Category: Medicine Hat News

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Prevention – West Nile Virus and Melanoma

If you are addicted to reading, listening and watching news then you probably feel your health and your very existence is being threatened by nature. Then in the comfort of your living room you wonder if Albertans have anything to worry about, besides the rising cost of buying gas.

Well, West Nile virus (WNV) is something to worry about. The medical officer of health, the Health Promotion Marketing Coordinator of the Palliser Health Region and the media do a good job of keeping the public informed on the subject of West Nile virus. So far I believe our region has had four cases of confirmed WNV and Alberta has had about six.

This is a small number compared to what we had in 2002 and 2003 when the first cases of infection in humans in Canada were documented. At that time 1300 confirmed cases of WNV where reported in seven provinces. In 2004, only 26 cases were reported and this year probably it will be less than that.

In 2003, Alberta experienced an epidemic of WNV when 275 human cases were reported. Nearly half the human cases (131) occurred in the Palliser Health Region, according to the statistics provided by Gordon Wright, the Health Promotion Marketing Coordinator for Palliser Health Region.

Credit should also be given to local municipal authorities who must be doing a good job applying larvicides to control the population of mosquito vectors. And the people are more aware of the dangers of exposing to mosquito bites. Many of them take preventive measures by using mosquito repellent, avoiding peak biting times and wearing protective clothing such as long sleeved shirts, trousers and socks. We should also avoid handling dead birds and animals that may be infected.

It is nice to read that we are doing better each year. But this is not the time to lower our guard. The WNV activity typically increases in late summer and early fall. The activity is also influenced by weather conditions and the number of birds and mosquitoes in the region.

An article in a recent Canadian Medical Association Journal warns that mosquito repellent should be used with caution in children under the age of 12. They should not be exposed to DEET concentration of more than 10 per cent and DEET should not be used on infants less than six months old.

There is no vaccine against WNV infection and there is no definitive treatment. So we have to rely on prevention.

When you are outdoors worrying about the mosquitoes you should also remember prevention is the key word when it comes to melanoma. Did you know that malignant melanoma rates have tripled in Alberta over the last 30 years? This is mainly due to our desire to tan. There are three types of skin cancers and melanoma is the worst kind. Prevention with early detection and treatment are the best way to control this problem.

Melanoma affects males and females equally. The most common site for males is trunk and for females it is hip and lower limb area. Although skin cancers occur more in sun exposed areas, it is still possible to have skin cancer on any part of the body.

Prevention of melanoma is best achieved by use of sun screen, avoiding sun exposure between 10 a.m. and 3 p.m. and wearing wide-brimmed hat. Surgical removal of suspicious looking moles also helps in the prevention of skin cancer.

So when you go outdoors, it is better to apply sunscreen first before applying DEET. Looks like we are going to have good weather for sometime to come. So enjoy but take care.

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Holiday in Portugal and Spain


Dr. Noorali Bharwani poses in front of the world-famous Alhambra on the left and city of Granada, Spain on the right. Granada was a long-time capital of Moorish Andalusia. Alhambra is one of the most important Arabian palaces with lush gardens.

Every now and then go away,
Have little relaxation,
For when you come back to your work
Your judgment will be surer……
-Leonardo da Vinci (1452-1519)

From time to time I listen to Leonardo da Vinci and pack my bags and leave town to reflect on the past, the present and plan for the future.

For more than one reason, 2005 is an important year for me. Many of my personal wishes and dreams are coming closer to fulfillment. I feel this year I have reached an important milestone in my life. So it was time to take a long break and think where I need to be in the next 10 years.

So I packed my bags and treated myself and my family to four weeks of holiday. We spent three weeks in Toronto, Portugal (Lisbon, Algarve), and Spain (Seville, Granada, Cordoba and Madrid). Before that I took five days off and did some continuing medical education and golfing in Canmore and Banff.

The holiday was wonderful. In Toronto, we attended Musoma Reunion. Musoma is in Tanzania where I was born and went to school until Grade nine. Since there was no high school in Musoma, I went to a boarding school in Dar-es-salaam. Then I moved on to India, England and Canada. So I had not seen most of my friends for many years. I hate to say how many! But it was an eye opener to see how passage of time has aged people – including me! I still remember many of my friends in their school uniforms!

In Portugal and Spain we found the people to be nice and friendly. The history of these countries is very fascinating. From 1000 BC to AD 1179 Portugal was under occupation, from Romans to Moors.

Then came the Age of Discovery and Portugal became a powerful empire. Portuguese ships rounded the Cape of Good Hope in 1488, and in 1497 Vasco da Gama reached Calicut, India. By 1560, Portugal had claimed Brazil and many other countries.

Spanish history is very similar. First came the Romans, then Moors and then the Christians. A Moor is a Muslim Arab who lives in northwest Africa. Moors invaded Portugal and Spain in the 8th century and established a civilization in Andalusia that lasted until the late 15th century.

Muslims built mosques where the Roman temples were. Christians built churches where the mosques were. For hundreds of years Jews, Muslims and Christians lived in harmony until they started fighting to control the land. Islam brought to Europe mathematics, papermaking, oranges, spices and rice as well as unique Islamic architecture and planning which is visible even today.

Temperatures in summer are anywhere in high 30s to high 40s Celsius. Between 3 p.m. and 8 p.m. most businesses shut down for siesta. You have to organize your schedule for shopping, meals and tours accordingly. Bullfights are scheduled only on Sundays. People smoke everywhere.

Not all shops, restaurants and banking machines accept credit or Interac cards. So carry enough cash with you. All our flights were running late by an hour or more. This makes it difficult to catch connecting flights. Make sure you have about three hours lay over to be on the safe side. These days airlines do not give a damn about our comfort. The planes are packed like sardines and leg room between seats is minimal. Not to mention other discomforts in the planes.

But, you cannot walk to Portugal and Spain. So, we have to fly because these countries are worth a visit. Remember, every now and then go away…

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Melanoma

How ironic that Chuck Cadman, 57, independent Member of Parliament from British Columbia, should die from melanoma during the summer month of July. His death reminds us again that we have to protect our skin from the damaging effect of the sunrays.

Artificial tanning machines are also dangerous. Recently, the World Health Organization (WHO) said the increased popularity of artificial tanning machines is one of the main reasons for a rapid increase in incidence of skin cancer, particularly among young women in Europe and North America.

WHO suggested Governments should pass laws on the responsible use of sun beds, banning their use for all people under 18.

For Canadian males, the rate for melanoma has tripled since the late 1960s. For Canadian females, the rates have varied over the years but still show a gradual increase.

Melanoma is the most serious form of skin cancer. If diagnosed and removed early then the cure rate can be excellent. Once the cancer advances and spreads to other parts of the body, it is hard to treat and can be deadly. The death rate from melanoma continues to rise about two percent annually.

Skin is the largest organ of our body and has many important functions to protect us from environment. Skin is constantly exposed to sun, wind, industrial elements and other causes of external and internal injury.

Melanoma arises from cells called melanocytes. These cells contain melanin (melas = black) – a principal pigment responsible for the color of human skin, hair, and eyes. Melanin also acts as a filter to decrease the harmful effects of ultraviolet rays to the dermis.

When the skin is exposed to ultraviolet radiation, there is immediate increase in the number of melanocytes and production of melanin pigment. This results in tanning. The amount of melanin produced is genetically determined. That is why some people burn easily without tanning.

The risk of skin cancer is increased in individuals who spend too much time out doors, children who have had episodic sunburn, and if there is a family or personal history of skin cancer (especially melanoma). Males are affected more than females.

Can we prevent skin cancer?

There are two important things to remember about prevention of skin cancer: cover up and stay out of the sun.

We need to remember that skin tanned by ultraviolet radiation is damaged skin which predisposes to cancer. We need to avoid sunburn and generally reduce exposure to ultraviolet radiation by staying out of the midday sun, wearing protective clothing, seeking shade, and applying sunscreen.

We should have moles or sun burnt skin surgically removed if they show signs of change or non-healing. Bleeding, chronic irritation, change in color or size should warn us to have these moles removed.

Despite having a good understanding of the relation between overexposure to the sun and skin cancer, 81per cent of North Americans still think they look good after being in the sun. Just like the smokers. They know smoking kills but they still smoke.

Does melanoma occur in children? Yes, approximately two per cent of melanomas occur in patients under the age of 20 years, and about 0.4 per cent of melanomas occur in pre-pubertal children.

Prevention of skin cancer is very important. This should start in childhood. More than 90 percent of skin cancers occur on sun-exposed areas of the body. So, protect yourselves from the damaging effects of sun and tanning beds.

This column will take a summer break and return in September. Have a safe summer!

Thought for the week:

“Genius is the ability to put into effect what is in your mind”.

– F. Scott Fitzgerald

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Lactose Intolerance

Dear Dr. B: I have chronic diarrhea. Is it possible that I may have lactose intolerance?

Answer: Many conditions can cause diarrhea. It can be acute or chronic in nature.

Acute diarrhea is more likely to be the result of a viral illness such as infection with rotavirus, adenovirus, or astrovirus. Bacterial or parasitic infection can also cause acute diarrhea. These may be contracted from exposure to contaminated water and food.

Chronic diarrhea can result from malabsorption, food allergy, celiac disease, bacterial overgrowth, lactose intolerance, chronic Giardia infection, short-bowel syndrome, inflammatory bowel disease, malignancy and irritable bowel syndrome.

Lactose intolerance is a condition where a person has inability to digest lactose, the natural sugar found in milk. Normally, the enzyme lactase breaks down lactose in the intestines to form the sugars glucose and galactose, which are easily absorbed through the intestinal wall.

Persons with lactose intolerance are unable to digest significant amounts of lactose because of a genetically inadequate amount of the enzyme lactase. As a result, the lactose remains undigested in the intestines and causes abdominal pain, diarrhea, bloating and excessive flatus.

The condition most commonly develops in adolescence and adulthood. It is more common in non-Caucasians than in Caucasians. It is present in up to 15 percent of persons of northern European descent, up to 80 percent of blacks and Latinos, and up to 100 percent of American Indians and Asians.

A diagnosis of lactose intolerance is usually not too difficult. It can usually be made with a careful history supported by dietary changes. If necessary, diagnosis can be confirmed by using a breath hydrogen or lactose tolerance test.

Individuals with chronic diarrhea believe they are lactose intolerant but do not actually have impaired lactose digestion, and some persons with lactase deficiency can tolerate moderate amounts of lactose, up to 250 mls. of milk daily without symptoms.

Lactose intolerance is usually a permanent condition. Treatment consists primarily of avoiding lactose-containing foods. Lactase enzyme supplements can be helpful. If one has to go off milk and milk products completely then one must maintain adequate body calcium balance by taking oral calcium supplements.

Question of the week:
What is the difference between a nice guy and a good guy?

According to 83 years-old Jack Fleck (1955 U.S. Open golf champion), nice guys are pleasant outwardly, but they’re looking for how situations can benefit them. Good guys give of themselves, no questions asked.

A thought for the week for the new graduates:
“Having an education is no excuse for not using your head”.
-from Musings by Dennis van Westerborg, a local artist and writer.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!