How sick he can get?

child-with-tablets-2The toxic compound in multivitamins overdose is not because of the vitamins but is because of the iron which is one of the so-called bomb medications meaning it is a medications that lack symptoms early after ingestion, but later have profound toxic course. There is a large variety of children multivitamins that contains different amounts of elemental iron per tablet or teaspoon while adult multivitamins may contain up to 60mg elemental iron per tablet. The toxic dose of iron ingestion is at least 20mg per kilogram of elemental iron and a lethal dose of iron is in the range of 60 – 180mg per kilogram of elemental iron.  Because iron can initially cause nausea, vomiting or abdominal pain, a child with a suspected but unknown amount of iron poisoning can be observed and an iron level can be obtained. If you are not sure about ingested tablet an abdominal radiography can also help. A Child who has no complain and has a normal physical exam after 4-6 hours of observation can be safely discharged home especially if serum iron level is less than 500 mcg/ml. If the ingested iron happens to be significant it can cause, shock, coagulation disorder, myocardial depression and cell death.

Dr. Hossein Sardari-Zadeh
Pediatrician
Armada Medical Centre

Iron-Deficiency-foodSources of iron:

  • Egg yolks
  • Molasses, liver and beef
  • Raisin bran, Raisins, Prunes, Dried apricots, Figs
  • Kidney beans, Pinto beans, Navy beans, Lentils, Split green peas
  • Enriched cereals, Enriched macaroni, rice bran
  • Spinach, Greens, Broccoli, Lima beans, Avocado

The following foods can help your body absorb iron better: 

  • Oranges
  • Cantaloupe
  • Strawberries
  • Grapefruit
  • Broccoli
  • Brussels sprouts

Foods to Reduce or Eliminate:

Cow's milk may cause anemia by interfering with iron absorption, so it may be beneficial not to consume dairy at the same time as iron-rich foods or supplements. Eliminate trans and hydrogenated fats, alcohol, processed foods, refined foods and sugar. These substances may interfere with iron absorption.

Dr. Asma Kossentini
General Practitioner
Armada Medical Centre

If you’ve ever wanted perfect white teeth, you're not alone!

teeth-whitening-dubaiA pearly white smile can make us feel good about ourselves, giving us the right amount of confidence necessary to get through life. 
The benefits of whiter teeth include a younger appearance, a more glamorous and overall cleaner look. The road to whiter, brighter teeth is now simple, as teeth whitening procedures have become a staple of the cosmetic dentistry industry. As a very common cosmetic procedure, you can count on your dentist to provide you with simple, fast and effective results. 

Teeth whitening patients often wonder how their teeth got stained in the first place and how they can prevent it from happening. The truth is, teeth staining is caused by a combination of various lifestyle and environmental factors such as natural aging, tobacco use, drinking coffee, tea, soft drinks, wine and eating highly pigmented food. While some of these things are preventable, teeth staining will still gradually occur throughout the years as a result of other natural causes. 

Initially, a layer gradually forms on top of the enamel layer and the foreign material accumulates to form a film over your teeth. This accumulation of plaque and bacteria makes our teeth stained and colored, then these foreign materials get deep into the outer layer, working their way down into the tooth where you can’t simply scour them away. People are typically drawn to ineffective “do-it-yourself” teeth whitening kits which don’t succeed in whitening the teeth because they only work on the outer layer of the teeth, ignoring the inside of the teeth, where the actual stains are! Going to the dentist for this procedure will save you time and money.

There are two proven medical treatments to whiten teeth using the chemicals CarbidePeroxide or Hydrogen Peroxide. These materials, when applied under the supervision of a dentist, can be highly effective. The first method is a simpler and safer method with minimal discomfort which takes place during an in-office treatment where the teeth and gums are covered for protection before applying the whitening gel, then the whitening gel is applied to the teeth, and they are exposed to a special light called Zoom. This procedure breaks up stains and brightens the teeth. When the treatment is over, a sensitivity reducing gel is applied. The second method is the home system method. It involves a dentist taking impressions (molds) of your mouth and then creating soft custom mouth trays where the patient is expected to apply the treatment at home. The treatment involves having the patient to apply a thin strip of the gel into the tray and wear it for two hours during the day, or while sleeping. This method usually takes a period of up to two weeks for results to show.

A combination of in-office and at-home systems can achieve up to 5 - 8 shades of whitening in most patients. These procedures are considered safe and effective when monitored by a dentist. It is recommended that before the tooth whitening treatment is started, dentists clean a patient’s teeth, fill any cavities and make sure the patient's gums are healthy. The dentist can also help decide what type of tooth whitening is required in-office, at-home or both and the concentration of the whitening gels. The dentist can monitor and treat patients who experience sensitivity to the whitening agents and modify the procedure for those who are having difficulty getting optimal results. 

However, it must be noted that not all teeth discoloration respond to tooth-Whitening treatments. Individuals contemplating tooth-whitening should consult with a dentist to determine the cause of the tooth discoloration and to determine whether a bleaching treatment will have the desired result. This step is especially important for patients with fillings, root canal treatments and crowns.

Finally, the dentist can help the patient explore other cosmetic dental options such as porcelain or resin veneers, and tooth colored fillings with or without tooth whitening. With the help of the dentist, the patient's cosmetic dental goals may be more easily attained. teeth whitening is safe and effective, and have not shown to cause any damage to the enamel of the tooth. However, if tooth sensitivity or gum irritation occurs it is usually slight and reversible, but you might consider not using the whiteners so frequently!

Dr. Yousra Yahia Bakhit
GP Dentist
Armada Medical Centre

heart-dieaseAccording to recent research the risk for heart disease doubles for women who enter menopause early, women who go through menopause before age 45 have a two to threefold risk of heart disease. Women who have their ovaries removed before age 35 have a sevenfold risk. If you’re older than 35 but still younger than 40, your risk is a only bit lower -- about twice the chance of developing heart disease. 

In fact, whether you’ve gone through a surgical or natural premature menopause, you’re at a higher risk of heart disease than women who have gone through menopause at the average age.

Especially if the early menopause is combined with one or more of the traditional cardiovascular disease risk factors:
1- Diabetes 
2- Smoking
3- Obesity
4- Hypertension
5- High LDL
6- Low HDL
7- Family History 

Estrogen is the hormone that prevents these cardiac risks. We know that ladies who are premenopausal but still producing hormones are at a significantly lower risk for coronary heart disease, heart attacks and strokes than are post-menopausal women or men of any age .

Dr. Moujahed Hammami MD, German Board (FACHARZT)
PhD Professor of Obs. & Gyn. (UOA)
Consultant Obstetrics & Gynecology
Armada Medical Centre

child-feverWhat Is Fever?

Temperature of our bodies is amazingly steady despite significant variation in environmental temperature. The thermo regulatory center is in our brain at hypothalamus, which act like a thermostat with a set point at normal body temperature. This is done by balancing heat production (by metabolic activity in liver and muscle) with heat loss through a skin and lung.

Fever occurs when the thermostat set point is raised above the current body temperature. When the body is exposed to infection organisms such as viruses or bacteria a number of so called pyrogens are produced as part of inflammatory response. These pyrogens can then act on the thermostat to raise the temperature set point by the release of a substance called prostaglandin. Now once the set point is raised heat generating action in the body like cellular metabolism in mostly skeletal muscle come into play to raise the temperature to the new set point.

What Is Fever Phobia?

Fever is one of the most common reasons that parents seek medical attention for their children. Parental concern usually arises because of the belief that fever is a disease rather than a symptom of an illness. This misconception and unrealistic concerns about the fever which ranges from thinking about the brain damage, losing their children, and the disease causing the fever is a potentially dangerous one rather than relatively benign one are termed fever phobia.

This parental fever phobia which exists across socio economic classes is strongly reinforced sometimes by the action of pediatric medical professionals, who are widely considered to be the primary resource of the subject. It is even emphasized as a discharge instruction, from emergency department and inpatient facilities as a warning to parents to call or return if fever develops or persists. So there is incongruence between the education of the family and the practice of the pediatrician. This mixed message which remains in existence does cause parents to lose sleep and experience unnecessary stress due to unwarranted concern about the harmful side effect of the fever.

Advice to Parents Regarding Their Febrile Child and Unwarranted Concerns about Harmful Side Effects of Fever:

I know it is hard to resist reacting to a hot little forehead and sad eyes, but if you remember the following, you will know when is the time to worry about your child’s fever and when you can be more patient and do not stress yourself.

1. Make sure your child has really fever (axillary temperature greater than 37.5°C or rectal temperature more than 38°C). Taking temperature by hand can be misleading.

2. Fever is only a sign of a disease and does not indicate the type of the disease or its severity no matter what the level of temperature is, high or low.

3. Remember that, especially in a child less than two to three years, most of the time the cause of the fever is viral infection, which is usually benign, and causes no serious damage to your child.

4. Fever is the body’s way of stimulating immune system, increasing white blood count, and fighting against infection. It also decreases the ability of viruses and bacteria to reproduce. Fever apart from being a sign of disease in your child, it has many beneficial effects and does not go higher and higher and usually not go beyond 41°C.

5. When your child has a fever, look for other signs i.e. Is he playful and looks normal between episodes of fever, is he alert and not weak or lethargic, does he smile, and has a normal color, these are the good signs indicating that the cause of the fever is not that serious and covers most cases of febrile children. If so, you can wait and do not stress yourself and do not need to call your doctor in the middle of the night. There is one exception and that is in a child less than six months of age where the immune system is not mature and the presence of fever may be an indication of a serious bacterial infection, which in that case you should call your pediatrician.

6. If he looks sick or constantly cries and irritable, is not playful, there is change of alertness, has a respiratory distress or swallowing problem, or the fever is persisting for more than two to three days, these are the bad signs and you should consult your pediatrician.

7. Febrile convulsion sometimes happen in kids less than four years, which usually stops after a few minutes and causes no problem, but if your child already had seizure in past or there is history of convulsion in the family, or any sign of neurological or central nervous system insult or problem, he needs more attention and should consult your pediatrician.

Dr. Hossein Sardarizadeh M.D.
Specialist Pediatrician (Board Certified)
Armada Medical Centre 

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