By Geoffrey Booth, M.D., Medical Director, LifeSync Malibu

When you make the courageous decision to quit heroin and turn your life round you might have pretty high expectations. You probably look forward to feeling healthy and whole again, and can’t wait to be a productive member of society.

So when depression clings to you, even after you have completed withdrawal and rehab, it can be disheartening. Worse than that, it can lead to a relapse. Depression is not just a common co-occurring condition among active heroin users, but it is also a prevalent aspect of post-acute withdrawal syndrome, or PAWS.

PAWS refers to the cluster of mild but persistent withdrawal symptoms that sometimes hang on for months in early recovery, and depression is extremely common. It can be frustrating to feel stuck in the gloom of depression when you had such high hopes after gutting out withdrawal. Setting realistic expectations in recovery, as your brain chemistry adjusts and stabilizes, can help you ride out the depressive symptoms and get to the other side.

Depression and Heroin

Heroin is a powerful drug made from morphine, a potent analgesic. When you use heroin, the drug is converted to morphine in the brain, which produces the well known desirable effects. Users experience a deep state of relaxation and rush of euphoria that the brain immediately registers as a pleasurable event. But because heroin is highly addictive, it isn’t long before the drug traps you into a cycle of using just to avoid feeling sick once it wears off.

Because heroin binds to the opioid receptors in the brain, it begins to slowly alter the way the brain functions. With the drug providing the dopamine surge, the brain becomes dependent on it and stops producing natural dopamine.

In addition to the chemical changes in the brain, people addicted to heroin are likely to experience many adverse psychosocial events, which can lead to depression. People often struggle with employment, relationships, legal problems, health problems, and homelessness. All of these factors increase the risk for suicide among heroin users. According to the publication, Addiction, a heroin users is 14 times more likely to die by suicide than their peers.

Causes of Depression After Heroin Withdrawal

There are various reasons for experiencing depression after completing treatment:

• Depression may have been present prior to getting treatment. If there was co-occurring depression present with the heroin addiction, the only way to achieve lasting sobriety is through a dual diagnosis treatment program. This is a specialty that provides simultaneous treatment for both disorders in an integrated plan. If the depression was not addressed during treatment, then there is a higher probability it will linger in recovery.
• Feeling disappointed in recovery. After years of living in an altered state due to substance abuse, sobriety may not seem all that great initially. In the early months of recovery feelings of depression can set in when expectations are not immediately met. Also, the consequences of the addiction may now be fully realized in sobriety, which can cause feelings of sadness, guilt, or shame.
• Post-acute withdrawal symptoms (PAWS). Depression is a PAWS symptom that may stubbornly persist for months following treatment. Because of the significant impact of heroin on the brain it is not surprising that there might be some long-lasting psychological effects. Even after completing detox and treatment, the PAWS can persist.

Regardless of how or when the clinical depression surfaced, treating depression after rehab is critical. Depression in recovery can pose serious risks to not only the recovery itself, but also may cause impairment in functioning, adverse effects in relationships, reduced productivity at work, and increased risk of suicide.

Post-Acute Withdrawal Syndrome (PAWS)

Depending on how long the heroin addiction was present, it can take time for the brain to begin to normalize following treatment. During this period of transition, it is very common to feel a lack of joy or happiness. Lingering depression is one of the most common effects of PAWS, a cluster of symptoms that may take months to resolve.

Depression symptoms include:

• Feelings of sadness, hopelessness, and despair
• Fatigue
• Changes in eating habits
• Slowed or agitated movements
• Sleep disruptions
• Loss of interest in things you used to enjoy
• Difficulty making decisions or concentrating
• Irrational feelings of shame or guilt
• Thoughts of suicide

Persistent depression poses a threat to recovery because the symptoms can become so unbearable that the individual may seek relief by returning to heroin use. This is why the longer you can remain in a treatment program the better. An extended treatment program, such as six months, allows the brain and body to stabilize within a supportive environment, reducing the risk for relapse.

Treatment for Depression After Quitting Heroin

The worst thing someone in recovery can do is to ignore the symptoms of depression. Treating depression in recovery involves ongoing psychotherapy, holistic methods, and possibly medication.

Therapy: Emotional and psychological support is key in heroin recovery. Therapy, both individual and group sessions, provide a safe environment where you can work through the feelings associated with depression.

Holistic: Depression symptoms can be relieved to some extent through natural means. These include getting regular exercise, sticking to a healthy diet, and getting adequate sleep. In addition, learning how to relax, through yoga, mindfulness, or massage, can also improve mood.

Medication: Medication for depression may be necessary. Antidepressants take about 4-6 weeks before the effects begin to be seen, but these drugs can possibly relieve the symptoms.

In the early months of heroin recovery it is important to heal the body and the mind. As difficult as it is to suffer through a bout of depression, be patient and always remember, this too shall pass.

About the Author

Geoffrey A. Booth, M.D. is the Medical Director of LifeSync Malibu, an exclusive rehabilitation program located in the heart of Malibu. Dr. Booth has treated thousands of addicts over the years and now has dedicated most of his clinical time to providing medical care and detoxification to clients who suffer from substance abuse. He is committed to helping them establish the foundations for long-term sobriety. While not working, Dr. Booth has a rich personal life filled with activities surrounded by friends and family.

By Arastou Aminzadeh, M.D., Founder, BNI Treatment Centers

One of the most distressing effects of the pandemic has been its affect on teen mental health. Young people spent a significant amount of time cooped up at home, forced to give up most of their social activities due to lockdowns. This resulted in increased teen loneliness.

At a time in their development that social interactions play a key role in helping adolescents acquire healthy social skills, teens were left few options this last year. Most would default to the Internet to find peers to chat with on social media platforms and forums, or to kill time with online activities. In fact, the majority of a teenager’s social life has occurred online for a year now.

Teen loneliness was already a common problem prior to the COVID-19 pandemic. Research from Italy and Iran had previously studied the connection between loneliness among young people and subsequent internet addiction. Both studies demonstrated a positive correlation between these two factors.

Now, a new study out of Finland further cements this relationship between teen loneliness and compulsive internet use. The new variable in this recent study is the pandemic and how it has exacerbated teen loneliness, and therefore, internet addiction. The fallout from the excessive time online is an increased sense of loneliness because it replaced real life social interactions.

About Teen Loneliness During COVID-19

Ask any teen if they sometimes experience loneliness and they are likely to nod their head in the affirmative. All young people sometimes feel left out or lonely. However, teens who suffered from more pronounced feelings of loneliness may have been struggling with depression or another mood disorder, social anxiety, or a personality disorder. Some loneliness is normal, but intense chronic loneliness is typically associated with a mental health challenge.

During the pandemic, however, loneliness became its own epidemic that affected everyone of all ages. Teens, though, were hardest hit by the effects of the social distancing policies because of the significant role socializing plays in their daily life. Where adults had plenty of other distractions, teens were left with a gaping void in their life.

Study Shows Increase in Internet Addiction Among Lonely Teens

According to the Finnish study that was published in February 2021 in the Child Development journal, compulsive internet use has increased at a statistically significant rate. Dysfunctional internet behavior would include online gaming addiction, copious amounts of time on social media sites, and consumption of online pornography.

Further, the study found a direct connection between compulsive online behaviors and depression. This went both ways. A teen that was depressed may have spent more time online, as a distraction or salve, while teens that spent copious amounts of time online were more prone to develop depression. In either scenario, depression was the link.

In addition to the mood disorder, adolescents that engaged in excessive online activity had poorer academic performance. This is attributed to the amount of time that is consumed by online activities, which cuts into the time available to study.

The study determined that it wasn’t only due to a lack of social time with their friends this last year that has resulted in compulsive online behavior. The authors found that teens whose parents were not around, or who were inattentive, were also likely to turn to the Internet to fill their sense of loneliness.

COVID-19 and Teen Mental Health

There is no denying the serious impact the pandemic and lockdowns have had on our young people. Major milestones have been skipped over, social events radically altered or cancelled, schools closed, and, of course, the loss of live, in-person social interaction.

Teens need structure, predictable daily routines, and a sense of safety. During the past year these basic needs are not being met. Many kids have lost loved ones to the virus, or seen their parents become unemployed. All of this is very difficult for a teen to process and manage, as their limbic system is not fully developed at this age. Brain functions like impulse control, emotion regulation, and decision-making will be under construction until age 25.

As a mental health practitioner, I can confirm that our teens are struggling at higher rates than usual. Anxiety and depression are definitely on the rise in this cohort. When the dust settles we will have to face the statistics head on and provide additional services for struggling adolescents.

Other Causes of Teen Loneliness

At first glance, it may seem that teen loneliness is simply caused by a lack of friends. Maybe the teen struggles socially and has trouble establishing or maintaining sound friendships. But in reality, there are many other factors that can contribute to feelings of loneliness. Consider these 5 things that can cause loneliness:

1. Moving. Possibly the family has recently relocated. Even if the new home is not that far from their former home, the unfamiliar surroundings can triggers feelings of loneliness. This even more so if the move is quite a distance away from their old friends and school.
2. Social anxiety disorder. Some teens have a heightened or irrational fear of being judged by their peers. Because of the fear of being publicly criticized or mocked, the teen chooses to isolate, leading to loneliness.
3. Feeling excluded. Teens are very sensitive. Most teens have the “fear of missing out,” or FOMO, which means they crave the feeling of belonging and being included in social gatherings. When they are passed over repeatedly it can lead to feelings of loneliness and even depression.
4. Social media. While the word “social” in social media may sound like it is all about connecting with others, in fact social media can enhance feelings of loneliness in teens. This is due to the unnatural, shallow, and sometimes toxic “relationships” made on social media platforms.
5. Being bullied. Cyber-bullying is extremely damaging to a teen’s self-esteem. When they happen to be the target of a bully who uses social media to embarrass or shame them, they will feel marginalized and isolated.

At this time in history it is essential for parents to be fully present for their children, and tuned into their mood states. If the teen is exhibiting signs of depression due to loneliness, and seem to self-medicate by engaging in compulsive internet use, it would be a good time to have the teen evaluated. Parents truly hold the key.

About the Author

Dr. Arastou Aminzadeh is a triple board certified physician in psychiatry, child and adolescent psychiatry, and addiction medicine, and is the co-founder of BNI Treatment Centers in Agoura Hills, California.  Dr. Aminzadeh is a fellow of the American Society of Addiction Medicine and also a fellow of the American Psychiatric Association.  A well respected leader in the field, he also holds an adjunct faculty position at the University of Southern California, Keck School of Medicine, where he completed his residency and fellowship.

You don’t have to put up with the limitations set by a stuttering disorder; you can do more to take charge of your life. It is your choice, though a few things that I have mentioned above might seem to put you off. This is because many stutterers have been conditioned by society to think that they are not normal, and they are therefore forced to put up with the limitations and restrictions they face. Others go through their lives without knowing that there are better options available. Those who suffer from the coronavirus, the rarest of stuttering-related syndromes, for example, have found remarkable success with therapies like Neuro-Linguistic Programming (NLP). They use modern techniques on their condition to retrain their thought patterns, leading them to be able to speak normally and fluently.

I would however caution those looking for easy fixes in the above paragraph. If you suffer from coronavirus or from some other similar condition, it is still possible to make a huge change in your life. The first step is learning to accept your condition and addressing the issues that cause it. For example, did you know that some foods can help stutterers feel more comfortable when they speak? Many stutterers love to eat certain types of food, like fish and eggs, so changing what you eat can really make a difference to how fluent you are when speaking.

Some other foods stutterers love to avoid are caffeine, nicotine, chocolate, tomato, onions, garlic, milk, and spicy food. All these are known to cause fluency problems when spoken. If you eat a healthy diet, avoid junk food and processed foods, and get plenty of exercises, you will notice an improvement in how fluently you can communicate.

Perhaps you are wondering why many stutterers do not learn to be fluent yet. The reason is that they set too much pressure on themselves to become fluent. I am sure you have noticed that many people try to force themselves to learn to speak faster than they can. Unfortunately, their anxiety gets the best of them and they end up slowing down instead of learning more.

Some stutterers might even resort to physical punishment, such as screaming or hitting, in an effort to learn to speak fluently faster. While this might be acceptable for children, who are being constantly punished to encourage them to do something right, it should not be used by stutterers, who are not being deprived of anything by not being able to communicate freely. This type of behavior can cause psychological difficulties, which will only make the problem worse. It can even result in psychological disorders like anxiety and depression.

If you are a stutterer, you should consider trying to be comfortable and at ease with others. By learning to converse fluently with the opposite gender, you will be able to open up to them easier. If you feel that you are not being understood, you can quickly revert back to your old habits and make things even worse.

If you have a friend or a loved one who is a fluent speaker, you might want to ask them to practice your language with you. Many co-workers are often willing to practice on you since they value your job. By simply converse with them, you will get better. Eventually, you might be asked out on a date with them.

You can learn more about the COVID-19 through online resources. There are many online sites dedicated to helping stutterers learn to speak the language fluently. You can also find forums and groups where you can meet other fluent speakers to share tips and techniques about the language. Learn more about What you need to know about the COVID-19 Mutation. You can check it all out here in this infographic created and designed by Harley Medic International a partnered with government-approved fit to fly covid test lab and clinic.

Vitamin C is one of the most talked-about vitamins and nutrients these days. The situation created by the COVID-19 pandemic and general health problems that have arisen because of the modern lifestyles has forced people to rethink their way of living.

When we search for natural foods and ways to boost our immunity, the first thing that we will find is nothing other than vitamin C.

The human body cannot produce vitamin C on its own, and we have to consume it through any of the hundreds of sources. Although, there are hundreds of benefits of Vitamin C, and it can do wonders for your body, particularly immunity.

This blog is your ultimate guide on Vitamin C, and we will be covering all the information and the best sources of Vitamin C. By the time you end up reading the article, you will be equipped with the knowledge to change your diet and help boost the immunity of your body.

Vital Information on Vitamin C

The first thing to know is the daily recommended quantity of Vitamin C that you should consume. There are many studies which talk about the different amounts, but all fall in a specific range.

As per most of the studies, we can conclude that 500 milligrams of Vitamin C daily is the right amount. If you try to consume that amount through natural sources, that would mean consuming 7-9 servings of fruits in a day. Eating fruits that frequently is almost an impossible task in the modern busy and fast lifestyles.

A lot of doctors advise taking Vitamin C supplements in this case to fulfil the requirements. We will also talk about the right supplements which can help you meet your Vitamin C requirements but let’s first understand the benefits and some fantastic natural sources of Vitamin C.

What is the use of vitamin C?

There are hundreds of health benefits of Vitamin C, which help your body in various ways. Let’s understand some of the major ones –

1. Vitamin C is one of the most potent antioxidants which works in building the immunity of your body. It is known for helping prevent some chronic diseases and prevent most of the health issues that one might face.

2. Vitamin C directly helps in managing high blood pressure and regulates the pressure levels

3. Heart diseases are among the primary cause of death all over the world, and Vitamin C will help you to prevent most of the heart-related issues

4. Vitamin C may help you reduce uric acid levels. It is also known for helping prevent gout, which is a form of arthritis which is extremely common and painful.

The primary reason for the development of gouts in humans is because of the increase in uric acid levels. Many other diseases are also linked to increased uric acid levels in the body.

Vitamin C regulates uric acid and prevents most of these diseases from happening.

5. Regular consumption of Vitamin C will help improve the iron secretion from food. This property helps prevent iron deficiency in the body

6. Vitamin C protects and promotes memory while helping you prevent memory loss or memory related to other illnesses. Conditions like impaired thinking and the ability to remember things reduce with age and the right quantity of Vitamin C in the blood will make sure to help you prevent these problems.

7. There are many things which are not backed by extensive studies and researches but have been witnessed for centuries. One of the most significant claims among this is that Vitamin C helps prevent the common cold.

8. Another set of studies claim that Vitamin C helps reduce the risk of cancer.

9. Vitamin C also helps prevent eye problems and some eye-related diseases.

Foods containing vitamin C

As you can see that there are many health benefits, and Vitamin C can help you prevent most of the health-related problems. In this section, we are going to discuss the significant sources of Vitamin C.

1. Oranges

Oranges are one of the best sources of Vitamin C and also the most famous ones.

One medium-sized orange contains 70 milligrams of Vitamin C, which in many studies is considered more than half of the daily value required by humans.

It is imperative to note that for best practises, you must try to consume orange as a fruit and not orange juice for maximum benefits.

2. Mango

Mangoes are another incredible source of Vitamin C and beta- carotene, which is considered best for your body’s immune system.

Green mangoes contain more Vitamin C; thus, you must prefer the green ones over all other variants.

3. Lemon

Lemons other than being a good source of Vitamin C are also considered an excellent antioxidant for the body.

One raw lemon has about 83 milligrams of Vitamin C and also helps to prevent diseases like scurvy.

4. Kakadu plums

If you are looking for a superfood with Vitamin C, it is Kakadu plums. This is not a common fruit, and its origins date back to Australia.

The best and the most exciting part of it is that it contains 100 times more Vitamin C than an orange which is considered one of the best sources.

Consuming just one Kakadu plum in a day can fulfil all your Vitamin C requirements.

5. Chilli peppers

Chillies are known for many health benefits, including helping in burning fat and reduction in pain and inflammation.

One green chilli contains 109 milligrams of Vitamin C, which is a considerable portion for your daily needs.

6. Kiwis

If you are looking for a tasty fruit while getting your source of Vitamin C, Kiwis are the answer.

One medium-sized Kiwi contains 71 milligrams of Vitamin C which will also help in reducing cholesterol levels in the body.

A lot of studies have been done on the regular consumption of Kiwi, which points out to the hundreds of health benefits.

It would be best if you also consider adding Kiwis to your daily diet.

7. Broccoli

Yes! Broccoli also contains Vitamin C among a combination of the best vitamins and minerals for the human body.

Many doctors and dieticians must have recommended you broccoli because of its health benefits.

One-half cup of cooked broccoli will provide you 51 milligrams of Vitamin C.

8. Lychees

Lychees are another excellent source of Vitamin C as well as Omega-3 and Omega-6 fatty acids.

Regular consumption of lychees is beneficial for different parts of your body, and the best part is that they are tasty as well.

9. Papayas

Papayas are known for numerous health benefits, and one of these is that they are a good source of Vitamin C!

Studies have also been conducted on Alzheimer’s patients, and regular consumption of Papaya helped in reducing inflammation.

Conclusion

The immune system of your body is the most crucial system in the human body. A robust immune system will prevent most of the diseases to remain away from your body. At the same time, a weak immune system will put you at risk of catching small illnesses that might snowball into big problems.

Taking care and boosting your immunity should be your priority. Consuming one of the fruits in the list will not help you to gain in all the benefits, but you have to make a divided approach and consume a combination of many of those!

If you are looking for an Immunity booster supplement that helps you consume all the essential Ayurvedic herbs known for boosting immunity, check out Emun Care.

EmunCare is an ayurvedic immunity booster supplement that is created after years of study on the most potent herbs which have been used for centuries. Check the website to know all the details!

The COVID-19 pandemic has brought with it unprecedented impact to economies and healthcare systems worldwide.

As a result, it has disrupted healthcare delivery and treatment for other life-threatening diseases, including cancer. This has brought anxiety among cancer patients, survivors, and caregivers, and, at the beginning of the pandemic, even healthcare professionals.

The good news is, hospitals, healthcare professionals, and patient advocates continue to work together to define a new normal for cancer care, to help patients safely navigate their cancer journey, amidst the time of the pandemic. 

Patients can better equip themselves by knowing more about the virus, its impact on cancer patients, and how best to avoid contracting it.

 What is COVID-19?

The 2019 Coronavirus disease, or COVID-19, is an illness caused by a novel strain of coronavirus (SARS-CoV-2). It was first reported in Wuhan, China, in December 2019. The virus can spread from person to person through droplets of saliva or discharge from the nose when an infected person coughs, sneezes, or talks.2 A person can also contract the virus by touching a surface or object with the virus in it, then touching the face, specifically the mouth, nose, or eyes.3 

Most people infected with COVID-19 will experience a mild to moderate respiratory illness. However, according to the World Health Organization (WHO), the people who are most likely to develop a severe illness if they contract the virus are older people and those with health conditions such as cardiovascular diseases, diabetes, chronic respiratory disease, or conditions affecting the immune system.

The most common symptoms of COVID-19 are fever, dry cough, and tiredness. The less common symptoms are muscle aches and pains, sore throat, diarrhea, headache, loss of taste or smell, and rashes on the skin or discoloration of the fingers or toes.

On the other hand, the most severe symptoms that a person may feel are chest pains, loss of speech, loss of mobility, and shortness of breath.5

What to Do to Avoid Contracting It?

Currently, tests for a viable COVID-19 vaccine are underway. In the meantime, the best way to lessen the possibilities of contracting it is to avoid exposure to the virus by adhering to set guidelines, such as proper handwashing and strict social distancing.  

The World Health Organization (WHO) has set these guidelines on how to reduce the risk of getting infected by the virus: first, stay at home as much as possible and avoid close contact with other people. However, if it is necessary to go out of the house to do errands, wear a face mask and distance yourself from other people for at least 1 meter – these should help you stay protected in a public setting.

Further, wash your hands frequently and properly, or in the absence of soap and water, use 70% alcohol or hand sanitizer. For people with underlying medical conditions, more stringent measures are needed to keep them safe from the virus.

 Impact of COVID-19 on Cancer Patients

As mandated by the Philippine Government, people aged 60 and above, as well as those who are immunocompromised, are encouraged to stay home.6 For some who are in this situation and need medical attention, their treatments may be hampered. Cancer patients in particular stand to face complications in the continuance of their cancer care, as their weakened immune systems may be more susceptible to viral infections.

Here are some tips on how to navigate the cancer patient’s journey, amid COVID-19. 

1. Consult your oncologist for a proactive approach to cancer management.

Have an open dialogue with your oncologist about the next steps after a cancer diagnosis and the goals of your upcoming or ongoing cancer treatment. Schedule a consultation via video conferencing or by phone to discuss the different cancer treatments available, like immunotherapy, chemotherapy, radiation therapy, or targeted drug therapy. Ask your doctor about the benefits and/or side effects of the different procedures.

The doctor can help point you to the right treatment option, let you know which treatments are available at which hospital, and guide you through the “new normal” procedures and precautions. 

 2. Observe a healthy lifestyle to improve your immune system. 

Like any other time, protecting yourself from any sickness involves strengthening your immune system. You can help boost your immune system through a healthy lifestyle: having optimum sleep and keeping yourself adequately hydrated; eating a balanced diet rich in protein, fruits, and vegetables, and keeping active, as your condition allows.  Make sure to ask your doctor about the appropriate activity and diet for you.

 3. Practice social distancing and incorporate preventive habits. 

As indicated by WHO guidelines, social distancing could lower the chances of getting infected by severe respiratory diseases like COVID-19.5 It is best to avoid crowded places and avoid interacting with relatives and friends who exhibit COVID-19 symptoms or may have come in contact with people unknown to you. Take advantage of online grocery and medicine delivery services, and disinfect deliveries as soon as they arrive.

For cancer patients who make hospital visits for treatments or check-ups, make sure you are wearing safety garments such as face masks and face shields. 

 4. Ask for assistance.

Breast cancer and lung cancer are two of the most prevalent cancer indications in the country every year, based on a Global Cancer Index Report7. As such, those cancer patients, or even experiencing breast or lung cancer symptoms, may feel anxious and worried. Worse, a cancer diagnosis and the thought of undergoing a cancer treatment regimen may have physical and financial burdens on patients and caregivers. With the COVID-19 pandemic affecting world economies, financial problems may be worsened.

 However, for the continuance of cancer care, there are many organizations providing health assistance in the Philippines. Different programs, such as Early Lung Cancer Support Group, also exist to help in disseminating awareness for the disease. Advocacies, such as The Cancer Game Plan PH and Hope From Within, have been established to help arm patients with the necessary resources to effectively fight cancer.

 Prioritizing Cancer Care During a Pandemic

You may have higher chances of contracting COVID-19 in a hospital, so you must seek the advice of your oncologist regarding your treatment. Oncologists can intervene in classifying the cancer patients who should be seen in the clinic or a cancer center, based on their underlying cancer status and their risk of getting infected with the virus. Some cancer treatments can be safely delayed, but others cannot. An oncologist needs to determine if a patient has an urgent or non-urgent condition based on their patient assessment.9 Cancer patients with urgent conditions are those that need to continue their treatment, as any delay could be fatal. Cancer patients with critical conditions are those diagnosed with early or locally-advanced cancer who have not completed their treatment and are qualified for surgery or other therapy treatments. The advice of the attending oncologist for a patient to come to the hospital for their treatment should always be balanced with the risk of contracting the virus. 

 On the other hand, patients with stable conditions, are asymptomatic, and have already completed their cancer treatment are classified to have non-urgent conditions. Clinic visits may be delayed as they may warrant a less aggressive approach to cancer management.

The pandemic has greatly affected the health sector globally. Although it continues to pose serious respiratory illnesses to most people, particularly those with weakened immune systems like cancer patients, doctors and patients must work together to ensure the continuance and safety of cancer care, as this cannot be compromised. Consulting your oncologist can help you better understand the effects of COVID-19 on cancer care, and support you with a proactive approach to cancer management.

 References

1 Inquirer Lifestyle. (2020, June 12). Retrieved from https://lifestyle.inquirer.net/364147/what-cancer-patients-need-to-know-in-the-time-of-coronavirus/

2 Merry Jennifer Markham, M. F. (2020, August 10). Coronavirus and COVID-19: What People With Cancer Need to Know. Retrieved from Cancer.Net: https://www.cancer.net/blog/2020-08/coronavirus-and-covid-19-what-people-with-cancer-need-know

3 Center for Disease Control and Prevention. (2020, June 1). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-factsheet.pdf

4 World Health Organization. (2020). Retrieved from https://www.who.int/health-topics/coronavirus#tab=tab_3

5 Coronavirus disease 2019 (COVID-19) Situation Report – 51. (2020, March 11). Retrieved from World Health Organization: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10

 6 Official Gazette. (2020, March). Retrieved from https://www.officialgazette.gov.ph/downloads/2020/04apr/2020030-EO-112-RRD.pdf

7 World Health Rankings. (2018). Retrieved from World Life Expectancy: https://www.worldlifeexpectancy.com/philippines-lung-cancers

8 Hope From Within. (2019, February 14). Retrieved from Hope From Within: https://hopefromwithin.org/new-cancer-game-plan-for-the-philippines-launched/

9 Abarquez, Honey Sarita; Sacdalan, Danielle Benedict; et al. (2020). Treatment of cancer patients during the COVID-19 pandemic in the Philippines. Retrieved from eCancer Medical Science: https://ecancer.org/en/journal/article/1040-treatment-of-cancer-patients-during-the-covid-19-pandemic-in-the-philippines

As last week’s huge blast tore through Beirut, it smashed the glass doors near where Abed Itani, 3 years boy was playing with his Lego blocks. He was stabbed in his head and cut off his small arms and feet, and rushed to the emergency room where he sat with other people who were bleeding.

Abed hasn’t been the same in the days since then. He is dealing with depression-like thousands of people in Lebanon.

“When I got to the hospital, I saw him sitting in the emergency room, shivering in the sight of the people who were seriously wounded, the blood falling all over the floor,” said his mother, Hiba Achi, who was at work when the blast hit his grandmother on 4 August and left him in his care.

“Now he hates purple. He refuses to wear his red socks, “said Achi, adding that she keeps on cleaning them.

More than 170 people were killed, about 6000 others were injured, and extensive damage was caused by the huge explosion of almost 3000 tons of ammonium nitrate in Beirut Harbour. The United Nations. UNICEF child agency said three children had been killed and at least 31 had been critically injured to seek hospital care.

According to Save the Children, up to 100,000 children were displaced from their homes and many traumatized.

“Some noise is now making him run. He doesn’t eat much anymore, “says Achi. “He was a very sociable, happy child. He’s not talking to anybody now.

Joy Abi Habib, Save The Children’s mental health specialist, says that traumatized youth will respond differently.

“The physical symptoms parents tend to overlook, headaches, nausea, bedwetting, digestive problems,” she said. “We feel really clingy and on the bottom.”

The daughters of Zeinab Ghazale, Yasmine, 8, and Talia, 11, refused to sleep alone in their bedrooms after the explosion smashed the doors of their apartment and sent glass to fly their house.

“We survived miraculously,” Ghazale said, who had to bring her daughters out of the house a few days before the windows were repaired. “But my daughter Yasmin continues to wonder, ‘Why have I no normal childhood? Why do I go through all of this when I’m just eight? After the blast, the psychologist Maha Ghazale, who is no partnership, treated a lot of children.

She said that many are in doubt “and still ask if this will happen again.” “Most kids refuse to go home to a glass door or window,” said Ghazale.

Ricardo Molaschi and his Lebanese mother visited his grandparents’ apartment in Beirut.

When the explosion struck, the 6-year-old was stitched by the glass. Kazem Shamseddine, his grandfather, had been murdered. The young person has repeatedly screamed against whoever caused the blast.

“I want to throw it into a volcano and let it explode,” he said.

Ghazale said that it is important for children to handle a trauma — to be angry but also to enable them to share their story orally or by means of art and playing.

“My son, Fares, continues to play a fire-fighting game, and he wants to flee,” Rania Achkar, mother of two, said.

Her daughter, Raya, who is 4 years old, has turned the Lebanese national hymn into a blasting album. “Someone exploded the earth,” she sings, “everywhere there is an explosion, everyone talks about us on TV.”

The trauma may arise again if children are subjected to adult news and conversations about it, says Ghazali, who encourages them to separate them and look for support.

“Children are resilient, but unprocessed trauma can lead to increased anxiety, behavioural problems and later to negative coping,” she says.

It will help restore a sense of security, normality and routine, says Ghazale.

Hiba Achi says she decided to leave Lebanon with her son and join her Dubai-based husband.

It’s a sentiment that others have shared. “This place is not safe, it’s never safe, never it’s never safe,” she says, “I won’t live, that’s it.”

Her guilt is felt by many parents, especially those who lived through the 1975-1990 civil war in Lebanon and feel that their children have failed.

“Our generation is traumatized forever,” says Achkar, two ‘s mother, referring to those who have grown up after the war in Lebanon.

“So why do our children go through this too?

Sildenafil is a drug used primarily for treating erectile dysfunction victims. It is also used in the treatment of PAH or Pulmonary Arterial Hypertension for clearing clogged arteries to the lung and heart and eventually stabilizing the blood pressure. Pfizer, a manufacturing company, formulated Sildenafil in the year 1989.

Pfizer synthesized Sildenafil as a treatment for hypertension and angina pectoris, also known as heart-related chest pain. But, it caused erections in male patients instead of treating the intended conditions, as a result of which Pfizer discovered that Sildenafil could be useful in treating ED or erectile dysfunction. 

It became the first FDA approved oral treatment for erectile dysfunction on 27th March 1998. Pfizer markets Sildenafil as the well known ‘blue pill’ also known as ‘Viagra’. In the case of PAH, Sildenafil is marketed under the brand name ‘Revatio.’

Phosphodiesterase type 5 or PDE5 is an enzyme present in the human body and is responsible for the degradation of the smooth muscle fibers that line the blood vessels. The atrophy of these muscle fibers happens to be the underlying cause of Pulmonary Arterial Hypertension and erectile dysfunction. Sildenafil inhibits the growth of this enzyme and in turn, eases the blood flow into the arteries. 

The drug Revatio uses the same principle to target the arteries in the heart and the lungs, hence reducing the high blood pressure which is generally seen in patients diagnosed with PAH, and Viagra uses this theory to stimulate blood flow to the penis. Although for Viagra to be effective, the patient needs to be in a state of sexual arousal. 

Although both Revatio and Viagra contain Sildenafil as their core ingredient, their usage depends largely upon the medical conditions being addressed. Revatio is administered in 20 mg doses at intervals of 4 to 6 hours whereas Viagra is taken in doses of 50 mg or 100 mg, usually an hour before sexual intercourse. Modes of administering the two drugs also vary. 

Revatio can be administered orally or via an intravenous syringe. On the other hand, Viagra is taken orally in the form of pills. The acting time and the half-life for which Sildenafil remains inside the human body are generally estimated to be around 30 minutes and 5 to 6 hours respectively. These durations are just an average and the effects of Sildenafil vastly vary from person to person. It also varies due to several other factors such as the dosage, age, diet, medications, etc. Read further to know about each of the factors.

• Dosage: Dosage of Sildenafil is an important factor when considering how long the effects of the drug last. For example, Revatio is administered in small doses of not more than 20 mg which is metabolized completely by the human body within 4 hours. On the other hand, a 50 mg dose of Viagra is absorbed by the digestive system partially within 4 hours, but its effects may last for up to 6 or even 8 hours. An even heavier dose will require more time to be metabolized and therefore have longer-lasting effects.
• Age: Age plays a vital role in the absorption of any kind of medication into the bloodstream. Younger patients and adults undergoing Sildenafil treatment are more likely to feel the effects of the drug faster than their elder counterparts, due to their more active metabolism. As a result, Sildenafil lasts longer in older patients, especially the ones aged 65 or above, due to their slowed metabolism.
• Diet: A diet consisting of high-fat foods will slow down the absorption of Sildenafil as the body is busy dealing with digesting fatty foods. But, it will also result in the effects lasting for a longer period as the onset is delayed. Consumption of alcohol reduces the blood pressure, as a result of which Sildenafil may become less effective for the patient to comfortably generate an erection.
• Medications: Any existing medications taken by the patient can also impact the effectiveness and absorption of Sildenafil in the human body. For example, antibiotics like ciprofloxacin interact with Sildenafil and affect how long it lasts.
• Psychological State: Psychological state is more important in the specific case of Viagra. Feelings of performance anxiety, discomfort, nervousness, stress, etc. may affect the effectiveness of Viagra. Hence, one should be relaxed and comfortable when taking Viagra so as not to negatively impact the intended functionality of the medication.

How Chronic Fatigue Syndrome Affects Your Life:

Higher left belly ache below the ribs will be associated to plenty of well being points starting from delicate to life-threatening. The higher left aspect of your physique accommodates your coronary heart, left lung, left kidney, abdomen, colon, and spleen. Delicate or sharp left higher quadrant ache below the ribs may very well be so simple as trapped fuel or different digestive issues like heartburn. Or, extra critical causes of higher left chest ache may very well be cardiac associated and will require immediate medical consideration.

7 Effective Home Remedies to Treat Heel Pain: