Summer is usually the time to enjoy the outdoors. However, asthmatic people tend to shy away from going out due to the intense heat triggering an asthma attack.  According to the World Health Organization (WHO), 12% of Philippine population of 90 million have asthma; and according to the Global Asthma Report, approximately 11 million or 1 out 10 Filipinos are suffering from asthma, yet 98 percent of Filipino asthma patients continue to lack proper treatment.

What is asthma? It is recurring inflammatory disorder in the airways of breathing, which undergoes variable expiratory flow and reversible bronchoconstrictions, usually caused by trigger factors, that is different for every patient. In an asthma attack, the lining of the airways swells, and the muscles around the airways tense up. This condition limits the flow of air  through the lungs and leads to abnormal breathing. Asthma is mostly genetic but can be triggered by a lot of factors—genes, stress,  strong emotions, change of temperature, environment, dust, pollen, molds, chemicals in the air or in food, tobacco smoke, exercise, animals and viral infections.  

The most common symptoms of asthma are cough, difficulty of breathing and wheezing. Asthma usually builds up before you actually have an attack. It can range from mild to severe. Unfortunately a lot of patients dismiss their asthma and asthma control, relying only on as needed medications when attacks occur. The goal of asthma treatment has always been to relieve attacks and prevent future exacerbations as well. When asthma is uncontrolled, this leads to more absent days, more ER visits, more hospitalizations, and reduced quality of life.

This is a disease that can be effectively controlled. There should be good partnership between patient and physician. Aside from avoiding trigger factors, having the right medications are important to stop or prevent an attack. Presently, there are a lot of maintenance inhalers available for asthmatic patients. They just have to look for one that suits them best (considering price, convenience of use and lifestyle). Aside from having the correct medication, lifestyle modification is important in the management of asthma.

Sources: World Health Organization, Global Asthma Report, GINA Guidelines 2017

Written by: Darwin Z. Angcahan

Edited by: Michelle Angela Tan-Reyes, M.D.

Coronary Artery Disease

Coronary artery disease (CAD) is a type of heart disease caused by the buildup of plaque and impairs blood flow in the arteries in our heart. Over time, this can lead to heart failure, arrhythmia, heart attack or even sudden death. There are a myriad of risk factors of CAD. The most common risk factors for CAD include hypertension and diabetes.

Diabetes mellitus is the deficiency of insulin in the body, which our bodies need to convert sugar into energy. It is usually produced in the pancreas. Without insulin, sugar cannot enter the cells, thus accumulate in the bloodstream, which, over a long period, can lead to elevated blood sugar level.

Diabetes mellitus has been gaining popularity over the years, both in developed and developing countries. The World Health Organization (WHO) has ranked the Philippines 10th with the highest diabetes incidence worldwide. Unfortunately, a huge number of Filipinos (estimated at 6 million) have diabetes but are not aware of it. Diabetes can be genetic, acquired or can manifest during pregnancy. The complications of diabetes are catastrophic to one’s health. These include eye disease, heart disease, stroke, kidney complications, nerve damage and foot complications.

An ounce of prevention is better than a pound of cure. Studies claim that reducing bad cholesterol and maintaining right blood sugar in our body can contribute to stabilizing plaque and reducing coronary atherosclerosis. Aside from drug therapy, more important is lifestyle modification to prevent cardiovascular events and prolong life expectancy. So, strive harder to control hypertension, promote smoking cessation, reducing BMI, increasing physical activity and removing stress!

     It’s almost summer once again. Temperatures in Metro Manila and other parts of the Philippines are expected to go up in a few weeks. The Department of Health (DOH) has been warning the public against the dangers of heat stroke for many consecutive years now as summer approaches. Over the years, temperature in the Philippines has reached 36-42°C.

     What is heat stroke? It is a medical condition wherein the body temperature reaches very high levels (~40°C) due to constant heat exposure. It is usually in combination with dehydration. Heat stroke is considered a medical emergency. If untreated, it can quickly damage your brain, heart, kidneys and muscles. The damage worsens the longer treatment is delayed, increasing your risk of serious complications or death. Most commonly, heat stroke often occurs as a progression from milder heat-related illnesses such as cramps, syncope and exhaustion. Although heat stroke mainly affects people over age 50, it can also affect healthy young athletes and anyone who is exposed to prolonged heat. Special precautions should be made for infants and children up to age 4 and adults over age 65, because these age groups adjust to heat more slowly than other people. Patients with particular disease are also at higher risk to have heat strokes – those with hypertension, diabetes mellitus, kidney disease, mental illness, alcoholism, and those with fever. Those taking particular medications are also at risk – diet pills, anti hypertensive medications, methamphetamines and anti-depressants.

Heat Stroke2

     What do we need to do to avoid heat stroke? Drink lots of water (versus iced tea, soda, coffee and alcoholic drinks), keep indoors, avoid long direct exposure to sunlight, and wear thin and loose and light-colored clothes. Anything that will help cool your body down is a good measure to prevent heat stroke. What if there are signs of heat stroke already? Go the extra mile and apply ice packs to the patient’s armpits, groin and neck. These are the areas rich in blood vessels close to the skin. And cooling them may reduce body temperature. Remember, always keep cool!

Sore Eyes

Sore eyes or Conjunctivitis is defined by the Department of Health (DOH) as a redness and inflammation of the membranes (conjunctiva) covering the whites of the eyes and the inner parts of the eyelids. It has many causes, but in most cases it results from viral infection, but can also be from bacteria or allergen. There have been epidemics in the Philippines, the most recent big one being in September 2015.

Conjunctivitis also has other symptoms, which may vary, depending on the cause. These symptoms can be used to diagnose the type of conjunctivitis. Common symptoms are eye redness, stinging and foreign body sensation, itching, and sticky eye discharge. Vision may become blurred from excessive tearing, discharges and from photophobia (or extreme glare), caused by the inflammation. It is self-limiting, lasting 7-10 days, but with some amount of variability depending on the viral strain. Conjunctivitis can be diagnosed by history and examination alone. Laboratory tests are usually not needed.

Treatment is aimed at reducing discomfort as there is no definitive medication against the viral infection. Cool compresses, ocular vasoconstrictors and antihistamine are helpful. As we all know by now, the infection is highly contagious, often resulting in epidemics, as it spreads easily by hand-to-eye primarily and to a lesser degree, droplet contamination.

Sources: Philippine Academy of Ophthalmology, American Academy of Ophthalmology

     Zika virus is spread to people through mosquito bites. Mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites. It is transmitted to people primarily through the bite of an infected Aedes species mosquito, that includes the Aedes aegypti mosquito, which also spreads dengue virus, yellow fever virus and Chikungunya. It can also be spread by Aedes albopictus mosquitoes, commonly known as the Asian Tiger Mosquito.

     The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon. Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.