almost all in the same breath! This is what markets are about and happen the World over – it could even  be Saturday morning in West Ealing or chatting on Pitshanger Lane.

Before meeting up for coffee a view around the many stalls containing foodstuffs, mostly locally resourced, homemade wooden items, soaps and jewellry aswell as random Morrocan , Peruvian stalls that find their way to Brantôme. The seasonal item that is most noticeable are  local strawberries including ‘Fraises de Bois’,  strawberries diligently gathered in the wild. Also, as always is the Asparagus which always appears at this time and has a very short season. Their are the familiar green asparagus but more popular in this region is the white or purple Charentais asparagus. Fresh asparagus is usually only available in French markets in May and June and stalls sell out very quickly.  White asparagus is derived from the same varieties as green asparagus, however its growing method separates it from other varieties; while being cultivated, it has never seen the light of day: soil is mounded over the asparagus plants to prevent the sun’s rays from producing chlorophyll as they grow. Hence,it matures without colour, making it the albino version of asparagus. When the slightest sight of a tip protrudes from the earth, the plant is picked.
Ideal White asparagus spears are pearly white, thick and rounded, about 6 to 8 inches in length with Christmas tree shaped crowns. Their flavor is mild, slightly herbaceous, earthy and nutty with notes of artichoke and fresh White corn. I have to say I prefer the green variety.
As it hasn’t received the nutritional elements of light, white asparagus is more brittle than green asparagus and must be used soon after harvest or the spears quickly turn fibrous and bitter, rendering them inedible. White salad asparagus are tender and sweet, and can be eaten raw or cooked. Sauté chopped white asparagus with shrimp or scallops, or cook quickly in brown butter and serve as a side.

An easy way to cook green asparagus is first break the stems where it breaks naturally to get rid of the less tender part then lie them in a pan or tray covered with water, bring the water to the boil and then turn the heat off and leave for 5 mins. Serve with butter or Hollandaise sauce on their own or an accompaniment with poached salmon.

image

The same evening we went to the local restaurant for supper and we were interested to note that our amuse-bouche ( pre-meal taster) was garnished with wild asparagus which was foraged in the local vicinity. I managed to discover the source in the next village and imagined Primitive Man ( a known resident of the Dronne valley) probably fed on this delicacy.

image

The Egyptians, Greeks and Romans valued asparagus for its medicinal value in addition to enjoying it as a food. The second century physician Galen attributed cleansing and healing properties to asparagus.

Asparagus can neutralize ammonia, protect small blood vessels, act as a diuretic… plus its fiber is a natural laxative.

Modern studies show the ancients were right to place high value on asparagus. By eating only a few calories you benefit from many nutrients.

It’s loaded with nutrients: Asparagus is a very good source of  fibre, folate, vitamins A, C, E and K, as well as chromium, a trace mineral that enhances the ability of insulin to transport glucose from the bloodstream into cells.
This herbaceous plant—along with avocado, kale and Brussels sprouts is a particularly rich source of glutathione, a detoxifying compound that helps break down carcinogens and other harmful compounds like free radicals.

This is why eating asparagus may help protect against and fight certain forms of cancer, such as bone, breast, colon, larynx and lung cancers.
Asparagus is packed with antioxidants, ranking among the top fruits and vegetables for its ability to neutralize cell-damaging free radicals. This, according to preliminary research, may help slow the aging process.

The asparagus tuber is used in Chinese medicine, known as Tian Men Dong and tonifies the Yin especially the lung and kidney Yin which are affected in debilitating illnesses such as cancer.

This is an an important ingredient of the formula Káng Ái Fāng (C82) which when I have noticed when  administered with Western medicine: the patients seem to respond better and become less debilitated and recover from the ill effects quicker. Most oncologists are not averse to supporting the use of this medication.

image     image

Lung Yin deficiency manifests itself by  a dry cough, loss of voice, thirst, dry throat, dry skin, sometimes spitting up thick sputum.  When advanced, can become Lung Consumption: chronic cough, low-grade afternoon fever, nightsweat, hemoptysis, thin, rapid pulse.

The kidney Yin deficiency occurs in most debilitating chronic illnesses and in Chinese medicine is considered part of the ageing process. It is manifest by symptoms such as dizziness, tinnitus, weak lower back and legs, warm palms and soles, afternoon low-grade fever, diminished sexual function, scanty and dark urine, red-dry tongue, thin pulse without strength.  Kidney yin fails to nourish Liver yin, which can lead to Kidney+Liver yin Deficiency.

In Chinese Medicine the relationship between the Liver and the Kidneys is of considerable clinical significance as it is based on the mutual exchange between blood and essence and is particularly important in gynaecology. Essence ( oversimplified) is a term in Chinese medicine to describe vital substances which are inherited and acquired and determines our basic constitutional strength and resistance to exterior pathogens. When the Essence is deficient it affects growth, development,  fertility and our ability to fight disease of body and mind.

I find that TCM for me gives some explanation to the mysteries of medicine, chronic illnesses and ageing and why we eat certain foods and understanding more about asparagus is a good example of that!

 
 

Tags: , , , , , , ,