Disease's information
disid disname disdiscription
1 Influenza (The Flu is a respiratory illness
Flu) caused by the influenza
virus that infects the nose,
throat, and lungs. Flu can
affect people differently
based on their immune
system, age, and health.
2 allergies An allergy is a reaction
the body has to a
particular food or
substance.
Allergies are very
common. They are
particularly common in
children. Some allergies
go away as a child gets
older, although many
are lifelong. Adults can
develop allergies to
things they weren't
previously allergic to.
3 HIV/AIDS HIV (human
immunodeficiency
virus) is a virus that
attacks the body’s
dissymptoms
Flu symptoms in children can
include coughing, fever, aches,
fatigue, vomiting, and diarrhea.
Allergic reactions usually
happen quickly within a few
minutes of exposure to an
allergen.
They can cause:
 sneezing
 a runny or blocked
nose
 red, itchy, watery eyes
 wheezing and
coughing
 a red, itchy rash
 worsening of asthma
or eczema symptoms
Possible symptoms include
 Fever,
 Chills,
 Rash,
treatment
Recommended to get flu
vaccine every year starting
when 6 months old
The best way to keep your
symptoms under control is
often to avoid the things
you're allergic to, although
this isn't always practical.
For example, you may be
able to help manage:
 food allergies by
being careful about
what you eat
 animal allergies by
keeping pets
outside as much as
possible and
washing them
regularly
 mould allergies by
keeping your home
dry and well-
ventilated, and
dealing with any
damp and
condensation
 hay fever by
staying indoors and
avoiding grassy
areas when the
pollen count is high
 dust mite allergies
by using allergy-
proof duvets and
pillows, and fitting
wooden floors
rather than carpets
Taking HIV medicines
keeps people with HIV
healthy and prevents HIV
 immune system. If HIV  Night sweats, transmission. Taking HIV
is not treated, it can  Muscle aches, medicines every day and
lead to AIDS (acquired  Sore throat, exactly as prescribed
immunodeficiency  Fatigue, (called medication
syndrome). There is  Swollen lymph nodes, adherence) also reduces
currently no effective and the risk of drug resistance.
cure. Once people get  Mouth ulcers.
HIV, they have it for some people may not feel
life. But with proper sick during acute HIV
medical care, HIV can infection. These symptoms
be controlled. People don’t mean you have HIV.
with HIV who get Other illnesses can cause
effective HIV treatment these same symptoms.
can live long, healthy
lives and protect their
partners.

4 asthma Asthma is a common The symptoms of asthma can Reliever inhalers – usually
long-term condition that range from mild to severe. blue – are taken to relieve
can cause coughing, Most people will only asthma symptoms quickly.
wheezing, chest experience occasional The inhaler usually
tightness and symptoms, although a few contains a medicine called
breathlessness. people will have problems a short-acting beta2-
The severity of these most of the time. agonist, which works by
symptoms varies from The main symptoms of relaxing the muscles
person to person. asthma are: surrounding the narrowed
Asthma can be  wheezing (a whistling airways. This allows the
controlled well in most sound when you airways to open wider,
people most of the time, breathe) making it easier to breathe
although some people  shortness of breath again.
may have more  a tight chest – which Reliever inhalers do not
persistent problems. may feel like a band is reduce the inflammation in
Occasionally, asthma tightening around it the airways, so they do not
symptoms can get  coughing make asthma better in the
gradually or suddenly These symptoms are often long term – they are
worse. This is known as worse at night and early in intended only for the relief
an "asthma attack", the morning, particularly if of symptoms.
although doctors the condition is not well Examples of reliever
sometimes use the term controlled. They may also medicines include
"exacerbation". develop or become worse in salbutamol and
Severe attacks may response to a certain trigger, terbutaline. They are
require hospital such as exercise or exposure generally safe medicines
treatment and can be to an allergen. with few side effects,
life threatening, unless overused.
although this is unusual. However, they should
rarely, if ever, be
necessary if asthma is well
controlled, and anyone
needing to use them three
or more times a week
should have their
treatment reviewed.
Everyone with asthma
should be given a reliever
inhaler, also known simply
as a "reliever".

Preventer inhalers –
usually brown, red or
orange – work over time to
reduce the amount of
inflammation and
sensitivity of the airways,
and reduce the chances of
asthma attacks occurring.
They must be used
regularly (typically twice or
occasionally once daily)
and indefinitely to keep
asthma under control.
You will need to use the
preventer inhaler daily for
some time before you gain
the full benefit. You may
still occasionally need the
blue reliever inhaler to
relieve your symptoms,
but your treatment should
be reviewed if you
continue to need them
often.
The preventer inhaler
usually contains a
medicine called an inhaled
corticosteroid. Examples of
preventer medicines
include beclometasone,
budesonide, fluticasone,
ciclesonide and
mometasone.
Preventer treatment
should be taken regularly if
you have anything more
than occasional symptoms
from your asthma, and
certainly if you feel the
need to use a reliever
 inhaler more than twice a
week.
Some inhaled
corticosteroids can
occasionally cause a mild
fungal infection (oral
thrush) in the mouth and
throat, so make sure you
rinse your mouth
thoroughly after inhaling a
dose. The use of a spacer
device also reduces this
risk. For more information
on side effects, see below.
Smoking can reduce the
effects of preventer
inhalers.

5 Malaria Malaria is a disease A malaria infection is Malaria is treated with

caused by a parasite. generally characterized by prescription drugs to kill
The parasite is the following signs and the parasite. The types
transmitted to humans symptoms: of drugs and the length
through the bites of  Fever of treatment will vary,
infected mosquitoes.  Chills depending on:
People who have  Headache  Which type of
malaria usually feel  Nausea and malaria parasite
very sick, with a high vomiting you have
fever and shaking  Muscle pain and  The severity of
chills. Each year, fatigue your symptoms
approximately 210 Other signs and symptoms  Your age
million people are may include:  Whether you're
infected with malaria,  Sweating pregnant
and about 440,000 The most common
 Chest or abdominal
people die from the antimalarial drugs
pain
disease. Most of the include:
 Cough
people who die from  Artemisinin-
the disease are young based
children in Africa. combination
therapies
(ACTs).
 Chloroquine
phosphate.
Other common
antimalarial drugs
include:
 Combination of
atovaquone and
proguanil
(Malarone)
 Quinine sulfate
 (Qualaquin) with
doxycycline
(Vibramycin,
Monodox, others)
 Mefloquine
 Primaquine
phosphate

6 Amebiasis Amebiasis is a parasitic it causes: If you have no symptoms

infection of the
intestines caused by
the protozoan
Entamoeba histolytica,
or E. histolytica. The
symptoms of amebiasis
include loose stool,
abdominal cramping,
and stomach pain.
However, most people
with amebiasis won’t
experience significant
symptoms.
 diarrhea (which
may be bloody) but are found to have E.
 stomach pains histolytica in a stool
 cramping
(faeces) specimen, it is
 nausea
 loss of appetite usually advised that you
 fever
should be treated with
medication to kill the
parasite. The medicine
diloxanide furoate is
commonly used.
Treatment is advised
because you can still pass
on the infection to others
even if you have no
symptoms. The amoebae
will still pass out in your
stools. Also, you may still
develop symptoms at a
later stage.
The treatment of
symptomatic amoebiasis
then depends on your
symptoms.

7 Mouth ulcer Mouth ulcers are usually In many cases, the reason for
round or oval sores that mouth ulcers is unclear. Most Mouth ulcers don’t usually
commonly appear inside single mouth ulcers are need to be treated,
the mouth on the: caused by damage to the because they tend to clear
 cheeks lining inside of the mouth. For up by themselves within a
 lips example: week or two.
 tongue  accidentally biting the However, treatment can
They can be white, red, inside of your cheek or help to reduce swelling
 yellow or grey in colour
and swollen.
It's possible to have
more than one mouth
ulcer at a time and they
may spread or grow.
Mouth ulcers shouldn't
be confused with cold
sores, which are small
blisters that develop on
the lips or around the
mouth. Cold sores often
begin with a tingling,
itching or burning
sensation around your
mouth.
8 Insomnia Insomnia is difficulty If you have insomnia, you
getting to sleep or may:
staying asleep for long
enough to feel refreshed
the next morning.
It's a common problem
thought to regularly
affect around one in
every three people, and
is particularly common
in elderly people.
a sharp tooth
 poorly fitting dentures
 hard food
 a defective filling
 find it difficult to fall
asleep
 lie awake for long
periods at night
 wake up several times
during the night
 wake up early in the
morning and not be
able to get back to
sleep
 not feel refreshed
when you get up
 find it hard to nap
during the day,
and ease any discomfort.
This may help if you keep
getting mouth ulcers or
your mouth ulcer affects
eating and drinking.
Self care
Things you can do to speed
up healing include:
 applying a
protective paste
recommended by
your pharmacist
 using a soft
toothbrush to
brush your teeth
 using a toothpaste
that doesn’t
contain sodium
lauryl sulphate, as
this may be
irritating
 avoiding hard,
spicy, salty, acidic
or hot food and
drink until the ulcer
heals
 using a straw to
drink cool drinks
 avoiding things that
may be triggering
your mouth ulcers
 setting regular
times for going to
bed and waking up
 relaxing before bed
time – try taking a
warm bath or
listening to calming
music
 using thick curtains
or blinds, an eye
mask and earplugs
to stop you being
woken up by light
and noise
 avoiding caffeine,
nicotine, alcohol,
 despite feeling tired
 feel tired and irritable
during the day and
have difficulty
concentrating
9 Nosebleed Nosebleeds can be Nosebleeds can be caused by
frightening, but they a number of different things.
aren't usually a sign of It's not always possible to
anything serious and can identify the exact reason why
often be treated at one occurs.
home. Nosebleeds can start just
The medical name for a inside your nostrils (anterior)
nosebleed is epistaxis. or at the back of your nose
During a nosebleed, (posterior). These different
blood flows from one or types of nosebleeds tend to
both nostrils. It can be have different causes.
heavy or light and last
from a few seconds to
15 minutes or more.
heavy meals and
exercise for a few
hours before going
to bed
 not watching TV or
using phones,
tablets or
computers shortly
before going to bed
 not napping during
the day
 writing a list of
your worries, and
any ideas about
how to solve them,
before going to bed
to help you forget
about them until
the morning
In some cases, a special
type of cognitive
behavioural therapy (CBT)
designed for people with
insomnia (CBT-I) may be
recommended
To stop a nosebleed:
 sit down and firmly
pinch the soft part
of your nose, just
above your nostrils,
for at least 10-15
minutes
 lean forward and
breathe through
your mouth – this
will drain blood
into your nose
instead of down
the back of your
throat
 place an ice pack or
bag of frozen
vegetables covered
by a towel on the
bridge of your nose
 stay upright, rather
than lying down as
this reduces the

10 Yellow Fever Yellow fever is an Symptoms of yellow fever
acute viral include fever, headache,
haemorrhagic jaundice, muscle pain,
disease transmitted nausea, vomiting and
by infected fatigue. A small
mosquitoes. The proportion of patients
"yellow" in the name who contract the virus
refers to the jaundice develop severe
that affects some symptoms and
patients. approximately half of
those die within 7 to 10
days. Once contracted, the
yellow fever virus incubates
in the body for 3 to 6 days.
Many people do not
experience symptoms, but
when these do occur, the
most common are fever,
muscle pain with prominent
backache, headache, loss
of appetite, and nausea or
vomiting. In most cases,
symptoms disappear after 3
to 4 days.
11 heart failure Heart failure is a serious  Breathlessness
condition, but it does  Tiredness and lethargy
not actually mean that  Leg swelling
your heart has failed. It  Loss of appetite
means that your heart is
not pumping blood
around your body very
efficiently.
The left side of your
heart pumps blood to
the body including the
blood pressure in
the blood vessels of
your nose and will
discourage further
bleeding
If the bleeding eventually
stops, you won't usually
need to seek medical
advice. However, you
should still follow the
recovery advice outlined
below.
Good and early
supportive treatment in
hospitals improves
survival rates. There is
currently no specific anti-
viral drug for yellow
fever but specific care to
treat dehydration, liver
and kidney failure, and
fever improves
outcomes. Associated
bacterial infections can
be treated with
antibiotics.
the standard medicines for
treating heart failure are:
 angiotensin
converting enzyme
(ACE) inhibitors
 angiotensin
receptor blockers
(ARBs)
 beta blockers
 diuretics (water
tablets)
 brain and kidneys. The
right heart pumps blood
to the lungs. Heart
failure can affect the left
or the right side of your
heart, or both.
Most commonly, a
problem with function
on the left side of the
heart produces back
pressure leading to
additional right heart
failure.
12 Prostate cancer Prostate cancer is the
most common cancer in
men, with over 40,000
new cases diagnosed
every year.
Prostate cancer usually
develops slowly, so
there may be no signs
you have it for many
years.
Symptoms often only
become apparent when
your prostate is large
enough to affect the
urethra (the tube that
carries urine from the
bladder to the penis).
When this happens, you
may notice things like an
increased need to
urinate, straining while
urinating and a feeling
that your bladder has
not fully emptied.
These symptoms
shouldn’t be ignored,
but they do not mean
you definitely have
prostate cancer. It is
more likely that they are
caused by something
else, such as benign
prostatic hyperplasia.
Prostate cancer does not
normally cause symptoms
until the cancer has grown
large enough to put pressure
on the urethra.
This normally results in
problems associated with
urination. Symptoms can
include:
 needing to urinate
more frequently, often
during the night
 needing to rush to the
toilet
 difficulty in starting to
pee (hesitancy)
 straining or taking a
long time while
urinating
 weak flow
 feeling that your
bladder has not
emptied fully
Many men's prostates get
larger as they get older due to
a non-cancerous condition
known as prostate
enlargement or benign
prostatic hyperplasia.
Symptoms that the cancer
may have spread include
bone and back pain, a loss of
appetite, pain in the testicles
and unexplained weight loss.
 mineralocorticoid
receptor
antagonists (MRAs)
A widely used method of
staging is a number staging
system. The stages are:
 Stage 1 – the
cancer is very small
and completely
within the prostate
gland
 Stage 2 – the
cancer is within the
prostate gland, but
is larger
 Stage 3 – the
cancer has spread
from the prostate
and may have
grown into the
tubes that carry
semen
 Stage 4 – the
cancer has spread
into the lymph
nodes or another
part of the body,
including the
bladder, rectum or
bones; about 20-
30% of cases are
diagnosed at this
stage
13 Sunburn Sunburn is skin damage It’s easy to underestimate You can usually treat mild
caused by ultraviolet your exposure to the sun sunburn at home, although
(UV) rays. It usually when outside, as the redness there are some
causes the skin to doesn’t usually develop for circumstances where you
become red, sore, several hours. Breezes and should seek medical advice
warm, tender and getting wet (such as going in (see below).
occasionally itchy for and out of the sea) may cool The following advice may
about a week. your skin, so you don’t realise help to relieve your
The skin will normally you’re getting burnt. symptoms until your skin
start to flake and peel You should always be aware heals:
after a few days and will of the risk of sunburn if you’re  Cool the skin by
usually fully heal within outside in strong sun, and sponging it with
seven days. look out for your skin getting cold water or by
While sunburn is often hot. having a cold bath
short-lived and mild, it's or shower –
important to try to avoid applying a cold
it, because it can compress such as a
increase your chances of cold flannel to the
developing serious affected area may
health problems, such as also help.
skin cancer, in later life.  Drink plenty of
fluids to cool you
down and prevent
dehydration.
 Take painkillers
such as ibuprofen
or paracetamol to
relieve any pain –
aspirin should not
be given to children
under 16.
Try to avoid all sunlight,
including through
windows, by covering up
the affected areas of skin
until your skin has fully
healed.
14 Dengue Dengue is a mosquito- The most common symptom Fever reducers and pain
borne viral disease of dengue is fever with any killers can be taken to
that has rapidly spread of the following:
in all regions of WHO control the symptoms of
 Nausea, vomiting
in recent years. muscle aches and pains,
 Rash
Dengue virus is
 Aches and pains (eye and fever.
transmitted by female
mosquitoes mainly of pain, typically behind  The best options
the species Aedes the eyes, muscle, to treat these
aegypti and, to a joint, or bone pain) symptoms are
lesser extent, Ae. acetaminophen or
 Any warning sign
paracetamol.
 albopictus. These
mosquitoes are also
vectors of
chikungunya, yellow
fever and Zika viruses.
Dengue is widespread
throughout the tropics,
with local variations in
risk influenced by
rainfall, temperature,
relative humidity and
unplanned rapid
urbanization.
15 Toothache Toothache refers to pain
in and around the teeth
and jaws that's usually
caused by tooth decay.
You may feel toothache
in many ways. It can
come and go or be
constant. Eating or
drinking can make the
pain worse, particularly
if the food or drink is hot
or cold.
The pain can also be
mild or severe. It may
feel "sharp" and start
suddenly. It can be
worse at night,
particularly when you're
lying down. A lost filling
or broken tooth can
sometimes start the
pain.
It can also sometimes be
difficult to decide
whether the pain is in
your upper or lower
teeth. When a lower
molar tooth is affected,
the pain can often feel
like it's coming from the
ear.
Toothache in other
 NSAIDs (non-
steroidal anti-
inflammatory
drugs), such as
ibuprofen and
aspirin should be
avoided. These
anti-inflammatory
drugs act by
thinning the
blood, and in a
disease with risk
of hemorrhage,
blood thinners
may exacerbate
the prognosis.
The type of treatment you
have for toothache will
depend on the cause of
the pain, so your dentist
will examine your mouth
and may carry out an X-ray
to try to identify the
problem.
If your toothache is caused
by tooth decay, your
dentist will remove the
decayed area and replace
it with a filling.
If your toothache is caused
by a loose or broken filling,
the filling will be taken out,
any decay will be removed,
and a new filling put in
place.
If the pulp inside your
tooth is infected, you may
need root canal treatment.
This procedure involves
removing the infected pulp
and then inserting a
special type of filling to
seal the tooth and prevent
reinfection.
Your tooth may need to be
removed if the toothache
can't be treated using
these methods or the
 upper teeth may feel
like it's coming from the
sinuses, the small, air-
filled cavities behind
your cheekbones and
forehead.
The area of your jaw
close to the infected
tooth may also be sore
and tender to touch.
It's also possible for
periodontal disease to
give rise to a "dull" pain.
Periodontal disease is a
bacterial infection that
affects the soft and hard
structures that support
the teeth.
16 Food poisoning Food poisoning is an
illness caused by eating
contaminated food. It's
not usually serious and
most people get better
within a few days
without treatment.
In most cases of food
poisoning, the food is
contaminated by
bacteria, such as
salmonella or
Escherichia coli (E. coli),
or a virus, such as the
norovirus.
tooth is wedged between
another tooth and your
jaw (impacted).
The symptoms of food Food poisoning can usually
poisoning usually begin within be treated at home
one to two days of eating without seeking medical
contaminated food, although advice. Most people will
they may start at any point feel better within a few
between a few hours and days.
several weeks later. It's important to avoid
The main symptoms include: dehydration by drinking
 feeling sick (nausea) plenty of water, even if
 vomiting you can only sip it, as you
 diarrhoea, which may need to replace any fluids
contain blood or lost through vomiting and
mucus diarrhoea.
 stomach cramps and You should also:
abdominal pain  rest as much as
 a lack of energy and possible
weakness  eat when you feel
 loss of appetite up to it – sticking to
 a high temperature small, light and
(fever) non-fatty meals at
 aching muscles first (bland foods
 chills such as toast,
In most cases, these crackers, rice and
symptoms will pass in a few bananas are good
days and you will make a full choices)
recovery.  avoid alcohol,
caffeine, fizzy
drinks and spicy
and fatty foods
 because they may
make you feel
worse

17 Alzheimer's Alzheimer's disease is The first sign of Alzheimer's There's currently no cure
disease the most common type disease is usually minor for Alzheimer's disease,
of dementia. Dementia memory problems. For although medication is
is a progressive example, this could be available that can
neurological disease forgetting about recent temporarily reduce some
which affects multiple conversations or events, and symptoms or slow down
brain functions, forgetting the names of places the progression of the
including memory. and objects. condition in some people.
The exact cause of As the condition develops, Support is also available to
Alzheimer's disease is memory problems become help someone with the
unknown, although a more severe and further condition cope with
number of things are symptoms can develop, such everyday life.
thought to increase your as:
risk of developing the  confusion,
condition. These disorientation and
include: getting lost in familiar
 increasing age places
 a family history  difficulty planning or
of the condition making decisions
 previous severe  problems with speech
head injuries and language
 lifestyle factors  problems moving
and conditions around without
associated with assistance or
cardiovascular performing self-care
disease tasks
It's becoming  personality changes,
increasingly understood such as becoming
that it's very common to aggressive, demanding
have both changes of and suspicious of
Alzheimer's and vascular others
dementia together  hallucinations (seeing
(mixed dementia). or hearing things that
aren't there) and
delusions (believing
things that are untrue)
 low mood or anxiety

18 Whooping cough Whooping cough, also The first symptoms of Treatment for whooping
called pertussis, is a whooping cough are similar to cough depends on your
highly contagious those of a cold, such as a age and how long you've
bacterial infection of the runny nose, red and watery had the infection.
lungs and airways. eyes, a sore throat, and a  Children under six
It causes repeated slightly raised temperature. months who are
 coughing bouts that can Intense coughing bouts start very ill and people
last for two to three about a week later. with severe
months or more, and  The bouts usually last symptoms will
can make babies and a few minutes at a usually be admitted
young children in time and tend to be to hospital for
particular very ill. more common at treatment.
Whooping cough is night.  People diagnosed
spread in the droplets of  Coughing usually during the first
the coughs or sneezes of brings up thick mucus three weeks of
someone with the and may be followed infection may be
infection. by vomiting. prescribed
 Between coughs, you antibiotics to take
or your child may gasp at home – these
for breath – this may will help stop the
cause a "whoop" infection spreading
sound, although not to others, but may
everyone has this. not reduce the
 The strain of coughing symptoms.
can cause the face to  People who've had
become very red, and whooping cough
there may be some for more than
slight bleeding under three weeks won't
the skin or in the eyes. normally need any
 Young children can specific treatment,
sometimes briefly turn as they're no longer
blue (cyanosis) if they contagious and
have trouble breathing antibiotics are
– this often looks unlikely to help.
worse than it is and While you're recovering at
their breathing should home, it can help to get
start again quickly. plenty of rest, drink lots of
 In very young babies, fluids, clean away mucus
the cough may not be and sick from your or your
particularly noticeable, child's mouth, and take
but there may be brief painkillers such as
periods where they paracetamol or ibuprofen
stop breathing. for a fever.
The bouts will eventually start Avoid using cough
to become less severe and medicines, as they're not
less frequent over time, but it suitable for young children
may be a few months before and are unlikely to be of
they stop completely. much help.

19 Typhus Typhus is a disease Symptoms vary slightly by Antibiotics most

caused by infection the type of typhus, but there commonly used to treat
with one or more are symptoms that are typhus include:
rickettsial bacteria. associated with all three  doxycycline
 Fleas, mites (chiggers), types of typhus, such as: (Doryx,
lice, or ticks transmit it  headache Vibramycin): the
when they bite you.  fever preferred
Fleas, mites, lice, and  chills treatment
ticks are types of  rash  chloramphenicol:
invertebrate animals Symptoms of epidemic an option for
known as arthropods. typhususually appear those not
When arthropods suddenly and include: pregnant or
carrying around  severe headache breastfeeding
rickettsial bacteria bite  high fever (above  ciprofloxacin
someone, they transmit 102.2°F) (Cipro): used for
thebacteria that causes  rash that begins on adults who are
typhus. Scratching the the back or chest and unable to take
bite further opens the spreads doxycycline
skin and allows the  confusion
bacteria greater access  stupor and seeming
to the bloodstream. out of touch with
Once in the reality
bloodstream, the  low blood pressure
bacteria continue to (hypotension)
reproduce and grow.  eye sensitivity to
There are three bright lights
different types of  severe muscle pain
typhus:
 epidemic (louse-
borne) typhus
 endemic
(murine) typhus
 scrub typhus

20 Fever in children A fever is a high Common conditions that can If your child has a fever,
temperature. As a cause fevers include: it's important to keep
general rule, in children  upper respiratory tract them hydrated by giving
a temperature of over infections (RTIs) them plenty of cool water
37.5C (99.5F) is a fever.  flu to drink.
As a parent it can be  ear infections Babies should be given
extremely worrying if  roseola – a virus that plenty of liquids, such as
your child has a high causes a temperature breast milk or formula.
temperature. However, and a rash Even if your child isn't
 it's very common and
often clears up by itself
without treatment.
A quick and easy way to
find out whether your
child has a fever is to
take their temperature
using a thermometer.
 tonsillitis thirsty, try to get them to
 kidney or urinary tract drink little and often to
infections (UTIs) keep their fluid levels up.
 common childhood If the environment is
illnesses, such as warm, you could help to
chickenpox and your child to stay at a
whooping cough comfortable temperature
by covering them with a
lightweight sheet or
opening a window.
However, they should still
be appropriately dressed
for their surroundings and
sponging your child with
cool water isn't
recommended to reduce a
fever.

21 Scarlet fever Scarlet fever is a Scarlet fever usually follows a Most cases of scarlet fever
bacterial illness that sore throat or a skin infection, clear up after about a
mainly affects children. such as impetigo, caused by week without treatment.
It causes a distinctive particular strains of However, treatment is
pink-red rash. streptococcus bacteria. recommended.
The illness is caused by Initial symptoms usually Treatment reduces the
Streptococcus pyogenes include a sore throat, length of time you're
bacteria, also known as headache and a high contagious, speeds up
group A streptococcus, temperature (38.3C/101F or recovery and lowers the
which are found on the above), flushed cheeks and a risk of complications of
skin and in the throat. swollen tongue. scarlet fever.
Generally, scarlet fever A day or two later the With treatment, most
is much less common characteristic pinkish rash people recover in about
than it used to be but in appears. It usually occurs on four to five days and can
recent years there have the chest and stomach before return to nursery, school
been a number of spreading to other areas of or work 24 hours after
significant outbreaks. the body, such as the ears and starting antibiotic
For example, figures neck. treatment.
published by Public The symptoms of scarlet fever Without treatment, you'll
Health England show usually develop two to five be contagious for one to
that from September days after infection, although two weeks after symptoms
2013 to March 2014 the incubation period (the appear.
there were 2,830 cases period between exposure to Scarlet fever is usually
of scarlet fever. For the the infection and symptoms treated with a 10-day
same period in 2014/15 appearing) can be as short as course of antibiotics. This
a total of 5,746 cases one day or as long as seven is often in the form of
were recorded. The days. penicillin or amoxicillin
reason for recent The rash feels like sandpaper tablets, although liquid
increase is unclear. to touch and it may be itchy. may be used for young
It’s important to be On darker skin the rash may children.
aware of the signs and be more difficult to see For people who are allergic
 symptoms of scarlet although its rough texture to penicillin, alternative
fever so that early should be apparent antibiotics such as
treatment with erythromycin can be used
antibiotics can be given. instead.

22 Hepatitis C Hepatitis C is a liver The incubation period for A new infection with
disease caused by hepatitis C ranges from 2
HCV does not always
the hepatitis C virus weeks to 6 months.
(HCV): the virus can Following initial infection, require treatment, as the
cause both acute approximately 80% of immune response in
and chronic people do not exhibit any
some people will clear
hepatitis, ranging in symptoms. Those who are
severity from a mild acutely symptomatic may the infection. However,
illness lasting a few exhibit fever, fatigue, when HCV infection
weeks to a serious, decreased appetite, becomes chronic,
lifelong illness. nausea, vomiting,
Hepatitis C is a abdominal pain, dark urine, treatment is necessary.
major cause of liver grey-coloured faeces, joint The goal of hepatitis C
cancer. pain and jaundice treatment is cure.
The hepatitis C virus (yellowing of skin and the
is a bloodborne whites of the eyes). WHO’s updated 2018
virus: the most guidelines recommend
common modes of therapy with pan-
infection are through
genotypic direct-acting
exposure to small
quantities of blood. antivirals (DAAs). DAAs
This may happen can cure most persons
through injection with HCV infection, and
drug use, unsafe
injection practices, treatment duration is
unsafe health care, short (usually 12 to 24
transfusion of weeks), depending on
unscreened blood
and blood products, the absence or presence
and sexual practices of cirrhosis.
that lead to exposure WHO recommends
to blood.
treating all persons with
chronic HCV infection
over the age of 12 with
pan-genotypic DAAs.
Pan-genotypic DAAs
remain expensive in
many high- and upper-
middle-income
countries. However,
prices have dropped
dramatically in many
 countries (primarily low-
income and lower
middle-income
countries), due to the
introduction of generic
versions of these
medicines.

23 Eye cancer There are a number of

different types of cancer
that affect the eyes,
including:
 eye melanoma
 squamous cell
carcinoma
 lymphoma
 retinoblastoma –
a childhood
cancer
Cancer can also
sometimes develop in
the tissues surrounding
your eyeball or spread
to the eye from other
parts of the body, such
as the lungs or breasts.

24 Anthrax Anthrax is a serious  Fever and chills  Antibiotics

infectious disease  Swelling of neck or  Other drugs
caused by gram- neck glands If treatment of anthrax is
positive, rod-shaped  Sore throat delayed (usually because the
bacteria known as  Painful swallowing diagnosis is missed), death is
Bacillus anthracis.  Hoarseness more likely.
Anthrax can be found  Nausea and vomiting,
naturally in soil and especially bloody
commonly affects vomiting
domestic and wild  Diarrhea or bloody
animals around the diarrhea
world. Although it is  Headache
rare in the United  Flushing (red face)
States, people can get and red eyes
sick with anthrax if they  Stomach pain
come in contact with  Fainting
infected animals or  Swelling of abdomen
contaminated animal (stomach)
products. Anthrax can
 cause severe illness in
both humans and
animals.
25 Earache Earache is a common You can ask your
problem, particularly in pharmacist about using
children. It can be over-the-counter
worrying, but it's usually painkillers such as
only caused by a minor paracetamol or ibuprofen
infection and will often to treat the pain. Children
get better in a few days under the age of 16 should
without treatment. not take aspirin.
Earache can be a sharp, Placing a warm flannel
dull or burning ear pain against the affected ear
that comes and goes or may also help relieve the
is constant. One or both pain.
ears may be affected. Your pharmacist may also
be able to recommend
over-the-counter eardrops
for your earache, but let
them know your
symptoms and ask for
their advice first.
Eardrops or olive oil drops
should not be used if the
eardrum has burst, and
they will not help an ear
infection.
If you or your child has an
ear infection, you should
avoid putting objects in the
ear, such as cotton buds,
or getting the affected ear
wet.

26 Dry mouth It's normal to A dry mouth can sometimes There are simple measures
occasionally have a dry be caused by an underlying you can try to help keep
mouth if you’re problem or medical condition, your mouth moist. For
dehydrated or feeling such as: example, it may help to:
nervous, but a  medication – many  increase your fluid
persistently dry mouth different medications intake – take
can be a sign of an can cause a dry regular sips of cold
underlying problem. mouth, including water or an
You should see your antidepressants, unsweetened drink
dentist or GP if you have antihistamines and  suck on sugar-free
an unusually dry mouth diuretics; check the sweets or chew
(known as xerostomia) leaflet that comes sugar-free gum –
so they can try to with your medicine, or this can stimulate
determine the cause. find it in the medicines your salivary glands
 section to see if dry
mouth is listed as a
side effect
 a blocked nose –
breathing through
your mouth while you
sleep can cause it to
dry out
 diabetes – a lifelong
condition that causes
a person's blood sugar
level to become too
high
 radiotherapy to the
head and neck – this
can cause the salivary
glands to become
inflamed (mucositis)
 Sjögren's syndrome –
a condition where the
immune system
attacks and damages
the salivary glands
27 Chilblains Chilblains are small, Chilblains usually develop
itchy swellings on the several hours after exposure
skin that occur as a to the cold. They typically
reaction to cold cause a burning and itching
temperatures. sensation in the affected
They most often affect areas, which can become
the body's extremities, more intense if you go into a
such as the toes, fingers, warm room.
heels, ears and nose. The affected skin may also
Chilblains can be swell and turn red or dark
uncomfortable, but blue.
rarely cause any In severe cases, the surface of
permanent damage. the skin may break and sores
They normally heal or blisters can develop.
within a few weeks if It's important not to scratch
further exposure to the the skin as it can break easily
cold is avoided. and become infected.
to produce more
saliva
 suck on ice cubes –
the ice will melt
slowly and moisten
your mouth
 avoid alcohol
(including alcohol-
based
mouthwashes),
caffeine and
smoking – these
can all make a dry
mouth worse
Chilblains often get better
on their own after a week
or two without treatment.
It may help to use a
soothing lotion, such as
calamine or witch hazel, to
relieve itching. Your
pharmacist may also be
able to recommend a
suitable product.
If your chilblains are
severe and keep returning,
speak to your GP. They
may recommend taking a
daily tablet or capsule of a
medication called
nifedipine. This works by
relaxing the blood vessels,
improving your circulation.
Nifedipine can be used to
help existing chilblains
heal, or can be taken
during the winter to stop
them developing.
28 Conjunctivitis Conjunctivitis, an These symptoms may last a Because pink eye is highly
(“pink eye“) inflammation of the few hours to several weeks: contagious, early diagnosis
transparent membrane redness, itching, tearing, is important. Bacterial
(conjunctiva) that lines burning sensation, pus-like cases can be cured with
your eyelids and part of discharge and/or crusting of antibiotic eye drops, viral
your eyeballs, has the eyelids. Because conjunctivitis clears up on
several possible causes. conjunctivitis causes its own, and allergic
It could be a bacterial or inflammation of the small reactions can be treated
viral infection, an blood vessels in the with various types of eye
allergic reaction to conjunctiva to become more drops. Here are some
pollen or animal dander, prominent, the whites of your general tips:
or a result of chemical eyes will appear pink or red.  Wash your hands
irritants (smoke, When you wake you are likely frequently to
chlorine, lens solution, to feel that your eyelids are prevent spreading
etc.). pasted shut, and your vision an existing
may not be as clear as usual. infection to your
other eye, and to
other people.

 Don’t rub your
eyes.

 Use a cool wet
washcloth to soak
off any crusting.

 Use a warm or cool
compress to reduce
discomfort.

 Discard eye make-
up because it may
cause future
infection.

 Wash any clothing
that may be
contaminated,
including towels
and pillowcases.
Try to use clean
towels and
pillowcases
everyday.

 Avoid wearing
contact lenses and
discard current

29 Headaches Everyone suffers the
occasional mild
headache, but if you
experience debilitating
pain and/or abnormally
frequent headaches, you
probably want to find
relief. There are
countless causes of
headaches, which differ
for each person, so
you’ll have to do some
experimenting to figure
out the cause of your
pain. Fortunately, the
vast majority of
headaches are primary
headaches, not the
result of underlying
medical conditions. The
three most common
types are cluster,
tension-type, and
migraine.
A cluster headache
affects a specific point of
the head, often the eye,
and is characterized by
lenses.

 If eye drops are
prescribed, place
drop in pocket
formed by pulling
down lower lid.
Make sure you
don’t touch the
bottle to the eye in
order to prevent
contamination.

 If the infection
does not improve
in 2 or 3 days,
make an
appointment for
re-evaluation.
Just as the causes vary for  Ice pack held over
each headache sufferer, so do the eyes or
the symptoms and severity of forehead
pain. Health professionals can 
often diagnose the type of  Heating pad set on
headache you suffer based on low or hot shower
your symptoms. to relax tense neck
Symptoms of a migraine: and shoulder
 pulsing or throbbing muscles
quality 
  Sleep, or at least
 begins with intense resting in a dark
pain on one side of the room
head, which 
eventually spreads  Taking breaks from
 stressful situations
 felt on one or both 
sides of the head  Regular exercise to
 increase endorphin
 lasts several hours levels and relax
 muscles. Even if
 severe enough to you already have a
interfere with routine headache,
activities exercising may
 relieve the pain.
 may be accompanied However, intense
by nausea or vomiting exercise may bring
 on a headache.
 sharp, piercing pain.  sometimes preceded 
Migraine and tension- by visual changes,  Occasional use of
type headaches are far such as an aura of over-the-counter
more common. zigzag lines or flashes medicines such as
“Tension“ headaches are of light acetaminophen,
now called “tension-  ibuprofen, or
type“ headaches  light and noise can aspirin can relieve
because pain is not only make the headache both migraine and
caused by stress, but worse, while sleep tension headaches.
also poor posture, tends to relieve *
depression, and even symptoms 
sexual activity. In fact, Symptoms of a tension-type  Prescription drugs
recent studies have headache: for severe
shown a connection  constant, dull ache headaches
between low serotonin  * Overuse of pain
levels and so-called  felt on both sides of medicine can actually
“tension“ headaches. the head result in more frequent
 headaches. Most pain-
 a feeling of squeezing relieving medicines used to
or pressure treat headaches can cause
 “analgesic rebound
 does not usually headaches“ if used too
interfere with routine often.
activities

 lasts from 30 minutes
to a few days

30 Blisters Blisters are small Most blisters heal naturally

pockets of fluid that after three to seven days
usually form in the and don't require medical
upper layers of skin after attention.
it's been damaged. It's important to avoid
Blisters can develop bursting the blister,
anywhere on the body because this could lead to
but are most common an infection or slow down
on the hands and feet. the healing process.
Fluid collects under the If the blister does burst,
damaged skin, don't peel off the dead
cushioning the tissue skin. Instead, allow the
underneath. This fluid inside the blister to
protects the tissue from drain and cover the area
further damage and with a dry, sterile dressing
allows it to heal. to protect it from infection
Most blisters are filled until it heals.
with a clear fluid
(serum), but may be
filled with blood (blood
 blisters) or pus if they
become inflamed or
infected.

31 legionellosis The bacterium L. Legionellosis is a generic Legionnaires’ disease

pneumophila was requires treatment with
term describing the
first identified in antibiotics (medicines
1977, as the cause of pneumonic and non-
that kill bacteria in the
an outbreak of pneumonic forms of body), and most cases of
severe pneumonia in
infection with Legionella. this illness can be treated
a convention centre
in the USA in 1976. The non-pneumonic form successfully. Healthy
The most common (Pontiac disease) is an people usually get better
form of transmission acute, self-limiting
after being sick with
of Legionella is Legionnaires’ disease, but
inhalation of influenza-like illness usually
they often need care in
contaminated lasting 2–5 days. The the hospital.
aerosols produced in incubation period is from a
conjunction with
water sprays, jets or few and up to 48 hours.
mists. Infection can The main symptoms are
also occur by fever, chills, headache,
aspiration of
malaise and muscle pain
contaminated water
or ice, particularly in (myalgia). No deaths are
susceptible hospital associated with this type of
patients. infection.
Legionnaires’
disease has an Legionnaires’ disease, the
incubation period of pneumonic form, has an
2 to 10 days (but up incubation period of 2 to 10
to 16 days has been
recorded in some days (but up to 16 days has
outbreaks). been recorded in some
Death occurs outbreaks). Initially,
through progressive
symptoms are fever, loss of
pneumonia with
respiratory failure appetite, headache,
and/or shock and malaise and lethargy.
multi-organ failure.
Some patients may also
have muscle pain,
diarrhoea and confusion.

32 sty A sty is a pimple-like The symptoms of a sty are The best home treatment
bump that forms on or  foreign body sensation to get rid of a stye is to
in the lower or upper in the eye (particularly apply a warm water
eyelid as the result of a with blinking), compress as often as
blocked gland. The word  eye pressure, and possible. It is important to
"sty" can also be spelled  a painful red bump, remember that a chalazion
"stye." though often they are may take months to
 painless. resolve completely.
There may also be blurred
vision if thick sebum or pus
from within the sty spreads
over the eye's surface.
If chronic meibomian gland
dysfunction is present, dry
eye symptoms are common.
This is because the
meibomian glands secrete an
oil onto the surface of the eye
to prevent the water layer of
tears from evaporating too
rapidly from the eye's surface
between blinks. Therefore,
poorly functioning meibomian
glands can lead to dry eye.
Signs of a sty include
 presence of a lump or
bump (like a pimple)
on the edge of the
eyelid,
 redness of the skin
overlying the eyelid
bump, and
 swelling and puffy
appearance of the
eyelid.

33 common cold A cold is a mild viral The main symptoms of a cold There's no cure for a cold,
infection of the nose, include: but you can look after
throat, sinuses and  a sore throat yourself at home by:
upper airways. It's very  a blocked or runny  resting, drinking
common and usually nose plenty of fluids and
clears up on its own  sneezing eating healthily
within a week or two.  a cough  taking over-the-
More severe counter painkillers,
symptoms, including a such as
high temperature paracetamol or
ibuprofen, to
(fever), headache and
reduce any fever or
aching muscles can also
discomfort
occur, although these
 using decongestant
tend to be associated
sprays or tablets to
more with flu. relieve a blocked
nose
 trying remedies
such as gargling salt
 water and sucking
on menthol sweets

34 skin cancer Most skin cancers are Signs and symptoms of basal There are several effective
locally destructive cell carcinomas include: means of treating skin
cancerous (malignant)  Appearance of a shiny cancer. The choice of
growth of the skin. They pink, red, pearly, or therapy depends on the
originate from the cells translucent bump location and size of the
of the epidermis, the  Pink skin growths or tumor, the microscopic
superficial layer of the lesions with raised characteristics of the
skin. Unlike cutaneous borders that are cancer, and the general
malignant melanoma, crusted in the center health of the patient.
the vast majority of  A raised reddish patch  Topical
these sorts of skin of skin that may crust medications: In the
cancers rarely spread to or itch, but is usually case of superficial
other parts of the body not painful basal cell
(metastasize) and  A white, yellow, or carcinomas, some
become life-threatening. waxy area with a creams, gels, and
poorly defined border solutions can be
that may resemble a used, including
scar imiquimod
Signs and symptoms of (Aldara), which
squamous cell carcinomas works by
include: stimulating the
 Persistent, scaly red body's immune
patches with irregular system causing it to
borders that may produce interferon
bleed easily which attacks the
 Open sore that does cancer, and
not go away for weeks fluorouracil (5-FU),
 A raised growth with a a chemotherapy
rough surface that is drug. Some
indented in the middle patients do not
 A wart-like growth experience any side
effects of these
topical treatments,
but others may
have redness,
inflammation, and
irritation. A
drawback of topical
medications is that
there is no tissue
available to
examine to
determine if a
tumor is removed
completely.
 Destruction by
 electrodessication
and curettage
(EDC): The tumor
area is numbed
with a local
anesthetic and is
repeatedly scraped
with a sharp
instrument
(curette), and the
edge is then
cauterized with an
electric needle. The
advantage of this
method is that it is
fast, easy, and
relatively
inexpensive. The
disadvantages are
that the scar is
often somewhat
unsightly, and the
recurrence rate is
as high as 15%.
 Surgical excision:
The area around
the tumor is
numbed with a
local anesthetic. A
football-shaped
portion of tissue
including the tumor
is then removed
and then the
wound edges are
closed with
sutures. For very
big tumors, skin
grafts or flaps are
needed to close the
defect. The
advantages of this
form of treatment
are that there is a
greater than 90%
cure rate, the
surgical specimen
can be examined to
be sure that the
 whole tumor is
successfully
removed, and the
scar produced is
usually more
cosmetically
acceptable than
that of the EDC
procedure. It is a
more complicated
procedure and is
more expensive
than EDC.
 Mohs micrographic
surgery: The site is
locally anesthetized
and the surgeon
removes the visible
tumor with a small
margin of normal
tissue. The tissue is
immediately
evaluated under a
microscope and
areas that
demonstrate
residual
microscopic tumor
involvement are re-
excised and the
margins are re-
examined. This
cycle continues
until no further
tumor is seen. This
more complicated
and expensive
option is the
treatment of choice
for tumors where
normal tissue
preservation is
vital, where the
tumor margins are
poorly defined, in
tumors that have
been previously
treated and have
recurred, and in
 certain high-risk
tumors.
 Radiation therapy:
Ten to fifteen
treatment sessions
deliver a high dose
of radiation to the
tumor and a small
surrounding skin
area. This form of
treatment is useful
in those who are
not candidates for
any surgical
procedure. The
advantage of
radiation therapy is
that there is no
cutting involved.
The disadvantages
of this expensive
alternative are that
the treated area
cannot be tested to
be sure the whole
tumor is gone and
radiation scars look
worse over time. It
is, for this reason, it
is usually reserved
for elderly patients.
 Other types of
treatments for skin
cancers include
cryosurgery where
tissue is destroyed
by freezing,
photodynamic
therapy (PDT) in
which medication
and blue light are
used to destroy the
cancerous tissue,
laser surgery to
vaporize (ablate)
the skin's top layer
and destroy
lesions, and oral
medications
 vismodegib
(Erivedge) and
sonidegib
(Odomzo).

35 Crohn's disease Crohn's disease is a long- Common symptoms can
term condition that include:
causes inflammation of
the lining of the
digestive system.
Inflammation can affect
any part of the digestive
system, from the mouth
to the back passage, but
most commonly occurs
in the last section of the
small intestine (ileum) or
the large intestine
(colon).
People with Crohn's
disease sometimes go
for long periods
without symptoms or
with very mild
symptoms. This is
known as remission.
Remission can be
followed by periods
where symptoms flare
up and become
particularly
troublesome.
 diarrhoea
 abdominal pain
 fatigue (extreme
tiredness)
 unintended weight
loss
 blood and mucus in
your faeces (stools)
There's currently no cure
for Crohn's disease, so the
aim of treatment is to stop
the inflammatory process,
relieve symptoms (induce
and maintain remission)
and avoid surgery
wherever possible.
The first treatment offered
to reduce symptoms is
usually steroid medication
(corticosteroids). If this
doesn't help, medication
to suppress the immune
system
(immunosuppressants)
and medication to reduce
inflammation may be used.
In some cases, surgery
may be needed to remove
the inflamed section of
intestine.
Once your symptoms are
under control (in
remission), further
medication may be needed
to help maintain this.

Medical information
No.
1
Dental health
We all know how important flossing is, and yet we don't all include it as part of our oral health
routine. Flossing is just as important as brushing and is one of the best ways to remove plaque from
between your teeth.
According to National Smile Month one third of people have never used dental floss and less than a
quarter of adults use dental floss regularly. Flossing should begin early in life and should be carried
out daily. Dental floss when used correctly removes any left over food and plaque from the teeth
preventing gum disease.
How to use dental floss
Dental floss comes in many different forms and product types. It's a thin thread, made of either
 plastic or nylon. Varieties include waxed, unwaxed and flavoured floss, normally mint. Along with
traditional floss that is dispensed from a container in a length of your choosing you can also get floss
picks. Floss picks have already got the floss threaded onto a u-shaped stick or plastic holder, taking
some of the fiddly elements out of flossing. All of these types have their own unique benefits, ask
your dentist or hygienist which is best for your needs and they will be able to advise.
How to use dental floss
Be thorough but gentle when using dental floss, make sure to reach the gumline but don't force it
down too far or too severely as this can damage your gums. Always follow flossing advice given to
you by your dentist, this includes how often you should use it. We have listed below all the
information you need to start flossing correctly today.
 Pull out a section of floss about 18 inches long, roughly the size of a long desk ruler. Take
your middle finger on each hand and wrap the floss around them leaving a length of taut
floss in the middle
 Use your thumb and forefinger of each hand, leaving about 1-2 inches length in the middle,
pull the length so it's tight and can be inserted in the gaps between your teeth
 Without any force move the floss up and down against the sides of the teeth and under the
gumline. Remember to be careful but thorough around the gumline
 Using a fresh section of floss for each tooth to avoid moving plaque around the mouth,
repeat the process of flossing on your next tooth until each tooth has been flossed
 Don't forget the teeth at the back of your mouth, the exposed surfaces of these teeth should
also be flossed
Bleeding gums when you floss
Your dentist should advise you that the first couple of times you floss your gums may bleed a little.
This is because your gums may be tender and aren't used to such a thorough clean, now you are
getting rid of any plaque build-up. Stick with the flossing and include it once a day in your oral health
routine and the bleeding and sensitivity should subside, if it doesn't then you should seek advice
from your dentist or hygienist.
If you are finding flossing too difficult or painful to continue with you should speak with your dentist
about your available options. They may be able to recommend a more suitable floss or another way
of cleaning between your teeth such as interdental brushes. Floss, in its many varieties, is available
from supermarkets, pharmacies and even from your dentist.
Brushing
Getting into a flossing routine is one of the best things you can do for your teeth in addition to
brushing twice a day.

2. Acne
Acne is a common skin condition. It causes bumps on the skin known as pimples. Pimples
form when the tiny hair follicles in your skin are blocked by dead skin and oil. This causes
bacteria to grow and irritate the skin. Pimples commonly appear on the face. However,
they can appear on the back, chest, arms, and neck. Acne usually starts in your early teen
years. It can last into or begin in adulthood. Both boys and girls get it.

 Small, raised, red spots.

 White, fluid-filled tips on the spots.
  Blackheads (looks like pepper in your pores).
 Solid, tender lumps under the skin.

3. Alcohol abuse
Alcohol abuse, also called alcohol misuse is a serious problem. It is a pattern of drinking
too much alcohol too often. It interferes with your daily life. You may be suffering from
alcohol abuse if you drink too much alcohol at one time or too often throughout the
week. It also is a problem if you can’t stop drinking and it harms your relationships. It can
cause you to be unable to function at work and in other areas of your life.
You are abusing alcohol when:
 You drink 7 drinks per week or more than 3 drinks per occasion (for women).
 You drink more than 14 drinks per week or more than 4 drinks per occasion (for
men).
 You have more than 7 drinks per week or more than 3 drinks per occasion (for
men and women older than 65).
 Consuming these amounts of alcohol harms your health, relationships, work,
and/or causes legal problems.

4 Allergic conjunctivitis
Allergic conjunctivitis is a common cause of “pink eye.” It occurs when the clear, thin,
membrane (conjunctiva) that covers your eyeball becomes swollen and irritated.

Some common allergens include:

 Pollen from trees, grass, and ragweed.
 Animal saliva or dander (tiny particles of skin shed by animals).
 Perfumes.
 Cosmetics (makeup).
 Skin medicines.
 Air pollution.
 Smoke.

5
Smart Food Choices for Healthy Aging
You may need to make some changes in your food and beverage choices to achieve a healthy eating
pattern. It’s easier than you think!
 A healthy eating pattern is not a rigid prescription. Rather, it is a framework that lets you enjoy food
that meets your personal preferences and fits your budget. To encourage healthy eating patterns,
the Dietary Guidelines suggests that you:
1. Follow a healthy eating pattern across the lifespan. All food and beverage choices matter.
Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain
a healthy body weight, meet nutrient needs, and lessen the risk for chronic disease.
2. Focus on variety, nutrient density, and amount. To meet nutrient needs within calorie
limits, choose a variety of nutrient-dense foods across and within all food groups in
recommended amounts.
3. Limit calories from added sugars and saturated fats, and reduce sodium intake. Cut back on
foods and beverages that are high in added sugars, saturated fats, and sodium. Aim for
amounts that fit within healthy eating patterns.
4. Shift to healthier food and beverage choices. Choose nutrient-dense foods and beverages
across and within all food groups in place of less healthy choices. Choose foods you like to
make these shifts easier to maintain.
5. Support healthy eating patterns for all. Everyone has a role in helping to create and support
healthy eating patterns, at home, school, and work and in communities.

6
Alcohol

The risks of drinking too much

Alcohol is a toxic chemical which can have a wide range of adverse effects on almost every part of
your body.
The effects of alcohol can vary.
Sometimes you may feel the effects almost instantly or after you'ver had a few drinks.
What affects alcohol's impact
Many things can affect the impact alcohol has on you, including what you have eaten, what mood
you are in and
how much sleep you've had.
This is an important reason for you to know and understand how many units you have consumed.
Don't risk your health
Drinking more than the low-risk guidelines on a regular basis increases your risk of serious health
conditions.
Regular or frequent drinking means having alcohol most weeks and the more you drink the higher
the risks to your health.
Serious risks include:
 cancers of the mouth, upper throat, larynx, oesophaghus, breast, liver and bowel.
 stroke
 heart disease
 liver disease
 damage to the nervous system
 pancreatitis
 mental health problems
Binge drinking
Drinking a lot of alcohol in a single occasion, sometimes called ‘binge drinking’, is especially harmful
and can increase your risk of:
 accidents resulting in injury or death
  misjudging risky situations
 losing your inhibitions and increased risk-taking/making decisions you usually would not
 becoming a victim or a perpetrator of crime
 self-harm and suicide
To reduce your health risks on any single occasion:
 limit how much you drink
 drink more slowly
 drink with food
 alternate alcoholic drinks with water or non-alcoholic drinks
Social issues
Drinking too much alcohol could also contribute to social problems such as unemployment,
relationship breakdowns, domestic abuse and homelessness.

7
Tobacco
Tobacco smoke contains:
 nicotine
 carbon monoxide
 tar
 toxic chemicals such as benzene, arsenic and formaldehyde
Nicotine
Although nicotine is a very addictive substance it's relatively harmless. It's the carbon monoxide, tar
and other toxic chemicals in tobacco smoke that will cause serious damage to your health. Clean
forms of nicotine are licensed to help smokers quit. These are much safer than smoking as they're
nicotine only, don't have other additives or toxic chemicals, and are proven to be safe and effective.
Carbon monoxide
Carbon monoxide is a poisonous gas which takes the place of oxygen in your blood. This forces your
heart to work much harder and stops your lungs from working properly. Your cells and tissues will
be prevented from getting the oxygen they need. This can lead to heart disease and stroke. If you
smoke during your pregnancy, carbon monoxide prevents your baby getting the oxygen it needs.
Tar
Tar is the sticky brown substance that stains smokers' teeth and fingers yellow-brown. It contains
cancer causing particles (carcinogens). Tar damages your lungs by narrowing the small tubes
(bronchioles) that absorb oxygen. It also damages the small hairs (cilia) that help protect your lungs
from dirt and infection. This can lead to a range of lung diseases such as chronic obstructive
pulmonary disease (COPD) and emphysema.
Using tobacco
Tobacco comes in many forms including:
 cigarettes
 rolling tobacco
 illicit tobacco
Cigarettes
Cigarettes are the most common type of tobacco product in Scotland. Cigarette tobacco products
contain:
 two main tobacco leaf varieties
 fillers including stems and other waste products
 water
  flavourings
 additives
The additives are used to make the cigarette more palatable to the user. 600 different additives are
currently permitted for use in cigarettes in the UK, such as:
 moisturisers to prolong shelf life
 sugars to enable the smoke to be more easily inhaled
 flavourings such as chocolate, vanilla and menthol
These additives can be toxic when combined with other substances or when burned during smoking.
Rolling tobacco
Many people who smoke roll-ups don't use a filter, so they also end up inhaling more tar and
nicotine and therefore become highly addicted and dependent on their habit.
Roll-ups are at least as harmful for you as ordinary cigarettes, and can cause the same health risks.
Studies have suggested that people who smoke roll-ups also have an increased risk of cancer of the
mouth, oesophagus, pharynx and larynx compared to smokers of manufactured cigarettes.
Illicit tobacco
This is tobacco that has been smuggled into Scotland illegally. This can be packaged to look like your
regular brand. It can be either rolling tobacco or cigarettes. Whilst it may be cheaper than legal
tobacco, it comes at a cost.
The ingredients of illicit tobacco aren't known or regulated. Whilst no tobacco is safe, illicit tobacco
could contain higher levels of harmful chemicals.
If you've used illicit tobacco before you can save even more money, without risking your health, by
stopping smoking completely.

Benefits of stopping
Stopping smoking increases your chances of living a longer and healthier life. You'll feel the benefits
from the day you quit. Not only will you to start to save money but you'll experience a reduced risk
of:
 heart disease, stroke, vascular disease and respiratory disease
 a whole range of cancers
Your life expectancy will be greater, and you'll notice an improvement in the symptoms of smoking
related diseases such as Chronic Obstructive Pulmonary Disease (COPD).
Stopping smoking can help you live life to the full. You'll feel fitter and more able to take part in
physical activity. This in turn can benefit your mental health and wellbeing.

8 Allergic rhinitis

Allergic rhinitis is the medical term for hay fever or allergies. You have an allergy when
your body overreacts to things that don’t cause problems for most people. These things
are called allergens. Your body’s overreaction to the allergens is what causes symptoms.
There are 2 forms of allergic rhinitis:
 Seasonal (hay fever): Caused by an allergy to pollen and/or mold spores in the air.
Pollen is the fine powder that comes from flowering plants. It can be carried
through the air and is easily inhaled. Symptoms are seasonal and usually occur in
 spring, late summer, and fall.
 Perennial: Caused by other allergens such as dust mites, pet hair or dander, or
mold. Symptoms occur year-round.

symptoms can vary, depending on the severity of your allergies. Symptoms can include:
 Sneezing.
 Coughing.
 Itching (mostly eyes, nose, mouth, throat and skin).
 Runny nose.
 Stuffy nose.
 Headache.
 Pressure in the nose and cheeks.
 Ear fullness and popping.
 Sore throat.
 Watery, red, or swollen eyes.
 Dark circles under your eyes.
 Trouble smelling.
 Hives.

9
mental wellbeing
Evidence suggests there are five steps we can all take to improve our mental wellbeing.
If you give them a try, you may feel happier, more positive and able to get the most from life.
Five steps to mental wellbeing
Below are five things that, according to research, can really help to boost our mental wellbeing:
 connect – connect with the people around you: your family, friends, colleagues and
neighbours. Spend time developing these relationships.
 be active – you don't have to go to the gym. Take a walk, go cycling or play a game of
football. Find an activity that you enjoy and make it a part of your life. keep learning –
learning new skills can give you a sense of achievement and a new confidence. So why not
sign up for that cooking course, start learning to play a musical instrument, or figure out how
to fix your bike?
 give to others – even the smallest act can count, whether it's a smile, a thank you or a kind
word. Larger acts, such as volunteering at your local community centre, can improve your
mental wellbeing and help you build new social networks.
 be mindful – be more aware of the present moment, including your thoughts and feelings,
 your body and the world around you. Some people call this awareness "mindfulness". It can
positively change the way you feel about life and how you approach challenges.

Low mood and depression

Difficult events and experiences can leave us in low spirits or cause depression.
It could be relationship problems, bereavement, sleep problems, stress at work, bullying, chronic
illness or pain.
Sometimes it's possible to feel down without there being an obvious reason.
If you are experiencing low mood, depression or anxiety call Breathing Space on 0800 83 85 87.
What's the difference between low mood and depression?
A general low mood can include:
 sadness
 feeling anxious or panicky
 worry
 tiredness
 low self-esteem
 frustration
 anger
However, a low mood will tend to lift after a few days or weeks.
Making some small changes in your life, such as resolving a difficult situation, talking about your
problems or getting more sleep, can usually improve your mood.
A low mood that doesn't go away can be a sign of depression. Symptoms of depression can include
the following:
 low mood lasting two weeks or more
 not getting any enjoyment out of life
 feeling hopeless
 feeling tired or lacking energy
 not being able to concentrate on everyday things like reading the paper or watching
television
 comfort eating or losing your appetite
 sleeping more than usual or being unable to sleep
 having suicidal thoughts or thoughts about harming yourself
Depression can also come on at specific points in your life, such as the winter months (seasonal
affective disorder, or SAD) and after the birth of a child (postnatal depression).
When to get help for low mood or depression
Whatever the cause, if negative feelings don't go away, are too much for you to cope with, or are
stopping you from carrying on with your normal life, you may need to make some changes and get
some extra support.
What types of help are available?
If you are diagnosed with depression, your GP will discuss all of the available treatment options with
you, including self-help, talking therapies and antidepressants.
Self-help
Whether you have depression or just find yourself feeling down for a while, it could be worth trying
some self-help techniques.
Life changes, such as getting a regular good night's sleep, keeping to a healthy diet, reducing your
alcohol intake and getting regular exercise, can help you feel more in control and more able to cope.
Self-help techniques can include activities such as meditation, breathing exercises and learning ways
to think about problems differently. Tools such as self-help books and online counselling can be very
 effective.
Anxiety and panic

How to deal with panic attacks

A panic attack is a feeling of sudden and intense anxiety.
Panic attacks can also have physical symptoms, including shaking, feeling disorientated,
nausea, rapid, irregular heartbeats, dry mouth, breathlessness, sweating and dizziness.
The symptoms of a panic attack are not dangerous, but can be very frightening.
They can make you feel as though you are having a heart attack, or that you are going to
collapse or even die.
Most panic attacks last somewhere from five minutes to half an hour.
How to handle a panic attack
Professor Paul Salkovskis, Professor of Clinical Psychology and Applied Science at the
University of Bath, says it's important not to let your fear of panic attacks control you.
"Panic attacks always pass and the symptoms are not a sign of anything harmful
happening," he says. "Tell yourself that the symptoms you're experiencing are caused by
anxiety."
He says don't look for distractions. "Ride out the attack. Try to keep doing things. If
possible, it's important to try to remain in the situation until the anxiety has subsided."
"Confront your fear. If you don't run away from it, you're giving yourself a chance to
discover that nothing's going to happen."
As the anxiety begins to pass, start to focus on your surroundings and continue to do
what you were doing before.
"If you’re having a short, sudden panic attack, it can be helpful to have someone with
you, reassuring you that it will pass and the symptoms are nothing to worry about," says
Professor Salkovskis.
Breathing exercise for panic attacks
If you’re breathing quickly during a panic attack, doing a breathing exercise can ease your
other symptoms. Try this:
 breathe in as slowly, deeply and gently as you can, through your nose
 breathe out slowly, deeply and gently through your mouth
 some people find it helpful to count steadily from one to five on each in-breath
and each out-breath
 close your eyes and focus on your breathing
You should start to feel better in a few minutes. You may feel tired afterwards

10
Know Your Food Groups
A healthy eating pattern includes a variety of nutrient-dense foods across and within all the food
groups: vegetables, fruits, grains, protein foods, dairy products, and oils. It also allows for a treat
now and then—what the Dietary Guidelines calls "calories for other uses." Each of the food groups
is described below, with equivalent examples. The Guidelines present three USDA Food Patterns
 with recommended amounts for how much you should consume from each food group per day.
Specific recommendations vary depending on your age, sex, and level of physical activity.

Vegetables
Vegetables come in a wide variety of colors, flavors, and textures. They’re also an important source
of vitamins, minerals, and fiber. Dark green vegetables include broccoli, collard greens, spinach, and
kale. Some red and orange vegetables are acorn squash, carrots, pumpkin, tomato, and sweet
potato.
Examples of starchy vegetables are foods like corn, green peas, and white potatoes. Other
vegetables include eggplant, beets, cauliflower, Brussels sprouts, celery, artichokes, green beans,
and onions. Beans and peas (legumes) include black beans, garbanzo beans (chickpeas), kidney
beans, soybeans, and tofu. Legumes can also be counted in the protein foods group.
Fruits
Older Americans generally do not eat enough fruit. Yet, there are so many choices—citrus fruits like
oranges and grapefruits; different kinds of berries; fruits that grow on trees such as apricots,
cherries, peaches, and mangoes; and others like figs, raisins, and pineapples.
Many fruits provide extra fiber that helps keep your digestive system moving. Just make sure you
wash all fruits thoroughly before eating. Whole fruits are best, but 100% fruit juice also counts as
fruit. When purchasing frozen, canned, or dried fruit, choose options that are lowest in added
sugars.
Dairy
Most adults do not get enough dairy in their diet. For your heart health, pick from the many low-fat
or fat-free choices in the dairy group. Choosing fat-free or low-fat milk and yogurt, as well as lower-
fat cheese, gives you important vitamins and minerals, with less fat.
Oils
Oils are high in calories, but they are also an important source of nutrients like vitamin E. For adults
age 51 and older, the daily allowance for women is 5 teaspoons of oil and, for men, 6 teaspoons.
If possible, use oils instead of solid fats, like butter, when cooking. Measuring your daily oils can be
tricky—knowing what you add while cooking or baking is one thing. But, oil is naturally part of some
foods.

11 anal fistula
An anal fistula is an abnormal tube-like connection that forms between the inside of the
anus (at the anal gland) and the skin right outside the anus. Think of it as a tunnel.
Anal Fistula Treatment

Most anal abscesses can be drained in a doctor’s office under local anesthesia. If a fistula
has developed, the doctor will need to surgically remove it.
After the fistula has been removed, you’ll need to take antibiotics. You may want to wear
a pad over your anal area until you’re healed. Sitz baths can help you feel better. Fill the
tub with enough lukewarm water to cover your hips and buttocks. Don’t use soap or
bubbles or any other products unless prescribed by your doctor. Relax in the sitz bath 3
 to 4 times a day for about 10 minutes at a time.
Living with an anal fistula
Most fistulas respond well to surgical treatment. If your fistula surgery is more
complicated due to the location of it, your doctor may need to cut a small portion of your
sphincter muscle during surgery. Your doctor will make every attempt to prevent muscle
damage. There is a chance, though, that it may be harder for you to control your bowels
after surgery. If the doctor believes this is likely, he or she may suggest other techniques
or treatments for dealing with your fistula.
12
Serving and Portion Sizes: How Much Should I Eat?
Eating a variety of foods from each food group will help you get the nutrients you need.
The Dietary Guidelines describe three USDA Food Patterns, each of which includes slight variations
in amounts recommended from different food groups. For example, people 50 or older following
the Healthy U.S.-Style Eating Pattern choose foods every day from the following:
 Vegetables — 2 to 3 cups
 Fruits — 1½ to 2 cups
 Grains — 5 to 8 ounces
 Dairy — 3 cups (fat-free or low-fat)
 Protein foods — 5 to 6½ ounces
 Oils — 5 to 7 teaspoons
Does this mean you have to measure or weigh everything you eat? Not really. Some people find it
helps to measure things carefully at first, but once you get used to your new eating plan, strict
measuring probably won’t be necessary. But, what exactly is a serving? And is that different from a
portion?
A “serving size” is a standard amount of a food, such as a cup or an ounce. Serving sizes can help
you when choosing foods and when comparing like items while shopping, but they are not
recommendations for how much of a certain food to eat.
The term “portion” means how much of a food you are served or how much you eat. A portion size
can vary from meal to meal. For example, at home you may serve yourself two small pancakes in
one portion, but at a restaurant, you may get a large stack of pancakes as one portion. A portion size
may also be bigger than a serving size. For example, the serving size on the Nutrition Facts label for
your favorite cereal may be 1 cup, but you may pour yourself 1½ cups in a bowl.
Portion size can be a problem when eating out. To keep your portion sizes under control, try
ordering one or two small appetizers instead of a large entrée. Or, you could share an entrée with a
friend, or eat just half and ask for a take-out container for the rest. Put the leftovers in the fridge as
soon as possible. Then enjoy them the next day for lunch or dinner.
13
Vitamins and Minerals for Older Adults
Vitamins and minerals are two of the main types of nutrients that your body needs to survive and
stay healthy. Find information on some of the essential vitamins recommended for older adults and
how to get the recommended amount within your diet.
Vitamins help your body grow and work the way it should. There are 13 essential vitamins —
vitamins A, C, D, E, K, and the B vitamins (thiamine, riboflavin, niacin, pantothenic acid, biotin, B 6,
B12, and folate).
Vitamins have different jobs to help keep the body working properly. Some vitamins help you resist
infections and keep your nerves healthy, while others may help your body get energy from food or
help your blood clot properly. By following the Dietary Guidelines, you will get enough of most of
these vitamins from food.
Like vitamins, minerals also help your body function. Minerals are elements that our bodies need to
function that can be found on the earth and in foods. Some minerals, like iodine and fluoride, are
only needed in very small quantities. Others, such as calcium, magnesium, and potassium, are
needed in larger amounts. As with vitamins, if you eat a varied diet, you will probably get enough of
most minerals.
How Can I Get the Vitamins and Minerals I Need?
It is usually better to get the nutrients you need from food, rather than a pill. That’s because
nutrient-dense foods contain other things that are good for you, like fiber.
Most older people can get all the nutrients they need from foods. But if you aren’t sure, talk with
your doctor or a registered dietitian to find out if you are missing any important vitamins or
minerals. He or she may recommend a vitamin or dietary supplement.
If you do need to supplement your diet, look for a supplement that contains the vitamin or mineral
you need without a lot of other unnecessary ingredients. Read the label to make sure the dose is
not too large. Avoid supplements with mega-doses. Too much of some vitamins and minerals can be
harmful, and you might be paying for supplements you don’t need. Your doctor or pharmacist can
recommend brands that fit your needs.
Measurements for Vitamins and Minerals
Vitamins and minerals are measured in a variety of ways. The most common are:
 mg – milligram (a milligram is one thousandth of a gram)

 mcg – microgram (a microgram is one millionth of a gram. 1,000 micrograms is equal to one
milligram)

 IU – international unit (the conversion of milligrams and micrograms into IU depends on the
type of vitamin or drug)
Recommended Sodium Intake for Older Adults
Sodium is another important mineral. In most Americans’ diets, sodium primarily comes from salt
(sodium chloride). Whenever you add salt to your food, you're adding sodium. But the Dietary
Guidelines shows that most of the sodium we eat doesn’t come from our saltshakers — it’s added to
many foods during processing or preparation. We all need some sodium, but too much over time
can lead to high blood pressure, which can raise your risk of having a heart attack or stroke.
How much sodium is okay? People 51 and older should reduce their sodium intake to 2,300 mg each
day. That is about one teaspoon of salt and includes sodium added during manufacturing or cooking
as well as at the table when eating. If you have high blood pressure or prehypertension, limiting
sodium intake to 1,500 mg per day, about 2/3 teaspoon of salt, may be helpful. Preparing your own
meals at home without using a lot of processed foods or salt will allow you to control how much
sodium you get. Try using less salt when cooking, and don’t add salt before you take the first bite. If
you make this change slowly, you will get used to the difference in taste. Also look for grocery
 products marked “low sodium,” “unsalted,” “no salt added,” “sodium free,” or “salt free.” Also
check the Nutrition Facts Label to see how much sodium is in a serving.
Eating more fresh vegetables and fruit also helps — they are naturally low in sodium and provide
more potassium. Get your sauce and dressing on the side and use only as much as you need for
taste.
14
Getting Enough Fluids
It’s important for your body to have plenty of fluids each day. Water helps you digest your food,
absorb nutrients from food, and then get rid of the unused waste. Water is found in foods—both
solids and liquids, as well as in its natural state.
With age, you might lose some of your sense of thirst. To further complicate matters, some
medicines might make it even more important to have plenty of fluids.
Remember, water is a good way to add fluids to your daily routine without adding calories.
Try these tips for getting enough fluids:
 Don’t wait until you feel thirsty to drink water or other fluids.
 Take sips of water, milk, or juice between bites during meals.
 Add liquids throughout the day.
 Have a cup of low-fat soup as an afternoon snack.
 Drink a full glass of water when you take a pill.
 Have a glass of water before you exercise.
 Drink fat-free or low-fat milk, or other drinks without added sugars.
 If you drink alcoholic beverages, do so sensibly and in moderation. That means up to one
drink per day for women and up to two drinks for men.
 Don’t stop drinking liquids if you have a urinary control problem. Talk with your doctor about
treatment.
15 Amblyopia
Amblyopia is also called “lazy eye.” It is an eye problem that starts in early childhood.
Amblyopia is the most common cause of vision problems in children. It happens when
one eye doesn’t work properly with the brain. The brain favors the eye that does work
correctly. This causes a loss of vision in the other eye.
Amblyopia usually affects only one of the eyes. Sometimes it can affect both. It is
important to detect amblyopia in your child early and treat it promptly. If you do, he or
she most likely will not have long-term vision problems. Left untreated, it can cause
severe vision problems, including legal blindness.

Amblyopia usually starts between birth and age 7. Symptoms in your child could include:
 Eyes that don’t work together.
 One eye that wanders inward or outward.
 Squinting, shutting one eye, or tilting the head to look at something.
  Problems with depth perception.
 An upper eyelid that droops.

16
10 Tips for Eating Healthy on a Budget
Even when you know what healthy foods to choose, being able to pay for them can be hard,
especially if you are on a fixed income. Start by deciding how much you can afford to spend on food.
There are websites that can help you plan a food budget. For example, the U.S. Department of
Agriculture supports Iowa State University’s Spend Smart-Eat Smart. This website also has
inexpensive recipes based on the Dietary Guidelines.
Once you have a budget, find store ads in the newspaper or grocery store websites to see what is on
sale. Try to plan some meals around featured items and pick up some extra canned goods or staples
that are on sale. And check the expiration or use-by date. A product might be on sale because it is
almost out of date. Choose items with dates farthest in the future.
While shopping, make use of these budget-wise 10 tips.
 Ask about discounts. Ask your local grocery stores if they have a senior discount or a loyalty
or discount card. Besides getting items at a lower price, you may also get store coupons.

 Use coupons when you can. Remember, coupons only help if they are for things you would
buy anyway. Sometimes, another brand costs less even after you use the coupon.

 Consider store brands—they usually cost less. These products are made under a special
label, sometimes with the store name. You might have to look on shelves that are higher or
lower than eye level to find them.

 Be aware that convenience costs more. You can often save money if you are willing to do a
little work. For example, buy whole chickens and cut them into parts, shred or grate your
own cheese, and avoid instant rice or instant oatmeal. Bagged salad mixes cost more and
might not stay fresh as long as a head of lettuce.

 Look at unit prices. Those small stickers on the shelves tell you the price but also the unit
price—how much the item costs per ounce or per pound. Compare unit prices to see which
brand is the best value.
 Try to buy in bulk, but only buy a size you can use before it goes bad. If you buy meat in
bulk, decide what you need to use that day and freeze the rest in portion-sized packages
right away.

 Focus on economical fruits and vegetables like bananas, apples, oranges, cabbage, sweet
potatoes, dark-green leafy vegetables, green peppers, and regular carrots.

 Think about the foods you throw away. For less waste, buy or cook only what you need.

 Resist temptations at the check-out. Those snack foods and candy are put there for impulse
buying. Save money and avoid empty calories!

 Sign up for meal delivery. While some older people have trouble finding enough money to
buy food, others need help preparing meals. There are a variety of groups around the
 country that deliver meals to people who have trouble getting out of their homes. These
groups usually offer one hot meal a day. One of the largest is Meals on Wheels America.
17
Food Safety
Food can be unsafe for many reasons. It might be contaminated by germs—microbes such as
bacteria, viruses, or molds. These microbes might have been present before the food was harvested
or collected, or they could have been introduced during handling or preparation. In either case, the
food might look fine but could make you very sick. Food can also be unsafe because it has “gone
bad.” Sometimes, you may see mold growing on the surface.
Avoid Getting Sick From Your Food
For an older person, a food-related illness can be life threatening. As you age, you have more
trouble fighting off microbes. Health problems, like diabetes or kidney disease, also make you more
likely to get sick from eating foods that are unsafe. So be careful about how food is prepared and
stored.
Some foods present higher risks than others. Here are some tips on selecting lower-risk food
options:
 Eat fish, shellfish, meat, and poultry that have been cooked to a safe minimum internal
temperature, instead of eating the food raw or undercooked.

 Drink pasteurized milk and juices instead of the unpasteurized versions.

 Make sure pasteurized eggs or egg products are used in recipes that call for raw or
undercooked eggs, such as homemade Caesar salad dressings, raw cookie dough, or eggnog.

 Always wash vegetables, including all salad ingredients, before eating. Cooked vegetables
also are a lower-risk option than raw vegetables.

 Choose cooked sprouts instead of raw sprouts.

 Choose hard or processed cheeses, cream cheese, or mozzarella, or any cheese that is clearly
labeled “Made from Pasteurized Milk” instead of soft cheese made from unpasteurized (raw)
milk, such as Brie, Camembert, blue-veined, or queso fresco.

 Heat up hot dogs, deli meats, and luncheon meats to 165 °F (steaming hot), instead of eating
the meat unheated.
Changing Taste and Smell
As you grow older, your senses of taste and smell might change. Some illnesses, like COVID-19, or
health conditions can change your senses of smell and taste. Certain medicines might also make
things taste different. If you can’t rely on your sense of taste or smell to tell that food is spoiled, be
extra careful about how you handle your food. If something doesn’t look, smell, or taste right, throw
it out—don’t take a chance with your health.
Smart Storage
Food safety starts with storing your food properly. Sometimes that’s as simple as following
directions on the container. For example, if the label says “refrigerate after opening,” do that! It’s
also a good idea to keep any canned and packaged items in a cool place.
When you are ready to use a packaged food, check the date on the label. That bottle of juice might
have been in your cabinet so long it is now out of date. (See Reading Food Labels to understand the
date on the food label.)
Try to use refrigerated leftovers within 3 or 4 days to reduce your risk of food poisoning. Throw
away foods older than that or those that show moldy areas.
For recommended refrigerator and freezer storage times for common foods, download our Storing
Cold Food tip sheet (PDF, 75K).
Foods and Medicines
Some foods, and also caffeine and alcohol, are unsafe to take with certain medicines. A food-
medicine interaction can prevent a medicine from working the way it should, cause a side effect
from a medicine to get worse, cause a new side effect, or change the way your body processes the
food or medicine. For example, some statins (cholesterol medicines) act differently on the body if
you consume large amounts of grapefruit juice. Every time you use a new medicine, check the label
for interactions. If you have any questions, talk to your doctor or pharmacist.
Food Safety When Cooking
When preparing foods, follow four basic steps—clean, separate, cook, and chill.
Clean
Wash your hands, the cutting board, and the counter with hot, soapy water, and make knives and
other utensils are clean before you start to prepare food. Clean the lids of cans before opening.
Rinse fruits and vegetables under running water, but do not use soap or detergent. Do not rinse raw
meat or poultry before cooking—you might contaminate other things by splashing disease-causing
microbes around.
Keep your refrigerator clean, especially the vegetable and meat bins. When there is a spill, use hot,
soapy water to clean it up.
Separate
Keep raw meat, poultry, seafood, and eggs (and their juices and shells) away from foods that won’t
be cooked. That begins in your grocery cart—put raw vegetables and fruit in one part of the cart,
maybe the top part.
Products like meat and fish should be put in the plastic bags and placed in a separate part of the
cart. At check-out, make sure the raw meat and seafood aren’t mixed with other items in your bags.
When you get home, keep things like raw meat separate from fresh fruit and vegetables (even in
your refrigerator). Don’t let the raw meat juices drip on foods that won’t be cooked before they are
eaten.
When you are cooking, it is also important to keep ready-to-eat foods like fresh produce or bread
apart from food that will be cooked. Use a different knife and cutting board for fresh produce than
you use for raw meat, poultry, and seafood. Or, use one set, and cut all the fresh produce before
handling foods that will be cooked.
Wash your utensils and cutting board in hot, soapy water or the dishwasher, and clean the counter
and your hands afterwards. If you put raw meat, poultry, or seafood on a plate, wash the plate in
hot, soapy water before reusing it for cooked food.
Cook
Use a food thermometer. Put it in the thickest part of the food you are cooking to check that the
inside has reached the right temperature. The chart below shows what the temperature should be
inside food before you stop cooking it. No more runny fried eggs or hamburgers that are pink in the
middle.
Bring sauces, marinades, soups, and gravy to a boil when reheating.
Chill
Keeping foods cold slows the growth of microbes, so your refrigerator should always be at 40 °F or
below. The freezer should be at 0 °F or below. But just because you set the thermostat for 40 °F
doesn’t mean it actually reaches that temperature. Use refrigerator/freezer thermometers to check.
Put food in the refrigerator within 2 hours of buying or cooking it. If the outside temperature is over
 90 °F, refrigerate within 1 hour. Put leftovers in a clean, shallow container that is covered and dated.
Use or freeze leftovers within 3 to 4 days. For recommended refrigerator and freezer storage times
for common foods, download our Storing Cold Food tip sheet (PDF, 75K).
Food Safety When Eating Out
It’s nice to take a break from cooking or get together with others for a meal at a restaurant. But, do
you think about food safety when you eat out? You should.
 Pick a tidy place with clean tables and floors.

 If your city or state requires restaurants to post a cleanliness rating near the front door,
check it out.

 Don’t be afraid to ask the waiter or waitress how items on the menu are prepared. For
example, could you have the tuna cooked well instead of seared? Or, if you find out the
Caesar salad dressing is made with raw eggs, ask for another salad dressing.

 Consider avoiding buffets. Sometimes food in buffets sits out for a while and might not be
kept at the proper temperature—whether hot or cold.

 If you take leftovers home, get them into the refrigerator within 2 hours—sooner if the
temperature outside is above 90 °F.
18 Ankle Sprain

ankle is the joint that connects your leg to your foot. This joint is made up of many
bones. The bones are connected to the joint with three ligaments. These ligaments keep
the bones from moving out of place. An ankle sprain happens when one or more of those
ligaments is stretched or torn.

Sprained ankles are divided into three grades, based on severity.

 Grade 1: This is a mild sprain. It’s the most common type. In this case, the
ligament is stretched, not torn. You may experience minor pain and stiffness but
you can still get around.
 Grade 2: This is a moderate sprain. In this case, one or more ligaments are partially
torn. Your ankle will likely be swollen, you will feel moderate pain, and it will be
hard to stand on that foot.
 Grade 3: This is a severe sprain. Here, one or more ligaments are completely torn.
Your ankle will be unstable, the pain will be severe, and you won’t be able to move
your ankle.
ankle sprains include:
 Pain or tenderness
  Swelling
 Bruising
 Stiffness
 Coldness or numbness in your foot
 Inability to walk or put weight on that foot
Typically, with mild sprains, you may have stiffness while walking. That should get better
in a few days to a few weeks. People who have moderate and severe sprains may have
limits for several weeks. And they may have ankle pain for a year or more.

19 Outdoor health
Food poisoning is an illness caused by eating contaminated food. It's not usually serious and most people get
better within a few days without treatment.
In most cases of food poisoning, the food is contaminated by bacteria, such as salmonella or Escherichia coli
(E. coli), or a virus, such as the norovirus.
Signs and symptoms
The symptoms of food poisoning usually begin within one to two days of eating contaminated food, although
they may start at any point between a few hours and several weeks later.
The main symptoms include:
 feeling sick (nausea)
 vomiting
 diarrhoea, which may contain blood or mucus
 stomach cramps and abdominal pain
 a lack of energy and weakness
 loss of appetite
 a high temperature (fever)
 aching muscles
 chills
In most cases, these symptoms will pass in a few days and you will make a full recovery.
What to do
Most people with food poisoning recover at home and don't need any specific treatment, although there are
some situations where you should see your GP for advice (see below).
Until you feel better, you should rest and drink fluids to prevent dehydration. Try to drink plenty of water,
even if you can only sip it.
Eat when you feel up to it, but try small, light meals at first and stick to bland foods – such as toast, crackers,
bananas and rice – until you begin to feel better.
Oral rehydration solutions (ORS), which are available from pharmacies, are recommended for more
vulnerable people, such as the elderly and those with another health condition.
How is food contaminated?
Food can become contaminated at any stage during production, processing or cooking. For example,
it can be contaminated by:
 not cooking food thoroughly (particularly meat)
 not correctly storing food that needs to be chilled at below 5C
  leaving cooked food for too long at warm temperatures
 not sufficiently reheating previously cooked food
 someone who is ill or who has dirty hands touching the food
 eating food that has passed its "use by" date
 the spread of bacteria between contaminated foods (cross-contamination)
Foods particularly susceptible to contamination if not handled, stored or cooked properly include:
 raw meat and poultry
 raw eggs
 raw shellfish
 unpasteurised milk
 "ready-to-eat" foods, such as cooked sliced meats, pâté, soft cheeses and pre-packed
sandwiches

20
Maintaining a Healthy Weight
Maintaining a healthy weight is important for overall health and well-being.
As you grow older, if you continue eating the same types and amounts of food but do not become
more active, you will probably gain weight. That’s because your metabolism (how your body gets
energy from food) can slow with age, and your body composition (amount of fat and muscle) may
be different from when you were younger.
The energy your body gets from the nutrients in the food you eat is measured as calories. As a rule
of thumb, the more calories you eat, the more active you have to be to maintain your weight.
Likewise, the reverse is also true—the more active you are, the more calories you need. As you age,
your body might need less food for energy, but it still needs the same amount of nutrients.
How Can I Keep a Healthy Weight?
Many things can affect your weight, including genetics, age, gender, lifestyle, family habits and
culture, sleep, and even where you live and work. Some of these factors can make it hard to lose
weight or keep weight off.
But being active and choosing healthy foods has health benefits for everyone—no matter your age
or weight. It’s important to choose nutrient-dense foods and be active at least 150 minutes per
week. As a rule of thumb:
 To keep your weight the same, you need to burn the same number of calories as you eat and
drink.
 To lose weight, burn more calories than you eat and drink.
 To gain weight, burn fewer calories than you eat and drink.
Tips for Maintaining a Healthy Weight
 Limit portion size to control calorie intake.
 Add healthy snacks during the day if you want to gain weight.
 Be as physically active as you can be.
 Talk to your doctor about your weight if you think that you weigh too much or too little.
What Should I Eat to Maintain a Healthy Weight?
Choose foods that have a lot of nutrients but not a lot of calories. NIA has information to help you
make healthy food choices and shop for food that’s good for you.
How Much Physical Activity Do I Need?
Aim for at least 150 minutes of moderate-intensity aerobic activity each week. You don’t have to do
that all at once—break it up over the whole week, however you like. If you can’t do this much
activity right away, try to be as physically active as you can. Doing something is better than doing
nothing at all.
The benefits of exercise aren’t just about weight. Regular exercise can make it easier for you to do
daily activities, participate in outings, drive, keep up with grandchildren, avoid falls, and stay
independent.
Tip: Physical Activity
Most older people can be moderately active. But, you might want to talk to your doctor if you aren’t
used to energetic activity and you want to start a vigorous exercise program or significantly increase
your physical activity. You should also check with your doctor if you have health concerns like the
following:
 Dizziness
 Shortness of breath
 Chest pain or pressure
 An irregular heartbeat
 Blood clots
 Joint swelling
 A hernia
 Recent hip or back surgery
Your doctor might have some safety tips or suggest certain types of exercise for you.
You don’t have to spend a lot of money joining a gym or hiring a personal trainer. Think about the
kinds of physical activities that you enjoy—for example, walking, running, bicycling, gardening,
housecleaning, swimming, or dancing. Try to make time to do what you enjoy on most days of the
week. And then increase how long you do it, or add another fun activity.