www.youtube.com/watch?v=oV-BFPdfqJU

How to Sit at a Computer
Regular computer users perform 50,000 to 200,000 keystrokes each day. Under certain circumstances and for vulnerable individuals, frequent computer use that involves awkward postures, repetition, and forceful exertions may be related to nerve, muscle, tendon, and ligament damage.

If you use a computer extensively (several hours each day), many experts recommend that you consider proper workstation layout and posture techniques to minimize your risk of developing injuries of the hand/arm, shoulder, neck, and back.

Overuse injuries develop over time, and may set in more quickly if you spend long hours sitting at a computer at home, as well as at work.

MANILA, Apr 14, 2011 (IPS) – In a country where an estimated 4,500 women die every year due to complications during childbirth, the enactment of a reproductive health (RH) policy is said to be a measure that could save lives.

The Catholic Church has been very vocal in its opposition to a RH policy in the country, but not all religious organisations agree.

In a press conference dubbed ‘To Sin or not to Sin: The Views of Other Churches on RH’, representatives from different faith-based organisations expressed their support for the passage of the highly debated House Bill 4244 or the ‘Responsible Parenthood, Reproductive Health and Population Development Act of 2011’ and its Senate counterpart.

“We support the RH Bill because it is pro-life, it is pro-development and it is pro-poor,” said Bishop Efraim Tendero, of the Philippine Council of Evangelical Churches (PCEC).

PCEC is the largest network of evangelical Christians in the Philippines and is composed of 25,000 evangelical churches, 66 denominations, and 150 community and mission organisations.

Addressing concerns of the Catholic Church that the bill would promote a “culture of death” by allowing artificial contraceptive methods, Tendero had this to say: “Life begins at fertilisation. Therefore if there is no fertilisation, there is no life yet. The use of artificial contraception is not taking away life because life has not yet started.”

Eduardo V. Manalo, executive minister of Iglesia ni Cristo to the Committee of Population and Family Relations, said that many of society’s worsening ills could be traced to families “growing so large that an increasing number of parents cannot provide the most basic human needs to their families.”

“The Bible states that a parent who does not provide for the needs of his own household is worse than an unbeliever. (I Tim 5:8),” Manalo said. “Since modern methods of contraception – by preventing married couples from having unwanted pregnancies – assist in supporting this Christian principle, we support their use,” according to the statement.

Iglesia ni Cristo is the largest entirely indigenous Christian religious organisation in the Philippines, and the largest independent church in Asia.

Bishop Rodrigo Tano of the Interfaith Partnership for the Promotion of Responsible Parenthood (Interfaith) claimed that if the Catholic Bishops Conference of the Philippines (CBCP) professed to value the dignity of every human person, they should have more respect for human rights.

“To allow the deaths of mothers and babies because of a lack of a national policy is almost criminal,” said Tano, citing figures of maternal and infant deaths in the country.

According to the United Nations Population Fund (UNFPA), maternal deaths in the Philippines are one of the highest in the region. An estimated 11 women die every day in the country due to complications during pregnancy – most of these deaths are preventable. The problem is said to be particularly severe within the Muslim communities in Mindanao, where as many 320 mothers died per 100,000 live births according to the UN.

The Philippines has one of Asia’s fasted-growing populations, which is nearing the 100 million mark.

Interfaith is a gathering of various faith-based organisations, whose members include Iglesia ni Cristo, evangelical protestant churches, Roman Catholic individuals, and Muslim groups in Mindanao.

Tano also said that he was disturbed by the use of ambiguous terms, the lack of clarity in medical terms, and claims of the CBCP that there is no relation between population size and poverty.

“We should go by evidence and not by ecclesiastical declarations,” said Tano. “Evidence shows that families are unable to maintain their income, expenditures and savings as their size increases. The incidence of child labour also rises as family size increases.”

“When talking about issues of morality, let us look at the context of the Philippines and the context of the world,” suggested Rommel Linatoc, of the National Council of Churches in the Philippines (NCCP). The NCCP is a fellowship of 10 Protestant and non-Roman Catholic denominations, and 10 service-oriented organisations in the Philippines. It represents close to 12 million adherents.

Linatoc expressed his support for the bill saying that it would affirm a better quality of life for families and ensure better health for women.

Ernesto Pernia, of the University of the Philippines School of Economics and a representative of Catholics for Reproductive Health (CRH), agreed that there is a morality issue that needed to be addressed.

“Our bishops in CBCP can not say that practicing RH is sinful in the Philippines, but it is not in Mexico, Argentina, Brazil, Spain, Ireland and Italy because Catholics there practice family planning as a matter of course,” Pernia said. “The Catholic Church does not stand in the way of the government promoting or implementing a population policy.”

CRH is an alliance of Filipino Catholics advocating for the passage of the reproductive health bill and fighting for Filipinos’ right to reproductive health services.

Pernia pointed out that the Philippines is the only Catholic country that has not addressed its population issue. He added that the having a reproductive health policy would promote human development and a “life of dignity” rather than a “life of misery”, which is what many people who cannot properly care for their children are currently facing.

Ramon San Pascual of the Philippine Legislators’ Committee on Population and Development Foundation, Inc. (PLCPD), said that churches support the passage of the RH bill as they know their members would benefit from it.

“We do not understand why some leaders of the Catholic Church are so stubborn that they refuse to see the issue in the perspective of their parishioners who in fact clamour for RH education and services,” said San Pascual.

Around 80 percent of the Philippines population is Catholic – and the Catholic Church sanctions only natural family planning methods.

Meanwhile, Pernia says that there were many priests, nuns and theologians who supported the bill as individuals but were still afraid to come out openly in support of it.

Following reports of the recent resumption of dialogue between the government and the Catholic hierarchy on RH, Elizabeth Angsioco, national chairperson of the Democratic Socialist Women of the Philippines (DSWP) said that other religions and women’s groups in the country deserve to be heard.

“The President should be reminded that the country is not 100 percent Catholic. It is only right that he listens to other religious leaders,” Angsioco said. By Kara Santos

The production of counterfeit or substandard anti-infective drugs is a widespread and under-recognized problem that contributes to morbidity, mortality, adverse drug reactions, drug resistance, enormous financial consequences for companies producing the genuine product and loss of confidence in the health care systems and the drug regulatory authorities. Counterfeit drugs particularly affect the most disadvantaged people in poor countries, like the Philippines. A wide array of different counterfeit types based on packaging, sophisticated fake holograms styles on blisterpacks and spurious tablets that contain no active drug have been found in Southeast Asia.

To counter such threats, simple field tests and advances on Forensic Analysis and Chemical Characterization of counterfeit and substandard anti-infectives can be done. Among of which are High Performance Liquid Chromatography (HPLC); Gas Chromatography coupled with optical, electrochemical or mass spectrometric detectors; Thin-Layer Chromatography (TLC); and Colourimetry.

There can be no simple solution to the problem of counterfeit drugs. A comprehensive, pragmatic plan of action, linking various organizations, health workers, industry, and civil society is essential. The increasing evidence that the trade in counterfeit drugs is linked to transnational organized crime presage the necessity to harmonize definitions and penalties between countries, apply strict police and customs action, intensify inspection and drug regulation, increase public awareness, and reinforce a strong political will and openness among countries.

1) the drug itself or the container or labeling thereof or any part of such drug, container or labeling bearing without authorization the trademark, trade name or other identification mark or imprint or any likeness to that which is owned or registered in the Bureau of Patent, Trademark and Technology Transfer (BPTTT) in the name of another natural or juridical person;

2) a drug product refilled in containers by unauthorized persons if the legitimate labels or marks are used;

3) an unregistered imported drug product, except drugs brought in the country for personal use as confirmed and justified by accompanying medical records;

4) a drug which contains no amount of or a different active ingredient or less than eighty percent (80%) of the active ingredient it purports to possess as distinguished from an adulterated drug including reduction or loss or efficacy due to expiration.”

Hence, a substandard quality medicine is a counterfeit medicine by definition.

For the internist, the following can be indicators for fake drugs:

• Patients are not getting well or getting sicker– therapeutic failures. We have observed quite a few cases of attempted suicides with benzodiapezines, taking as much as over 50 tablets without any toxic effects. These drugs were sourced from undisclosed drug stores or from the streets. Hence, no active ingredients, patient do not get well or deteriorates and there is delay in treatment.
• Patient may report unusual side effects that are not known in current literature. Ask the patients where they had sourced their medicines. If they hesitate or refuse, suspect that the source is not from a legal channel. Please remember that even legal channels (i.e. licensed drug stores sometimes source medicines from illegal channels). Counterfeit medicines may contain nothing of the original active principles but something else (e.g. branded antihypertensive drugs were used, patients developed bleeding, while the diagnosis might be hypertensive bleed, the differential may be coumarin chemicals). Hence, wrong active ingredients can kill.
• The packaging is not in its original package, they do not have the requisite BFAD registration numbers andexpiry dates, printing is misaligned, labels easily destroyed or removed, discoloration of the package, no package inserts, tablets crumble, parenteral or bottle for reconstitution is tampered (i.e. needle holes seen in the rubber stopper) and the contents cannot be dissolved easily, evidence of contamination, foreign particles.

What the doctors must not do:

• With knowledge of substandard or fake drugs and of less than active ingredients, the doctor must not double the dose.
• Refusal to share information with other colleagues and hence missed out on patterns.
• Refusal to consider substandard drugs or counterfeit medicines as differentials to deterioration of patien conditions.
• Refusal to cooperate with the concerned drug industry in the investigation of counterfeit drugs.
• Buy drugs from questionable sources or abroad on their own and sell these in their clinics.

References:

Newton PN, Dondorp A, Green MD, et.al. Counterfeit artesunate antimalarials in Southeast Asia. The Lancet. 2003; 362:169.

By MARILYNN MARCHIONE, AP Medical Writer Marilynn Marchione, Ap Medical Writer – Mon Jun 14, 10:59 am ET

We fret about airport scanners, power lines, cell phones and even microwaves. It’s true that we get too much radiation. But it’s not from those sources — it’s from too many medical tests.

Americans get the most medical radiation in the world, even more than folks in other rich countries. The U.S. accounts for half of the most advanced procedures that use radiation, and the average American’s dose has grown sixfold over the last couple of decades.

Too much radiation raises the risk of cancer. That risk is growing because people in everyday situations are getting imaging tests far too often. Like the New Hampshire teen who was about to get a CT scan to check for kidney stones until a radiologist, Dr. Steven Birnbaum, discovered he’d already had 14 of these powerful X-rays for previous episodes. Adding up the total dose, “I was horrified” at the cancer risk it posed, Birnbaum said.

After his own daughter, Molly, was given too many scans following a car accident, Birnbaum took action: He asked the two hospitals where he works to watch for any patients who had had 10 or more CT scans, or patients under 40 who had had five — clearly dangerous amounts. They found 50 people over a three-year period, including a young woman with 31 abdominal scans.

When other radiologists tell him they’ve never found such a case, Birnbaum replies: “That tells me you haven’t looked.”

Of the many ways Americans are overtested and overtreated, imaging is one of the most common and insidious. CT scans — “super X-rays” that give fast, extremely detailed images — have soared in use over the last decade, often replacing tests that don’t require radiation, such as ultrasound and MRI, or magnetic resonance imaging.

Radiation is a hidden danger — you don’t feel it when you get it, and any damage usually doesn’t show up for years. Taken individually, tests that use radiation pose little risk. Over time, though, the dose accumulates.

Doctors don’t keep track of radiation given their patients — they order a test, not a dose. Except for mammograms, there are no federal rules on radiation dose. Children and young women, who are most vulnerable to radiation harm, sometimes get too much at busy imaging centers that don’t adjust doses for each patient’s size.

That may soon change. In interviews with The Associated Press, U.S. Food and Drug Administration officials described steps in the works, including possibly requiring device makers to print the radiation dose on each X-ray or other image so patients and doctors can see how much was given.

The FDA also is pushing industry and doctors to set standard doses for common tests such as CT scans.

“We are considering requirements and guidelines for record-keeping of dose and other technical parameters of the imaging exam,” said Sean Boyd, chief of the FDA’s diagnostic devices branch.

A near-term goal: developing a “radiation medical record” to track dose from cradle to grave.

“One of the ways we could improve care is if we had a running sort of Geiger counter” that a doctor checked before ordering a test, said Dr. Prashant Kaul of Duke University.

He led an eye-opening study that found that U.S. heart attack patients get the radiation equivalent of 850 chest X-rays over the first few days they are in the hospital — much of it for repeat tests that may not have been needed.

How much radiation is risky?

It’s hard to say. The best guess is based on the 1986 Chernobyl nuclear power plant accident and studies of Japanese atomic bomb survivors who had excess cancer risk after exposures of 50 to 150 millisieverts (a measure of dose) of radiation.

A chest or abdominal CT scan involves 10 to 20 millisieverts, versus 0.01 to 0.1 for an ordinary chest X-ray, less than 1 for a mammogram, and as little as 0.005 for a dental X-ray. Natural radiation from the sun and soil accounts for about 2 millisieverts a year.

A big study last year estimated that 4 million Americans get more than 20 millisieverts a year from medical imaging. Two percent of people in the study had high exposure — 20 to 50 millisieverts.

Another study by Columbia University researchers, published in 2007, estimated that in a few decades, as many as 2 percent of all cancers in the U.S. might be due to radiation from CT scans given now. Since previous studies suggest that a third of all tests are unnecessary, 20 million adults and more than 1 million children are needlessly being put at risk, they concluded.

Just because a scan didn’t find anything wrong doesn’t mean a test wasn’t needed. Scans are useful for many diagnoses. But many studies suggest people are getting too much imaging now. For example, Mayo Clinic researchers reviewed the medical records of 251 people given heart scans in 2007 and found that only a quarter of them were clearly appropriate.

Reasons for overuse:

_Accuracy and ease of use. Scans have become a crutch for doctors afraid of using exams and judgment to make a diagnosis. Some think a picture tells more than it does. Imaging that shows arthritis in a knee or back problems doesn’t reveal how to make it better, said Dr. Richard Baron, a primary care doctor in Philadelphia.

“Physical therapy for an orthopedic injury is always the first choice,” yet doctors rush to order tests, he said. “The question you should be asking when you do sophisticated imaging is, ‘Is there something I can fix with an operation?’”

_Malpractice fear. A missed heart attack or a burst appendix could be devastating for a patient — and mean a lawsuit.

“I have great sympathy for the ER physicians because of the responsibility placed in their hands with strangers that come in off the street,” said Louis Wagner, chief physicist at the University of Texas in Houston. “They have to make a decision that could mean life or death for a patient, and the fastest way to find out is CT.”

_Patient pressure. People urge doctors to “do something” to figure out what’s wrong, and “often, doctors feel that the way to demonstrate that they’re doing something is to order tests,” said Dr. Christopher Cassady, a radiologist at Texas Childrens Hospital and the American Academy of Pediatrics‘ expert on this topic.

At his hospital, doctors first do an ultrasound on suspected appendicitis cases instead of rushing into a CT scan. Ultrasounds require no radiation.

_Health care chaos. One doctor may not know that another has ordered the same test. If a patient is referred to a specialist, “it’s often easier for him to order another study than to figure out how to get the one that was done somewhere else,” Baron said.

_Insurance issues. X-rays often are required by insurers to prove health, or for students to study abroad.

_Availability. Rural hospitals may not have an ultrasound technologist on duty in the wee hours, but imaging machines are always there.

_Treatment choice. A quick fix for chest pain — artery-opening angioplasty — requires far more imaging and radiation than bypass surgery does. The same is true of “virtual colonoscopy” instead of the standard version.

Which tests are overused? A scientific group, the International Commission on Radiological Protection, cites routine chest X-rays when people are admitted to a hospital or before surgery; imaging tests on car crash victims who don’t show signs of head or abdominal injuries; and low-back X-rays in older people with degenerative, but stable, spine conditions.

Even when tests are justified, they often include more views than needed and too much radiation. Top offender: chest CT scans looking for clogged arteries and heart problems. Cardiologists are increasingly aware of this risk and are seeking solutions.

At Columbia University, a study on dummies by Dr. Andrew Jeffrey Einstein found two dose-modifying techniques could lower the needed radiation dose by 90 percent without harming image quality.

Another cardiologist and radiation safety expert, Dr. Gilbert Raff, showed the same in real life. A study he led of nearly 5,000 patients at 15 imaging centers in Michigan found that radiation dose could be cut by two-thirds with no loss of quality.

What should patients do?

“You should question everything — what’s the dose, why am I getting it? You should be an informed consumer,” said Dr. Fred Mettler, radiology chief in the New Mexico Veterans Administration health care system. He led a study of health effects after the Chernobyl accident and is a U.S. representative to the United Nations on radiation safety.

He advised challenging “big ticket” tests like CT scans that deliver a lot of radiation to the chest and abdomen — places where cancer is likely to develop. “You shouldn’t get too excited about feet and knee X-rays,” Mettler said.

Questions to ask about radiation scans:

_Is it truly needed? How will it change my care?

_Have you or another doctor done this test on me before?

_Are there alternatives like ultrasound or MRI?

_How many scans will be done? Could one or two be enough?

_Will the dose be adjusted for my gender, age and size? Will lead shields be used to keep radiation away from places it can do harm?

_Do you have a financial stake in the machines that will be used?

_Can I have a copy of the image and information on the dose?

Mettler suggests bringing a blank CD or thumb drive with you.

“You should have all of your stuff digitally on something,” he said. “I keep mine on my laptop.”

A POWERFUL EARTHQUAKE struck at sea off Mindoro on Friday, but there were no immediate reports of casulties or damage, seismologists said.

The Philippine Institute of Volcanology and Seismology (Phivolcs) said the quake had a magnitude of  6.1 and occured at 2:24 p.m. The epicenter was about 116 kilometers southwest of Calapan, Mindoro Oriental. It had a depth of 45 km.

Phivolcs said the tremor was tectonic in origin caused by movement in the Manila Trench.

Intensity 3 was felt in Manila, Makati, Pasay, Tagaytay and Lucban, Quezon while intensity 2 was felt in San Jose Occidental Mindoro and Puerto Galera.

Big Waves
“It was a strong earthquake and it lasted for quite a while,” officer Rose Macabenta told AFP by telephone from provincial police headquarters.

“It rattled the tabletops, but the wall frames stayed in place,” she said.

Seismologist Ismael Narag said the quake generated enough power to unleash big waves, but added that no warning was issued because authorities did not think it was capable of triggering a tsunami.

“It would have to be at least 6.5 magnitude to generate a tsunami,” said Narag, from Phivolcs.

In Legaspi City, Philvolcs warned that small explosions and ash puffs similar to the one first experienced on Tuesday were possible and may affect the stability of the 200,000 cubic meter lava dome, which might result in its eventual collapse.

Aerial Survey
Resident volcanologist Eduardo Laguerta said the Phivolcs was was niw focusing its attention on the lava dome.An aerial survey is scheduled to be conducted once the weather clears up for an observation from above the crater.

“An aerial survey is crucial for rechecking the stability of the lava dome whether it is still intact or ready to roll down, we would only know if we could take a closer look at the crater.”

Laguerta said as much as the Phivolcs wants to conduct an aerial survey on Friday the  crater was obscured by clouds.

“Doing so would just be a waste of time and fuel for the helicopter so we have to patiently wait for the clouds to disappear so we could only reiterate the warning within the danger zones,” he added.

The seismic network detected 13 volcanic earthquakes and recorded 582 tons of sulfur dioxide emissions during the past 24-hour observation period.

Disaster officials have maintained their warning against venturing into the six-kilometer permanent danger zones, particularly at the southeast flanks, for possible rock falls from the upper slopes.

Avoid lahar-prone areas
Active river channels and those areas perennially identified as lahar-prone in the southeast sector should also be avoided, especially during bad weather or when there is heavy and prolonged rainfall, officials added.

Joey Salceda, Albay governor and chair of the Provincial Disaster Coordinating Council, said that “Albay is ready and our preparations have been  in place well ahead and would merely be escalated and enhanced.”

Mayon Volcano, famous for its nearly perfect cone, has a height of over 2,400 meters. It last erupted in 2006. Alcuin Papa, Rey M. Nasol, Inquirer Southern Luzon and AFP