Bisher AKIL, MD

Archive for April 28th, 2009|Daily archive page

Do I have to?

In General Health on April 28, 2009 at 7:43 pm

As the media coverage of this infection spreads, I have been asked more questions. Here are some of them:

1. Should I cancel my trip to Mexico? The CDC is recommending against unnecessary travel to Mexico. Similarly, many countries have done the same. I recommend canceling all unnecessary travel for the time being to any destination. 

2. Are airplanes safe? Not clear. This was reported earlier today in the NYTimes: “Most of Boeing’s airplanes have air filtration systems with “similar performance to those used to keep the air clean in hospitals, operating rooms and industrial clean rooms,” according to Jim Proulx, a Boeing spokesman. “These filters are very effective at trapping microscopic particles as small as bacteria and viruses,” Mr. Proulx continued. “All Boeing production airplanes have HEPA filters, which are effective at capturing greater than 99 percent of the airborne microbes in the filter air.”- However, if you are sitting next to someone with Swine Flu (or within 6 feet from that person) then filters will not be of much use to you.

3. Should I wear a mask?: Face masks and respirators (see below) are most useful for people who are in crowded settings, such as classrooms, subway or airplanes, where they will protect the mouth and nose from germs and reduce the likelihood of coughing or sneezing on other people.

4. Would any mask do? No! Don’t count on those disposable masks to completely protect you against the swine flu. These are loose-fitting and designed largely to help stop droplets from spreading from the person wearing the mask. They also protect the wearer’s mouth and nose from splashes. They are not created to protect the wearer from breathing in very small particles. Respirators, on the other hand, are made for just that. They are similar in appearance to the relatively inexpensive face masks but are designed specifically to protect the wearer from breathing in such particles. These masks, known as N95 for its filtering ability, fit more snugly on the face than face masks so that most air is breathed through the filter material. They work best if they are fitted specifically to the person wearing the mask. so wear the correct mask (N95) and fit them snugly on your face.

5. Is this it? Am I now protected? No.  Face masks and respirators should be used along with other precautions, such as frequent hand-washing, covering coughs, staying at home if ill and avoiding crowds.

6. Should I panic now? No absolutely not. This is preventable and treatable illness. If you protect yourself and others, use common sense and do not ignore symptoms, then we will all be better.

Do I have the Swine flu?

In General Health on April 28, 2009 at 6:18 pm

Many of us are concerned about the Swine flu. As a physician in Medical practice, I received a lot of call from my patients about this. So here I will try to answer some:

1. What is Swine Flu? :Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs.

2. Is it contagious? Do I have to go to Mexico to get it? CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people. People who have it can pass it on to others.

3. If I have it what do I feel? The symptoms of swine flu are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu.  Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

4. How can I tell if it is Swine Flu from regular flu?: probably the most telling symptom is fever. Swine flu usually brings on fever above 100.5F, which is not common with regular flu.

5. How can I get infected with Swine flu? Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

6. How soon can one infect other? Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

7. How long would the flu virus stay infectious if it is on a door knob or handle or other hard surfaces? In addition to the droplets from coughing or sneezing, germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. the virus will remain contageous probably for 24- hours after dropping on a surface.

8. How can I protect myself  from the flu? First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.There is no vaccine available right now to protect against swine flu. 

9. What can I do to protect myself from getting sick? There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:

   * Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

    * Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.

    * Avoid touching your eyes, nose or mouth. Germs spread this way.

    * Try to avoid close contact with sick people.

    * If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

10. Is there any good news? Swine Flu responds to treatment, and we have two medications that can treat it (Tamiflu, Relenza). These medications must be started within the first 48 hours of symptoms. These medication do not prevent the infection, but rather treat it. Do not take thee medications unless there is high level of suspicion for Swine flu.

PSA, should we check it?

In Cancer on April 28, 2009 at 4:37 pm

Prostate cancer is the most common noncutaneous cancer in men in the United States. Despite its prevalence, the natural history of this disease is remarkably heterogeneous. In many patients, the cancer progresses slowly, resulting in tumors that remain localized to the prostate gland. Although potentially life-threatening, such cancers are most often curable.  Many patients with low grade and volume cancers may be candidates for active surveillance. In other patients, however, tumor growth may be more rapid, resulting in cancer spreading beyond the confines of the prostate. In such cases, long-term survival may be considerably diminished compared to survival associated with organ-confined cancers. Strategies for managing prostate cancer have therefore been aimed at early detection, with selective, tailored treatment.  Prostate-specific antigen (PSA) is a tumor marker currently used for early detection of prostate cancer. The American Urological Association has recommended that baseline prostate-specific antigen testing (and digital rectal exam) be offered to men as young as age 40 — with life expectancies of 10 years or more — after a discussion of testing’s benefits and risks. The recommendation appears in the group’s updated “Best Practice Statement” on PSA testing and contrasts with guidelines issued by other groups, including the U.S. Preventive Services Task Force. In August 2008, the USPSTF concluded that “the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75”; the group also recommended against screening those aged 75 or older. Ref: Comments: Two reports came out recently against routine testing for PSA. The reports created a lot of stir and made front page for may newspapers. The definitive study is yet to be done; in the meantime, testing for younger men, along with proper counseling, digital exam and common medical sense is the way to go for now_BA