At that special time when in Australia and New Zealand we remember the men and women of our military forces and reflect on their service and sacrifice, much of the rest of the world has its attention on a preventable and curable disease that every year causes more deaths than occur in most theatres of war.

The 25^th of April is also World Malaria Day.

Most cities of the Western world are now malaria free. However, that wasn’t always the case. Malaria is one of the oldest diseases in human history. There is some evidence that it plagued populations pretty much throughout the world as far back as 6000 BCE. As recently as several centuries ago malaria spread from the Arctic town of Archangel in Russia to Argentina and what is now Australia in the southern hemisphere.

During the Middle Ages malaria was widespread throughout Europe. Henry VIII suffered malaria as a young man.  Lord Nelson during the Battle of Trafalgar had to contend with the fever of malaria as well as his regular bouts of sea sickness. Another sailor of renown, J. F. Kennedy, contracted malaria, apparently while in the Solomon Islands in the 1940s

According to the World Health Organization (WHO) Roll Back Malaria website there are now 109 so-called malarious countries in four regions throughout the world – chiefly the tropical and sub-tropical areas of Africa, Asia the Middle East and Latin America.

Malaria is a life-threatening disease caused by parasites that are transmitted to humans through the bites of infected mosquitoes. Whilst it’s difficult to determine the exact number of annual worldwide deaths from malaria (many of the worst affected countries are too poor to have reliable health statistics), a reasonable estimate is around 1 million – mostly in Africa, many of them children.

WHO states that approximately half of the world’s population is at risk of malaria, particularly those living in lower-income countries; but travellers from malaria-free areas to disease “hot spots” are especially vulnerable to the disease.

The English word malaria comes from the Italian expression meaning bad air and the French word for malaria is derived from the Latin for lagoon. So there was early recognition that the disease emanated from swamps, marshes and stagnant water. But it wasn’t until the late 19^th century that the role of mosquitoes was identified.

Ancient remedies included the wearing of a large fish tooth to ward off the evil spirits. Later treatments fortunately proved more successful. By far the most significant was the bark of the Peruvian cinchona tree, which was supposed to have been introduced into Europe via Rome by Jesuit priests in the mid 17^th century. Despite some quite encouraging results this bark from the “fever tree” was not universally accepted for some time. It did not cure all fevers (only those of malaria), and adulterated or alternative barks were often promoted by unscrupulous dealers.

Quinine, the active ingredient from cinchona is still used as a treatment today, however, more effective, especially against drug-resistant malaria, are the combination products containing artemisinin, originally extracted from the ancient herb “sweet wormwood”.

Except for the occasional case, Australia is malaria free; but for how long? Climate change, population growth and migrating mosquitoes could alter that situation. Scientists in Victoria, Queensland and Papua New Guinea are currently collaborating on the development of malaria vaccine. Meanwhile prevention is the best course of action.

If you’re travelling overseas, check whether anti-malarials are recommended. Be sure to apply insect repellent, cover up after sun-down and use bed-nets at night. No mosquito bite – no malaria.

You can get more information about malaria and other travel health issues from pharmacies providing the Pharmaceutical Society’s Self Care health information. Log onto the website, www.psa.org.au and click on Self Care then Find a Self Care Pharmacy for the nearest location.

World War I; it was known as the Great War; the war to end all wars. Of the ten million soldiers who died in just four years, 60,000 were Australians – out of a total population then of less than five million. Denis Winter subtitles his book, 25 April 1925, “the inevitable tragedy”. More recently this day has become arguably Australia’s most significant national occasion.

ANZAC Day now goes beyond commemorating the landing on the Gallipoli peninsula in Turkey in 1915. It is the day we remember all Australians who served and died in all wars, conflicts and peace keeping operations.

ANZAC Day brings with it a mix of emotions – a sense of achievement, a sense of pride, but also a sense of sadness. Nevertheless, for everyone it’s a time for reflection – a time to reflect on what is and what might have been.

By the mid 1930s all the rituals we now associate with ANZAC Day were well established – dawn vigils, marches, memorial services, reunions and even two-up games. Another of these traditions is the bugle call of the Last Post. Originally part of a more elaborate routine that began in the 17^th century known in the British Army as “tattoo”, the Last Post signals the day’s end.

The ceremonial presence of the lone piper is also likely to have become a feature of Australian memorial services from the early 20^th century. The traditional Scottish song of mourning and remembrance, Flower of the Forest, is the tune usually played on these occasions.

Flowers and plants in their own right have come to play a part in this process of reflection and remembrance. It’s now commonplace to wear a sprig of rosemary on ANZAC Day. Centuries ago this aromatic herb was believed to have properties to improve memory; and possibly because of these supposed properties rosemary became an emblem of both fidelity and remembrance in ancient literature and folklore.

The Flanders Poppy is another flower increasingly being used as part of ANZAC Day observances. During the First World War, red poppies were seen to be among the first living plants that sprouted from the devastation of the battlefields of northern France and Belgium.

The narcotic pain relievers were developed from another kind of poppy – the opium poppy – and remain one of the most valuable groups of medicines available. It’s a grim irony that the Taliban, fighting our forces in Afghanistan, are being supported by funds derived from the heroin trade – heroin manufactured from those same poppy plants.

Unfortunately the pain experienced by our troops in war zones is often such that it can’t be managed by pain relievers alone. Post traumatic stress can be severe and long lasting.

Official recognition was given to the condition known as post-traumatic stress disorder (PTSD) in 1980 following the Vietnam War. While the majority of causes of PTSD are war related – war veterans, peace keeping forces and refugees are all at high risk – people who are victims of national disasters may also suffer PTSD.

According to Vietnam veteran and NSW RSL state vice president, Dr Roderick Bain, Afghanistan and Iraq ex-servicemen may also suffer “mild traumatic brain injury”; that is concussion caused by home-made devices exploding within 100 metres. Ongoing headaches, memory loss and loss of organisational skills can all occur despite no obvious physical damage.

With the assistance of the Australian Government and the Department of Veterans Affairs, the Pharmaceutical Society has produced a fact card on Post Traumatic Stress Disorder. It’s one of a series of Cards that includes Anxiety, Depression andSleeping Problems available at your nearest Self Care pharmacy. Phone the Pharmaceutical Society on 1300 369 772 for more information or check the Society’s website: www.psa.org.au and click on “Self Care” then “Find a Self Care Pharmacy”, for the location of pharmacies providing the Society’s Self Care health information.

Some studies have shown that people with certain types of recurrent headaches, not responsive to conventional treatments, may get some relief from a form of electrical stimulation.

Fortunately, for most of us, headaches and general aches and pains are just an occasional inconvenience where the use of simple pain relievers is all that’s necessary to obtain relief. Sometimes no pain reliever is necessary. Especially if the cause of the pain is known, a lifestyle or behaviour change can alleviate the pain or prevent it happening again.

When a pain reliever is required, even with non-prescription products, there is a wide choice of alternatives. And sometimes what we choose is quite important to ensure the greatest benefit and the least risk.

Often we are preconditioned to request a specific product by brand name. Usually this preconditioning has occurred as a result of the weight of advertising; sometimes it’s on the recommendation of a friend or family member; and sometimes it’s because of previous positive history with the product. Even so, we should never assume the same product is always the one likely to be the most suitable for our needs.

The type of pain, how it occurred, what other medicines have been taken for the pain, what other conditions we might have, and what (if any) medicines are being taken for these conditions will all influence the choice of pain reliever. Sometimes no over-the-counter pain reliever might be suitable and a doctor’s advice might be a better option.

Of course, the two most commonly used non-prescription pain relievers – paracetamol and ibuprofen – are available from locations other than pharmacies (supermarkets, grocery stores, newsagents, service stations and so on); but that doesn’t mean they are without risk or that they are suitable for everyone on every occasion.

Generally pain can be described as acute or chronic. Acute pain starts suddenly and usually (but not always) has a readily identifiable cause, is of short duration and is self limiting. Sports injuries, toothache and period pain are examples. This is the kind of pain which tends to diminish as the body heals and can usually be alleviated with non-prescription pain relievers.

Chronic pain (that is pain which is long lasting or persistent) may be related to medical conditions such as arthritis or cancer, or it can also develop from acute pain if the acute pain is not effectively managed in the first place. So-called neuropathic pain (pain associated with nervous system injury) is a common cause of chronic pain. Psychological and emotional factors often contribute to chronic pain and the symptoms of chronic pain should be assessed and managed by a doctor. In some cases referral to a hospital pain clinic might be necessary.

Several of the so-called non steroidal anti-inflammatory medicines (NSAIDs) are now available without prescription. Aspirin, ibuprofen, diclofenac and naproxen are examples of NSAIDs. They may be preferred to paracetamol where inflammation is associated with the pain. Studies have shown that in recommended non-prescription doses and for the recommended non-prescription duration (i.e. up to three days) ibuprofen has similar gastrointestinal tolerability to paracetamol (and need not be taken with food); however, as with all NSAIDs, there are some specific precautions which need to be considered.

Non-prescription pain relievers containing codeine (i.e. in combination with aspirin, ibuprofen or paracetamol) are now only available directly from the pharmacist. Nevertheless, it is interesting to note that the strength of codeine in these combination pain relievers is not always sufficient to be effective; and not everyone finds codeine effective at any strength. Ask your pharmacist for more advice.

And check out the Fact Cards on Pain Relievers, Headache, Migraine, Back Pain, Arthritis and Gout. They’re all available from pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. Phone            1300 369 772       or log onto the website www.psa.org.au for the nearest location.

Taking the pressure out of eye disease  21 March 2012  1299

There seems to be an increasing trend amongst businessmen to be dressed more casually. Suits and ties haven’t disappeared altogether, but the open-necked shirt, with or without a jacket, is certainly more common. This new dress code may have an unexpected health benefit.

Results of a study, reported some years ago in the British Journal of Ophthalmology, suggested that men who tie their neckties too tightly might increase their risk of the sight-destroying disease glaucoma. Scientists found that a really tight tie could increase pressure in the eye – one of the risk factors for the disease (albeit a very minor risk factor).

Whether or not you wear a tie, if your sight is hazy or blurred and your eyes often difficult to focus, then you should definitely focus your attention on the messages to come from the recent World Glaucoma Day – a global event organised to raise awareness of what is known as the “silent blinding disease”.

Glaucoma is the name given to a group of eye diseases where the optic nerve at the back of the eye is damaged. The damage is caused when pressure in the eyeball rises due to a build up of fluid. This fluid build-up takes place because either too much fluid is formed or the canals in the eye, which normally drain the fluid away, don’t work properly.

More than 300,000 Australians are affected by glaucoma. However, as generally there is no pain, and loss of sight is gradual, many people – perhaps as many as 50% – are completely unaware they have a problem.

Unfortunately, glaucoma can’t be cured. Once there is damage to the nerve cells in the eye, repair is not possible. However, the serious consequences of glaucoma can be prevented if the condition is discovered soon enough; and early treatment, usually with eye drops to stabilise the pressure in the eye, can help avoid further loss of sight.

If someone in your family has glaucoma, you are almost three times more likely to have it yourself. And the risk of developing glaucoma increases as you get older. You are also at greater risk of getting glaucoma if you have diabetes or high blood pressure, if you are short-sighted or if you get migraine headaches.

In the early stages of glaucoma, most people experience no symptoms, even when losing their sight. Nevertheless, there are sometimes warning signs. Some people may notice a need to change their glasses more often, perhaps find it hard to see in dark rooms, lose wide vision, or have blurred sight.

The only way to prevent complete loss of vision is early detection and treatment. If you’re over 40, you need to see you ophthalmologist or optometrist (no need to wear a necktie!!) every two years; more often if you also have other risk factors.

There are several ways to check if you have glaucoma. Your eye specialist or optometrist can measure the pressure of the fluid in your eye; the nerves and blood vessels in your eye can be checked for damage; and your fields of vision can be tested for blind spots or sight loss.

As well, it’s been estimated that more than 10% of visual loss from glaucoma is because the prescribed eye drops are not used properly. Whether this is due to occasional forgetfulness or a deliberate or accidental failure to follow the doctor’s directions, the unfortunate result is the same. So, check with your pharmacist that you’re using you eye drops to the best advantage.

Up-to-date advice about glaucoma is available by way of the new Vision Impairment fact card, available at pharmacies around Australia providing the “Self Care” health information. For the nearest location phone the Pharmaceutical Society on            1300 369 772       or log onto the website www.psa.org.au and click on Self Care and then Find a Self Care Pharmacy.

It’s almost certain that you, someone in your family or a close friend will have some form of arthritis.

Arthritis is Australia’s major cause of pain and disability. It directly affects about 4 million people and impacts indirectly on millions more. It’s an enormous economic cost burden on the community too – collectively we pay some $24 billion every year – and the extra hidden social and emotional costs are immeasurable.

Arthritis is often thought of as a single disease, but it’s really an umbrella term used to describe well over 100  different medical conditions – conditions which are similar to the extent that they all involve our bones and muscles and particularly the joints where two or more of our bones meet.

Arthritis Awareness Week (25 – 31 March) gives us an opportunity to reflect not only on the problem, but also, in a positive way, how we can control the symptoms and enable people with arthritis to lead normal active lives.

In conjunction with Arthritis Australia (the peak patient support organisation), the Pharmaceutical Society of Australia has developed information and materials to help ensure arthritis can be managed effectively. These materials include three fact cards on the most common forms of arthritis – osteoarthritis, rheumatoid arthritis and gout.

Osteoarthritis (OA) mainly affects the weight bearing joints: the legs, the shoulders, the knees and the lower spine. Often the hands are also affected, especially at the base of the thumb and the end joints of the fingers.

Presently there is no cure of OA, so all treatment is aimed at achieving symptom control. Effective management of OA involves a combination of strategies: joint protection and energy conservation, periods of both rest and exercise, physical aids, medication – both oral and injectable and, usually as a last resort, surgery.

In so far as medicines are concerned, as the primary aim of treatment is to reduce pain, simple pain relievers are the first choice for OA; and paracetamol is the best option.

For optimum results paracetamol should be taken not just now and again but routinely – 3g to 4g per day. This can be either two 500mg tablets up to four times daily, or two of the higher strength (Panadol Osteo) three times daily.

As with all chronic conditions, particularly when conventional therapies are less than perfect in every case, there is plenty of interest in alternative or complementary treatments.

There is some evidence from clinical trials that glucosamine sulphate (1500mg/day) decreases the pain associated with OA of the knee joint. There may be benefit for other joints as well; however, it should be noted that results from later studies have not been universally supportive of the early trials.

Gout is the only form of arthritis where it is likely that some foods can aggravate the condition (check out the Gout fact card), but there is evidence that some foods will actually help other inflammatory forms of arthritis such as rheumatoid arthritis (RA).

Specifically, the beneficial foods are those rich in what we know as omega-3 fatty acids, and the best sources of the omega-3 are oily fish. Olive oils and oils and spreads from flaxseed, canola and wheat germ are also beneficial.

Supplements of fish oil, and the more concentrated krill oil, are now available if fish is not a regular on your menu. Your pharmacist will be able to advise you on the most appropriate product and the correct dose.

Meanwhile, the arthritis fact cards are available from pharmacies around Australia providing the Pharmaceutical Society’s (PSA) Self Care health information. Check out the PSA website at www.psa.org.au and click on “Self Care” then “Find a Self Care Pharmacy”. There are also a few other fact cards with helpful advice for sufferers of arthritis. These include Pain Relievers,Preventing Falls, Relaxation Techniques and Weight and Health.

Food allergy or food intolerance affects just about every one of us at some time; however the uncomfortable gastrointestinal symptoms we occasionally experience are usually due not to an allergic reaction but to over eating or drinking to excess, or perhaps food poisoning – the result of organisms or other toxic substances contaminating the food.

Of course, the vast majority of us eat far too much; certainly we eat too much of the wrong foods – foods that make us overweight and obese, and much more likely to suffer serious conditions such as diabetes and heart disease.

Cereals and grain, and plenty of them – that’s what we’re told we need as part of a healthy diet.  And for most of us that’s really good advice. But for some people, eating certain cereals and grains containing a protein component called “gluten” can be life threatening.

Around one in 100 Australians has a permanent intolerance to gluten; and these people are said to have coeliac (pronounced see-lee-ak) disease. Symptoms can include bloating, diarrhoea, nausea, wind and chronic fatigue. Sometimes the symptoms are very vague and may be confused with irritable bowel syndrome (IBS) or sometimes the symptoms may be put down to stress or just getting older.

Stomach pain and constipation can also occur.  Children with coeliac disease fail to thrive; adults are more susceptible to mouth ulcers and osteoporosis.  As well, unexplained weight loss, hair loss, skin problems, even infertility and recurrent miscarriages can result from coeliac disease.

National Coeliac Awareness Week (13-20 March) highlights the need for us to consider coeliac disease when “stomach problems” persist.  Despite the markedly varying symptoms and sometimes their extreme severity, treatment is usually simple and effective.

Gluten is found in wheat, rye and barley and to a lesser extent in oats. It is often present in bread, cakes, biscuits, pasta, pizzas and many processed foods – meats, soups, sauces and so on.

In coeliac disease our body’s immune system seems to overreact to what it sees as this foreign protein.  The result is sometimes disastrous.  Damage to the intestine leads to deficiencies in vitamins, iron, folic acid and calcium because of the poor absorption of nutrients.  Sugars, proteins and fats are poorly absorbed as well.  In some very severe cases coeliac disease can be fatal.

Early diagnosis of coeliac disease is important.  However, the good news is that, once diagnosed, the treatment for coeliac disease is extremely successful.  It very simply involves strict adherence to a gluten-free diet.

This might sound difficult but it’s well worth the challenge of finding gluten-free foods on the supermarket shelves.  Once started on a gluten-free diet, coeliac disease sufferers will pick up quickly and regain their energy and good health.

Be aware, however, that a gluten free diet is not a fad diet; certainly not for the more than 200,000 Australians who suffer with these gluten triggered symptoms.  And a gluten free diet should not be started before the appropriate blood screening or other tests your doctor can order.  Otherwise diagnosis may prove difficult or inconclusive.

For more information consult your local Coeliac Society or access the internet at www.coeliac.org.au.  It has dietary advice, recipes, information on where to buy gluten-free food, and above all the support needed to achieve effective control over the condition.

You can also get advice about intestinal and bowel problems from pharmacists providing the Pharmaceutical Society’s Self Care health information.  Call             1300 369 772       or log on to the Pharmaceutical Society website at www.psa.org.au and click on “Self Care” then “Find a Self Care Pharmacy” for the nearest location.  There are fact cards on Heartburn and Indigestion, Vomiting and Diarrhoea, Constipation and Irritable Bowel Syndrome.

In the United States, February each year is designated Child Dental Health Month. In Australia we have no such celebration; well not yet anyway. But, if recommendations from the recently released report of the National Advisory Council on Dental Health are accepted, there will be much more attention given to dental health services for our children.

The Council’s report suggests a Medicare-style scheme which could cost up to around $14 billion over four years. That’s more than enough to make a sizeable cavity in any Government’s anticipated budget surplus; however, with priority given initially to children and lower income adults, it’s estimated a more palatable $400 million would be needed in the first financial year.

Money well spent, according to Dr Shane Fryer, President of the Australian Dental Association. He welcomes the focus on children and those already on public waiting lists – an estimated 400,000 people in Australia. Better than a “broad brush” approach, he says

Chair of the Advisory Council, Mary Murnane, agrees: “improvements to child oral health and prevention will reduce the overall burden of disease and improve long term oral health across the population”.

Tooth decay and gum disease are the obvious results of lack of oral hygiene, but there are other potentially more serious consequences. There’s increasing evidence of a link between gum disease and heart disease. Some years ago a French study indicated that the more severe the periodontal (gum) disease, the more widespread the damage to the arteries.

It’s not yet known how gum disease might trigger heart disease, but there’s a suggestion that bacteria released from infected gums may enter the bloodstream where they activate the immune system causing inflammation and narrowing of the blood vessels. There are suggestions, too, that elderly residents of nursing homes may be more susceptible to infections like pneumonia if they have poor oral health.

Gingivitis is the name given to inflammation of the gums; and periodontitis is a more severe form of gingivitis where the connective tissue around the teeth is progressively destroyed. Apart from lack of attention to tooth and gum care, other factors which might frequently cause or worsen these conditions are common mouth infections, such as oral thrush, more serious infections (such as HIV) where the immune system is compromised, poorly controlled diabetes, smoking and certain medicines.

Medicines are also a major, possibly the most common, cause of dry mouth – known medically as xerostomia.

As we get older, all our body secretions are reduced in both quantity and quality. We get dry skin, dry eye and, not surprisingly, we’re more likely to have dry mouth. When we are taking a few medicines as well, then dry mouth becomes a strong probability.

Antidepressants are among those most commonly implicated, but the list of possible offenders also includes some non-prescription medicines such as antihistamines (particularly the older, more sedating antihistamines) and the so-called anticholinergic medicines used for stomach cramp.  The high dose codeine-containing pain relievers might also be a problem for some people.

There are a number of useful products for the treatment of dry mouth – mouth sprays, mouthwashes, gels and toothpastes. Pharmacists providing the Pharmaceutical Society’s Self Care health information have a fact card titled Dry Mouth. It offers some good suggestions on how to avoid this annoying and uncomfortable condition. There are also fact cards on the general topic ofOral Hygiene and more specifically Mouth Ulcers which. explains the likely causes and the possible “cures”. Local trauma is often the reason for a mouth ulcer – maybe from a hard bristle toothbrush, dentures or some other form of orthodontic appliance.

To locate the “Self Care” pharmacy closest to you, log onto the Pharmaceutical Society website www.psa.org.au and click on Self Care and then Pharmacy Finder.

It’s about this time school-age children will be meeting old friends and making some new friends too.  Almost certainly in the mix of new acquaintances – the uninvited ones – will be head lice. Statistics indicate that more than 20% of primary school students are likely to have head lice.

However, the fact is anyone with a head can catch head lice – regardless of age, sex, background or how clean your hair is.  Head lice spread anywhere that people work, play and live together. Indeed, it takes only one infested head to infest a whole classroom full of heads; then our children so unselfishly pass the infestation on to the rest of the family.

The medical term of head lice is pediculus humanus capitis.  But however you describe them, these tiny wingless insects are extremely common.  In fact, head lice are endemic in Australia.  Interestingly, they can’t jump or fly but they sure can crawl and climb; and they live their entire life (about a month or so) on the head of their host.

Their favourite hiding places are behind the ears and at the back of the neck.  Female lice lay their eggs (known as nits) close to the scalp, where they remain firmly stuck to the base of the hair shaft until they hatch a week or so later.

Head lice feed exclusively on human blood; but unlike body lice and mosquitoes, two other groups of little blood suckers, it appears that head lice do not carry disease.  They can, however, cause severe itching and this can lead to scratching and skin infections.

Of course an itchy scalp may be due to many other causes – among them dandruff, psoriasis and so-called seborrhoeic dermatitis.  So, before you start shampooing with insecticide, it’s best to get an accurate diagnosis.  The recently revised Pharmacy Self Care fact card titled Head Lice will help confirm the problem and find the solution as well.

The good news is that if you or your children have head lice, there are simple, safe and effective strategies to send them on their way.  Various shampoos, lotions, cream rinses and conditioners are available.  Many chemical treatments are based on the chrysanthemum-type pyrethrin insecticides; some contain malathion; and there are several remedies available based on essential oils such as anise, lavender, rosemary and the Australian favourite melaleuca (tea tree) oil.  When used as indicated these natural treatments have been shown in some studies to be more effective even than the chemical treatments.

There are also special fine tooth combs (some battery operated) to help facilitate the removal of the sticky nits.

If live lice are found in the combings after treatment, it’s possible that the head lice are resistant to the particular product, and the person should be retreated as soon as possible using a product from a different group.  Nevertheless, most treatment failures are due to inadequate time in contact with hair and scalp, inappropriate application methods, or the use of ineffective products.  Ask your pharmacist to recommend an evidence-based product – that is: one that is proven to be effective.

Remember whatever head lice treatment you choose, a fine toothcomb is essential to get the nits out and a good hair conditioner will get rid of the knots out.

Regular inspection, and detection, and persistence and perseverance with an effective product used appropriately are the keys to success with head lice treatments. Of course, it helps if you can convince all the parents of your children’s classmates to put in place similar procedures.

For information on where to find a Head Lice fact card, phone the Pharmaceutical society on             1 300 369 772       or go to the Pharmaceutical Society website at www.psa.org.au and click on Self Care then Pharmacy Finder.

In Australia, most people spend more time in the sun than they really should – or at least more time than they should without adequate protection.

Of course, we all know that some sunshine is very helpful for good health; within our body it’s the natural stimulant to the manufacture of vitamin D; and exposure to sunlight has a positive effect in relation to a number of skin conditions.

Specifically, controlled exposure to artificial to UV radiation – a procedure known as phototherapy – is a recognised treatment for psoriasis. It produces local anti-inflammatory and immunosuppressant effects.

Psoriasis is a comparatively common skin condition affecting about 3% of all Australians. It’s not infectious and it’s not an allergic reaction; it is in fact an auto-immune disease. That is: the immune system is overactive and causes new skin cells to multiply and mature at an abnormally fast rate – about four times the normal rate – resulting in a build-up of a mix of new and old skin cells in the form of raised, red, scaly lesions known as “plaques”.

These psoriasis plaques can develop just about anywhere on the body but the scalp, knees and elbows and lower back are the most commonly affected. And the lesions – ranging from a few millimetres to a few centimetres in diameter – are very often inflamed, itchy and painful. When these symptoms are not effectively controlled the plaques can crack and bleed.

Bleeding or not, it’s not usually bleeding obvious, whether the cause of a skin irritation is actually psoriasis. Skin conditions such as atopic eczema, contact dermatitis, seborrheic dermatitis, tinea and skin cancer need to be excluded in any diagnosis. The location and the appearance of the plaque will help the assessment; and silver scales are usually a tell-tale sign.

For many people the risk of psoriasis is inherited. Research has shown that if one parent is affected, there’s a 16% chance their children will develop psoriasis and a 50% chance if both parents are affected.

There are also a number of well documented trigger factors – for instance, a flare-up of psoriasis can occur two or three weeks after an acute viral or bacterial infection; or trauma of any kind – physical, chemical or surgical. Also, certain medicines can trigger psoriasis; and while most patients experience an improvement in symptoms during the warmer months and on exposure to sunlight, strong sunlight and especially sunburn, can aggravate the condition.

As well as, and to a large extent because of, the physical aspect of psoriasis, there are associated psychological issues. Psoriasis can have a significant effect on the quality of life. Studies indicate that a high percentage of people with psoriasis will avoid swimming (70%), avoid playing sport (40%) and even avoid leaving the house (12%). Fifty percent of people with psoriasis say it adversely affects their personal relationships. Not surprisingly many people with psoriasis have anxiety and/or depression.

Currently there is no known cure for psoriasis but symptoms can be controlled. As well as the vitamin D-stimulating sunshine and the artificial phototherapy, synthetic vitamin D-based creams, ointments, lotions and gels generally provide good control (your pharmacist can give you more advice). And regular use of moisturisers is recommended to reduce dryness and the urge to scratch.

If you or someone in your family is continually shedding those rough, scaly skin cells, you can shed some extra light on how to be more at ease with the problem of those itchy, painful, patchy plaques by getting a copy of the new PsoriasisFact Card. It’s available at all pharmacies providing the Pharmaceutical Society’s Self Care health information. For the nearest location, phone             1300 369 772       or log onto the Pharmaceutical Society website (www.psa.org.au) and click on “Self Care” and then “Pharmacy Finder”.

Publishing the results of their studies in a recognised scientific journal is a major aim of all researchers. In fact, publication is frequently a requirement before any of the work is acknowledged. And often further studies are necessary to validate or confirm the original work.

To a large extent the success of scientific development depends on what other scientists have already achieved and how they’ve gone about it. So publication is vital.

It was surprising therefore to see a request in December last year made to two of the world’s leading scientific journals, Natureand Science, that they not publish some research being undertaken on the influenza virus.

As the February 3 issue of the Economist magazine put it, the researchers from The Netherlands and the United States had been “tinkering” with H5N1 influenza, better known as bird flu, to produce a strain of the virus that could be transmitted from human to human. (Up until now, no human to human transmission has been identified.) Fears were expressed by the National Scientific Advisory Board for Biosecurity (NSABB) in the US that if details were to become known by terrorists the consequences could be catastrophic.

The bird flu virus is indeed dangerous. Around 60% of the nearly 600 cases reported have proved fatal.

So far, the current research has been confined to ferrets. But when it comes to flu, it seems ferrets and humans are similar. And supporters of the research say studies like this could well lead to the development of effective vaccines and drug treatments. In any event, further research in this area has been voluntarily deferred for two months.

Another aspect of medical research is how we interpret the results for our own circumstances. Different studies sometimes provide apparently different conclusions. The use of aspirin is s good example. Aspirin was first marketed more than 100 years ago as an effective pain reliever. Since then it has been largely superseded by other medicines for this purpose, but has been widely promoted in low dose to prevent heart and blood vessel disease.

Now, most recent research has shown that whilst this benefit of aspirin still applies to people who have already suffered a heart attack or stroke, the benefit for other people is outweighed by the risk of gastric bleeding. Meanwhile in the January 2012 issue of the journal Ophthalmology it has been suggested that frequent use of aspirin may be linked with age related macular degeneration. And we also know that aspirin is not recommended for the prevention of blood clots associated with long distance travel.

Clearly, before self medicating with any medicine, even something as simple as low dose aspirin, we should seek our pharmacist’s or doctor’s advice.

Perhaps a more basic and down to earth example of the relevance of research to our everyday life is illustrated in a study published  online December 2 last year in the International Journal of Hospital Infection. Investigators from the Leeds General Infirmary in the UK examined the bacterial contamination of the air following the flushing of lidded and lidless toilets.  Specifically the study looked at the spread of an organism called Clostridium difficile which is sometimes found in stool specimens.

So-called toxin producing strains of C. difficile can multiply after treatments with antibiotics and cause antibiotic-induced diarrhoea. Aggressive forms of this organism have emerged worldwide and have caused outbreaks on both hospitals and the community with significant mortality especially in the elderly.

The researchers from Leeds found that the number of airborne bacteria was 12 times higher from open toilets compared with the same toilet when the lid was closed when flushing. So this research, at least, has confirmed we should keep a lid on it.

Self Care pharmacies provide a range of information that is based on the evidence coming out of all of this research. This information is for consumers on topics such as Cold and Flu, Travel Health and Vomiting and Diarrhoea. For your nearest Self Care pharmacies go to www.psa.org.au and check out the Pharmacy Finder.