Thursday, January 24, 2008

How Do Drugs Work - Antibiotics

Hello Everyone,

Since the name of this blog is "How Do Drugs Work", I figured it was time again to talk about some different drugs and how they work.

Say you are not feeling well, you go to the Doctors office and you have some type of infection. Have you ever wondered how the Doctor decides which antibiotic to prescribe for you? How does the Doctor decide what strength of antibiotic to give you? Is one antibiotic better than the other?
In the upcoming series of topics I am going to discuss:
  • An overview of the different types of bacteria

  • Which type of bacteria can cause which type of illnesses.

  • The different classes of antibiotics.

  • Which classes of antibiotics work against which type of bacteria.

  • How the antibiotics work to eradicate the bacteria.

  • How different antibiotics work in different ways.

  • How some bacteria can become immune to some antibiotics.

  • Why it is important to take your antibiotics as directed.

That is a bunch of material to cover and I plan on addressing those topics in multiple posts.

Stay tuned.

Dr. Paul

Saturday, January 19, 2008

General Health Information - Bell's Palsy

Hello Everyone,

My last two posts have covered strokes and recognition of strokes. A colleague of mine wrote and stated that it would be a good idea to cover Bell's Palsy since the symptoms are often confused with that of a stroke.

What is Bell's Palsy?

Bell's palsy is paralysis of the face caused by an irritation of cranial nerve VII (seven). It occurs with no apparent cause. Cranial nerve VII controls most facial muscles, including those needed to smile, blink, and wrinkle the forehead. The nerve also controls the function of certain salivary glands and the lacrimal (tear) glands as well as the tiny muscles inside the ear that dampen loud noises. The nerve also controls the function of some salivary glands and the lacrimal (tear) glands. This does not include the facial paralysis associated with known causes such as infection or stroke.

Some evidence suggests that the cause is inflammation of cranial nerve VII is triggered by a viral infection, possibly a virus in the herpes family. People with diabetes or high blood pressure, and pregnant women, are at slightly greater risk, but most patients have no known predisposing factors

The classic symptom of Bell's palsy is weakness on one side of the face. The weakness may range from difficulty blinking all the way to a complete paralysis on one side of the face with an inability to close the eye. Onset usually occurs acutely, but the weakness may worsen for 24 to 48 hours before stabilizing

Most patients with Bell’s palsy recover completely or or some have minimal lasting effects, even without treatment. The percentage may increase with medical treatment.

Using the S-T- R stroke identification method one would find a patient with Bell's Palsy unable to Smile. However, they would probably be able to Talk and form complete sentences and would be able to Raise their arms.

Facial paralysis does not always indicate Bell's Palsy. It is best to have a patient evaluated by their physician to rule out other causes of facial paralysis.

Hopefully this information will help distinguish different situations you may run into.

Please email me if you have any questions.

Dr. Paul

Monday, January 14, 2008

General Health Topic - Stroke Identification

Hello Everyone,


It is well known that the sooner a patient is diagnosed and treated after experiencing an acute stroke the better the outcome is likely to be. However, it is often difficult for a non-stroke specialist to recognise and diagnose stroke.

There is a method going around and listed on numerous Internet resources that tries to increase the awareness and importance of rapid stroke identification.

This portion of the post was copied from an email that I received.

RECOGNIZING A STROKE - Remember the "3" steps, S T R .

"Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke

Now doctors say a bystander can recognize a stroke by asking three simple questions:

S * Ask the individual to SMILE.

T * Ask the person to TALK to SPEAK A SIMPLE SENTENCE(Coherently) ( I.e. It is sunny out today)

R * Ask him or her to RAISE BOTH ARMS. NOTE: Another 'sign' of a stroke is this: Ask the person to 'stick' out their tongue. If the tongue is 'crooked', if it goes to one side or the other that is also an indication of a stroke.

If he or she has trouble with ANY ONE of these tasks, call 911 immediately and describe the symptoms to the dispatcher. A cardiologist says if everyone who gets this e-mail sends it to 10 people; you can bet that at least one life will be saved."

This stroke recognition system appears to be a variation of a widely used field diagnostic test used by paramedics and other first responders. The FACE, ARM, SPEECH TEST (FAST).

Results from a study funded by The Stroke Association indicate that ambulance paramedics can accurately identify a stroke patient before they arrive in hospital.

The Face Arm Speech Test (FAST) has been developed as a stroke identification instrument.

The test assesses 3 neurological signs of stroke:
· facial weakness
· arm weakness
· speech disturbance

FAST has been incorporated as an integral component of ambulance paramedics training module, and is included in the rapid ambulance protocol.

Please pass it on to all your friends, family and patients.


Dr. Paul

Friday, January 11, 2008

General Health Topic - Stroke - What Is It?

Hello Everyone,

This was sent to me as a suggested topic and I agree that we need to spread the word.

About Strokes - There are two types of strokes (also called a cerebrovascular accident).

An ischemic stroke occurs when the blood supply to all or part of the brain is cut off. Most strokes are of the ischemic type. A transient ischemic attack (TIA) is a transient stroke that lasts only a few minutes. It occurs when the blood supply to part of the brain is briefly interrupted.

A hemorrhagic stroke is when a blood vessel bursts in the brain.

Without oxygen, brain cells begin to die. Permanent disability or death can result. High blood pressure, smoking, and having had a previous stroke or heart attack increase a person’s chances of having a stroke.

Stroke is the third leading cause of death in the United Sates. In 2002, stroke killed 162,672 people, accounting for about 1 of every 15 deaths in the United States. Four million Americans who have survived a stroke are living with impairments and 15 to 30 percent are permanently disabled. The American Heart Association also estimates that stroke cost about $68 billion in both direct and indirect costs in 2005 in the United States alone. For more information check out the following:

With timely treatment, the risk of death and disability from stroke can be lowered.

It is very important to know the symptoms of a stroke and act in time.

Signs of a Stroke - The National Institute of Neurological Disorders and Stroke notes these major signs of stroke:

•Sudden numbness or weakness of the face, arms or legs
•Sudden confusion or trouble speaking or understanding others
•Sudden trouble seeing in one or both eyes
•Sudden trouble walking, dizziness, or loss of balance or coordination
•Sudden severe headache with no known cause

If you think someone is having a stroke, you should call 911 immediately.

I'll post more information on stroke identification in the next article.


Dr. Paul

Thursday, January 10, 2008

General Health Topic - Four Healthy Changes Can Prolong Life 14 Years

Hello Everyone,

I don't know if you have read this article that was published by a group of British researches in the Journal PLoS Medicine.

I have included the article that was written by Michael Kahn from Reuters and can be found at the following link:

Four Healthy Changes Can Prolong Life 14 Years
Posted: 2008-01-10 11:36:29
Filed Under:
Health, Healthy Living, Diet & Fitness

LONDON - People who drink moderately, exercise, quit smoking and eat five servings of fruit and vegetables each day live on average 14 years longer than people who adopt none of these behaviors, researchers said.

Overwhelming evidence has shown that these things contribute to healthier and longer lives, but the new study actually quantified their combined impact, the British team said."These results may provide further support for the idea that even small differences in lifestyle may make a big difference to health in the population and encourage behavior change," the researchers wrote in the journal PLoS Medicine.

Between 1993 and 1997 the researchers questioned 20,000 healthy British men and women about their lifestyles. They also tested every participant's blood to measure vitamin C intake, an indicator of how much fruit and vegetables people ate.

Then they assigned the participants -- aged 45-79 -- a score of between 0 and 4, giving one point for each of the healthy behaviors.

After allowing for age and other factors that could affect the likelihood of dying, the researchers determined people with a score of 0 were four times as likely to have died, particularly from cardiovascular disease.

The researchers, who tracked deaths among the participants until 2006, also said a person with a health score of 0 had the same risk of dying as someone with a health score of 4 who was 14 years older.

The lifestyle change with the biggest benefit was giving up smoking, which led to an 80 percent improvement in health, the study found. This was followed by eating fruits and vegetables.

Moderate drinking and keeping active brought the same benefits, Kay-Tee Khaw and colleagues at the University of Cambridge and the Medical Research Council said.

"Armed with this information, public-health officials should now be in a better position to encourage behavior changes likely to improve the health of middle-aged and older people," the researchers wrote.

The article also contained the following tips:

Be as lean as possible without becoming underweight. A body mass index (BMI) between 21 and 23 is the ideal recommendation.

Be physically active daily for at least 30 minutes.

Avoid sugary drinks. Limit consumption of energy-dense foods (particularly processed foods high in added sugar and fat, or low in fiber).

Eat more variety of vegetables, fruits, whole grains and beans. Earlier this year, the CDC reported that Americans are not consuming enough vegetables and fruit in their diet.

Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats. Processed meat -- such as bacon -- consumed per day increases the risk of colorectal cancer.

If consumed at all, limit alcoholic drinks to two for men and one for women a day. Alcohol is linked to an increased risk of throat, breast and liver cancers.

Limit consumption of salty foods and food processed with salt/sodium.

Don't use supplements to protect against cancer, opt for a balanced diet.

Researchers also suggest against smoking or chewing tobacco in any form because of the increased risk of cancer and other serious diseases.

Hope this information helps,

Dr. Paul

Tuesday, January 8, 2008

General Health Topic - How are Your New Year's Resolutions Holding up?

Hello Everyone,

Just a quick note of encouragement to stick to those New Year's Resolutions you made. How are they holding up? Are you doing anything special to help you stay with your program?

Drop me a note so I can pass on your success stories.

All the best,

Dr. Paul