MANILA, Philippines – last week, we learned that smoking kills. is it about time that we kill (the) smoking (habit)? Like any addiction, it can be almost impossible to stop because of the associated pleasure smoking brings. But quitting may be the only way to get back your health if it’s not too late.

Benefits of quitting. A 2001 University of California study revealed the immediate effects of not lighting up:

Within 20 minutes, blood pressure decreases; pulse returns to its normal level.

After eight hours, carbon monoxide levels in the blood return to normal, oxygen level increases.

After 24 hours, chance of heart attack starts to decrease; breath, hair, and body stop smelling like smoke.

After 48 hours, damaged nerve endings begin to recover; sense of taste and smell improves.

After 72 hours, the body is virtually free of nicotine; bronchial tubes relax and breathing becomes easier;

After 2–12 weeks, lungs can hold more air; exercise becomes easier, and circulation improves.

The long-term effects of quitting include:

After 1 year, the risk of coronary heart disease is cut in half.

After 5 years, the risk of stroke falls to the same as a non-smoker.

After 10 years, the risk of lung cancer is cut in half and the risk of other cancers decreases significantly.

After 15 years, the risk of coronary heart disease drops, usually to the level of a non-smoker.

Smoking cessation. to date, there are seventeen (!) methods of quitting smoking. They all deal with getting off nicotine dependence, the main chemical culprit in the addiction. So make no mistake about it – withdrawal symptoms start as early as four hours after stopping and peaks at 3 to 5 days but tapers off in two weeks. Expect the physical effects of tingling in the hands and feet, sweating, intestinal disorders (cramps, nausea), dizziness, headache, cold symptoms as the lungs begin to clear (sore throat, coughing, and other signs of colds and respiratory problem). and if that’s not enough, watch out for: Temper tantrums, insomnia, anger, depression, irritability, and anxiety. (QuitSmokingSupport.com). and oh by the way, weight gain (nicotine is an appetite suppressant, too).

What works. There’s just stopping (“cold turkey”); pharmacological — nicotine replacements in the form of lozenges, patches, sprays, and inhalers; anti-depressant bupropion, the nicotinic receptor agonist varenicline which controls the withdrawal symptoms; and of course cigarette substitutes like the electronic cigarette or herb preparations (non-tobacco). Hypnosis and acupuncture are alternative approaches.

Individual or group counseling is available in hospitals that offer smoking cessation services. So get help. Don’t do it alone because there are also support groups.

It is not too late to quit smoking. But you must commit to stop. not only restaurants or buildings can be “smoke-free.” Dr. Pujalte is an orthopedic surgeon.

MANILA, Philippines – Fireworks-related injuries have reached 929 cases, according to the latest count from the Department of Health (DoH).

The breakdown of injuries is as follows: 882 were due to firecrackers, 36 to stray bullets, and 11 to firecracker ingestion.

Three days ago, the number of fireworks-related injuries was 20 percent lower than last year. but in the DoH surveillance update dated January 3, the margin of difference was closing and is now only 106 cases or 10 percent lower than last year.

Fifty-five patients suffered amputation after getting injured by blasts or burns while 693 were more fortunate they did not get amputated from their injuries.

Four hundred fifty one were caused by illegal fireworks led by Piccolo at 245 cases; kwitis at 134; five-star at 58; Pla-Pla 49 and Luces, 42.

Some 113 persons who were injured were found to be under the influence of alcohol.

DoH officials reiterated their call to injured persons who haven’t sought medical attention to take their wounds seriously as they are at great risk for acquiring tetanus.

Injured persons must receive anti-tetanus shots as tetanus is fatal if not managed early.

Symptoms of tetanus include locked jaw, difficulty in swallowing, spasms, convulsion and difficulty in walking and breathing.

Dr. Eric Tayag, chief of the National Epidemiology Center (NEC), said many wounded patients usually wait for the next day before seeking medical attention.

“Those who were injured by fireworks should immediately seek medical attention because we consider all fireworks-related wounds as serious. they are at risk for tetanus,” Tayag warned.

“we think that the wound is not serious, but if doctors open the wounds, they are actually deep. inside, we can find the chemical and paper used in manufacturing the firework, soil, and dead tissue,” he said.

MANILA, Philippines – It should come as no surprise that the back hurts several times in a “whole lifetime’s length.” It was anatomically predestined in the time we evolved from crouching, four-legged beasts into upright, walking animals. So, really, it’s not a question of when it’s “oh-my-aching-back” but of how and what kind of back pain it is.

Worrisome back pain. But since back pain is so common, it is most often ignored. For older people, it’s explained away as one of the givens of aging (it’s not) and for active young adults, back pain becomes a grin-and-bear-it affair. What kind of back pain should be cause for concern?

Acute lumbar strain. By far, the most explainable of back pains is acute lumbar strain. A direct cause and effect can be elicited. that is, the patient comes complaining of an aching back after a day of lifting heavy objects, or of stooping to do some house work like gardening or plumbing. sometimes it can be due to carrying a baby day in and day out, especially big ones. back muscles are in spasm; they feel tight and may feel shortened or contracted.

Herniated disk. Intervertebral disks are the shock absorbers of the spine. In youth, they are sturdy, flexible, and elastic. as the spine ages, disks become rigid and dry. now with continued intense pressure, a disk can rupture its center (imagine a chocolate éclair with the creamy filling) and this center called the nucleus pulposus can pinch an adjacent nerve. This is the impingement that causes pain, numbness, or weakness of the extremities. In theory, all disks can displace. However, the most common herniations are found in the lower back and in the neck.

Signs and symptoms. The following are textbook descriptions of a ruptured disk:

* Sharp “electric” pain shooting down from the back to one or both legs immediately after lifting a heavy object or falling on your back or some other back injury.

* back pain, especially after sneezing, coughing, or straining during a bowel movement.

* Numbness or tingling of the arms and hands (cervical or neck disc) or of the legs and feet (lumbar or lower back disk).

* Difficulty in bending or straightening the back because it is very painful.

* as leg pain worsens, the back pain may disappear.

Non-orthopedic causes. there are good reasons for not ignoring back pain of more than two to three weeks. The back is such a large area that pain from non-musculo-skeletal sources makes its presence known in a treacherous kind of way. For example, infections of the kidney and urinary tract, tumors of the uterus, or gut problems can all present as back pain.

Diagnosis. A thorough history and physical examination should be able to re-create back pain in the clinic. A reliable sign is a positive SLR or Straight Leg Raising test in which shooting pain down the leg occurs when the examiner lifts the patient’s leg from a lying position. X-rays of the back may show loss of the normal curve signifying muscle spasm and/or loss of intervertebral space. to properly identify the offending disc, the doctor may request a CT (computed tomography) Scan or an MRI (magnetic resonance imaging).

Treatment. start by resting for one or two days. Lie down on a firm mattress and not on a hard surface. new studies have pointed out that staying in bed for longer periods leads to a loss of muscle tone. This further delays recovery. Pain medications range from over-the-counter drugs such as acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs) that are popular from marketing overload. Examples of NSAIDs are mefenamic acid, ibuprofen, diclofenac, naproxen, piroxicam, and indomethacin. COX-2 Inhibitors like celecoxib and etoricoxib, in higher doses (400mg and 120 mg, respectively) may also be used. Other drugs for back pain are tricyclic antidepressants and narcotics. These will need the approval and prescription of doctors. Physiotherapy may be helpful. A rehabilitation medicine specialist designs a physical therapy program for a back patient. This program may include cold or heat therapy, hydrotherapy, bracing, exercises, and TENS or transcutaneous electric nerve stimulation. TENS is thought to relieve pain by stimulating the release of endorphins or pain-inhibiting molecules.

Surgery. An operation (usually performed by either a neurosurgeon or an orthopedic surgeon) is suggested for the following reasons: Progressive increase in pain, failure of conservative treatment, loss of bowel or bladder functions; sudden or progressive muscle weakness; loss of sensation in the buttocks and perineal area (saddle anesthesia), and loss of movement. all these signify that the back will not be better unless there is surgery. The operation usually involves removing the disk (diskectomy) and unroofing the spine (laminotomy/laminectomy). sometimes, portions of the back bones are also joined together (fusion) to prevent pain and instability.

Most back pains go away. some don’t. all must be investigated.

As our politicians love to say, “Watch your back.”

MANILA, Philippines – At least 891 people were injured by firecrackers and stray bullets during the New Year revelry, the Department of Health said Monday.

Based on the latest DOH data, 844 people were injured by firecrackers, 36 were hit by stray bullets and 11 were hurt after ingesting firecrackers.

The casualty count is 13% lower than last year’s total of 1,028 casualties, according to Dr. Eric Tayag of the DOH’s National Epidemiology Center.

Tayag said the leading cause of injuries is piccolo, followed by kwitis and 5-star.

He said most of the victims waited for 5 days before going to the hospital for treatment.

The DOH is now on tetanus alert in anticipation of the surge of complications from untreated firecracker injuries. Tayag said they are treating all victims of firecrackers as serious cases.

Manifestations of tetanus come out as early as 3 days to one month. Among the symptoms of tetanus are headache,lockjaw, high fever and weakness.

"Yung mga galing na sa ospital na naputukan dapat nyong tiyakin na nabigyan kayo ng anti tetanus na bakuna. Kung wala, kailangan niyong bumalik," he said.