When I was young, I learned about liquor’s misdeeds from my parents, elders, and from books I read. I accumulated general knowledge, including the disadvantages of alcohol, through these sources. As I thought more about liquor, a series of thoughts came to my mind, and I ended up writing down everything that came to me.
It’s not necessarily a good thing that young people no longer frequent bars these days. The places where alcohol is served, such as restaurants and hotels, are not just places where anyone can sit and drink; it’s something that even those with decent finances have to think about. It’s the kind of place that only those who have the money to spend go to. So what I want to say is that due to the rising cost of goods, people may start avoiding bars and pubs.
There are some good aspects. Since drinkers can’t sit at a bar or have become unable to, they have controlled the cost of meals. However, they do not taste meals while drinking liquor. Although they do not sit at the bars to drink, bars are now popping up everywhere like mushrooms, so people still drink at home. However, it’s undeniable that the cost of meals to be eaten in the sapping bar has reduced significantly. While I’m not referring to every drinker, in general, the cost reduction for drinking has led many people to spend even more on alcohol. A good thing about the rising prices is that, when sitting at a bar, people tend to pay attention to their behaviour and become more careful not to cause trouble. So, they miss chances to commit quarrels. Bars are also less populated now, and it’s rare to find someone taking up a whole space along the route to their homes by themselves. People can only make noise at home, and they’re allowed to make only limited disturbances in the surrounding area.
Everybody knows alcohol is not good. No matter what people say, whether they quote any scriptures or say this or that, if you ask why alcohol is being produced, how would you answer? If someone asks why bars are being opened, questions will arise. If you talk about the beginning of things, like the first chicken egg or the hen, it won’t hurt anyone. But thinking about how alcohol, bars, liquor stores, and alcohol consumers could be discussed in a way that might affect or harm others, well… let’s just leave it at that.
From the beginning, I want to refer to the fact that young people drink alcohol, just like how it has been discussed before. I’ve encountered many alcohol users, but if we’re talking about my friend, there are those who drink while embracing life. Such situations are common. However, because they are just similar experiences, I don’t feel like talking about them. Nevertheless, I can’t stay silent anymore, and I want to speak up. This is not a created story, but a heartfelt experience. I want to talk about a dear friend I had the pleasure of knowing and share this with you.
Once upon a time, there were three friends, including me. Although we met and became close when we were over 30, we built a fraternity among us deeply, with mutual understanding and affection. It was unbelievable for all that to the extent that, when one of us started to speak, we all knew what would be said and how it would end. When one person looked at another, we could understand why they were looking, and what they wanted to say, without needing any explanation. We were so close that we understood each other without words.
When the time came, everyone went to their separate places, but they still kept in touch with each other, either through phone or letters. Two of them were in Yangon, and a Yangonite was in Mandalay. Back then, whenever someone arrived in Mandalay, they would greet each other just like before, with a warm welcome. Likewise, whenever someone from Mandalay came to Yangon, the remaining two would always arrange to meet up.
Out of these three, the character I’m about to talk about doesn’t even seem like someone who would drink alcohol, let alone be a heavy drinker. I think they would even walk down to the river and get called for it. They don’t seem to get drunk either. They can drink without even knowing how much they’ve had. Whether you call them a liquor lover, a drinker, an alcoholic, a heavy drinker, or even something more colourful, no matter how you address them, they would still act the same. That’s why I almost want to call them the king of alcohol.
In Mandalay, one person drinks when they encounter it. If they don’t encounter it, they search for it to drink. If they can live, they just live. Drinking when they encounter it means they never bear the full cost with their own money. They drink with others’ money. Drinking with others’ money has never been a burden, but his talk of boasting may be mounted like Mandalay Hill. Those who have fought with him over alcohol or beer have not only suffered but also had to pay the debts of their lifetime. At that time, his salary was at the scale of a deputy staff officer. Despite that, he still drank with others’ money.”
The other person is from Yangon. Until the age of thirty, he had never drunk alcohol, smoked cigarettes, chewed betel nuts, or had a romantic partner. He lived in a very disciplined way, but this kind of person tends to become an idiot in some way. This writer is someone who has written in their mind alone and thinks that no one else can match them. I am a civilian who has not yet married and works as a gazette officer, but his salary was not so low that you wouldn’t expect him to be able enough of himself. At that time, with the price of goods and the books he used, he was struggling to get by. He contributed his salary to his home and then asked for it back.
Among those three, the one with the best income is the alcohol king. He is a government employee and is also working a second job at a private business in the evenings, so he’s the busiest. However, when you look at him, he always seems to be in a dishevelled state. He’s constantly draining his money on alcohol. But no matter where you look, he never lets go of his cigarette.
Since the time the three friends first met, it’s been about fifteen years. During this period, the “alcohol king” has risen to one rank in his job. He has become quite skilled in his work and is very good at speaking to the point where others can be overwhelmed by his words. His ability to judge people is also quite impressive. Although he doesn’t have a degree and is a heavy drinker, his superiors promoted him to a higher position, so he was content with his job. He no longer expected further promotions. His income was steady, and as long as he could drink properly, he was satisfied.
What I mean is that the king of alcohol’s friend passed away in 2019. It is known to be from a liver disease. Before he passed, he had completely deteriorated. It’s quite sad. Unfortunately, I couldn’t attend the funeral due to various reasons. Before he passed, I heard news about him from his colleagues. He was constantly drunk and no longer thought about anything. Alcohol took over him, and the king of alcohol no longer had control over his life, ultimately leading to a drastic change in his life.
The big friend passed away with age and alcohol, and while reflecting on that, I thought about how in the old days, people used to write at the bottom of letters, like legal texts, that they didn’t want to publish. The wife of the big friend had already passed away for many years before the friend even passed. Now that she’s gone, only their little daughter remains in this world with a lack of chance to rely on her parents. The end of a family member is always saddening. But the friend just went where he needed to go. It’s nothing unusual. Just as he left in his own way, isn’t it true that those left behind will leave in their own ways too?
Currently, the two remaining friends have earned the positions they deserve in their respective professions and have reached their expected goals. However, it can be seen that the big friend with the nickname “the king of alcohol’ may still be wandering in the circle of life dubbed the Samsara in Pali aimlessly. Since the big friend would be alone, feeling bored, he might tell the remaining two friends to quickly follow him, perhaps to places with many people. In the past, he was luckier than the other two, so he might be holding a cigarette in his hand, still enjoying the alcohol he likes, without caring about anything.
Whatever it may be, alcohol has been killing most of the drinkers since its emergence. My friend lost his life at a workable age. It is believable that alcohol will continue to separate the bonds and affection between friends.

Source: The Global New Light of Myanmar

Twenty-Seven Es for disease prevention and control activities are a set of essential strategies that focus on various aspects of public health interventions aimed at preventing and controlling diseases. While there may be variations in the lists of these 27 Es, they generally revolve around elements like education, environment, and engagement in health practices.
The 27 Es for disease prevention and control activities expand on the principles involved in managing public health issues. These ideologies cover a wide range of strategies, from education to environmental control. The following is an expanded list that reflects key actions for effective disease prevention and control:
1. Education – Raise awareness and educate communities about healthy practices and disease prevention.
2. Early Detection – Detect diseases early through screenings and monitoring to prevent further spread.
3. Environmental Health – Improve environmental conditions (clean water, sanitation) to reduce disease risk.
4. Empowerment – Empower individuals and communities with the tools and knowledge needed for self-care.
5. Epidemiology – Collect and analyze data on the spread and causes of diseases to guide prevention efforts.
6. Engagement – Engage communities in disease control measures through participation and collaboration.
7. Equity – Ensure equal access to health services, information, and resources for all groups.
8. Evidence-Based Practices – Use scientific research and data to develop effective disease prevention strategies.
9. Enforcement – Enforce laws and policies that protect public health (e.g., vaccination requirements).
10. Emergency Response – Prepare for and respond quickly to outbreaks, natural disasters, or health emergencies.
11. Evaluation – Continuously assess and evaluate the effectiveness of prevention programs and interventions.
12. Efficacy – Ensure that disease control measures are proven to be effective in reducing health risks.
13. Ecosystem Protection – Preserve and protect ecosystems, which contribute to overall human health.
14. Economic Support – Provide financial resources for public health initiatives to control and prevent disease.
15. Examination – Regular medical examinations to detect diseases early and prevent complications.
16. Aetiology – Study the causes and origins of diseases to better prevent and treat them.
17. Exclusion – Prevent the movement of infected individuals or contaminated goods to limit disease spread.
18. Ethical Practices – Maintain ethical standards in health interventions, respecting human rights and dignity.
19. Extrapolation – Apply lessons learned from one community or disease to other situations or regions.
20. Experience Sharing – Share successful disease control strategies and lessons learned from previous outbreaks.
21. Elimination – Work towards the complete obliteration of diseases in certain areas.
22. Enhancement – Enhance health systems with better resources, training, and infrastructure for disease control.
23. Evaluation of Interventions – Continuously monitor and adjust disease prevention strategies to ensure their effectiveness.
24. Emergency Preparedness – Develop and implement plans to address and mitigate public health emergencies.
25. Epidemic Control – Use effective strategies to contain and control epidemics quickly, minimizing damage.
26. Eradication – Actively works to completely abolish certain diseases from the population (e.g., smallpox).
27. Evaluation of Outcomes – Measure and assess the long-term impacts of disease control efforts on public health.
In addition, these 27 Es cover an inclusive, multi-layered approach to public health, with an emphasis on preparedness, scientific evaluation, community engagement, and ethical standards.

Source: The Global New Light of Myanmar

UNIVERSAL health coverage (UHC) means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
Public health is the science of protecting and improving the health of people and their communities. This work is achieved by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing, and responding to infectious diseases. Overall, public health is concerned with protecting the health of entire populations. These populations can be as small as a local neighbourhood or as big as a whole country or region.
Public health education refers to the educational process that provides students with knowledge and skills related to various aspects of public health, including biology, environmental factors, communication, data management, epidemiology, health policy, and emergency management. It aims to prepare students for cross-disciplinary roles and to promote a better world by expanding their focus to account for health factors in their future careers.
Public health education plays a critical role in achieving Universal Health Coverage (UHC) by promoting health literacy, preventative care, and fostering healthier behaviours within populations. The following are a few key points on how public health education contributes to UHC: 

• Raising Awareness about Health Issues

  Public health education helps raise awareness about common health conditions, preventive measures, and available healthcare services. When people are well-informed about health risks, such as the dangers of smoking, unhealthy diet, or lack of exercise, they are more likely to make healthy lifestyle choices, which can reduce the burden on healthcare systems.

• Promoting Preventive Healthcare
  By educating communities about preventive measures, such as vaccination, screening for diseases (e.g., cancer, diabetes), and safe hygiene practices, public health education helps in reducing the incidence of preventable diseases. This not only improves health outcomes but also helps reduce healthcare costs in the long term, aligning with UHC goals of providing equitable and affordable healthcare.

• Empowering Communities
  Public health education empowers individuals and communities to take responsibility for their health. When people understand their rights to healthcare and know how to navigate the healthcare system, they are better able to access services, adhere to medical treatments, and avoid delays in seeking care.

• Addressing Health Inequalities
  Public health education can address health disparities by targeting vulnerable populations, including those in rural areas, low-income groups, and marginalized communities. By providing information tailored to their needs, education can break down barriers to accessing healthcare and ensure that undeserved populations are not left behind in achieving UHC.

• Improving Health Behaviours
  Health education encourages individuals to adopt healthier behaviors, such as quitting smoking, reducing alcohol consumption, engaging in physical activity, and managing stress. These behavioural changes contribute to a reduction in the prevalence of chronic diseases, which can strain healthcare systems and impede UHC efforts.

• Supporting Mental Health Awareness
  Mental health is a critical component of UHC, and public health education can reduce the stigma surrounding mental health issues. Educating the public about mental health can help people seek the necessary support, reducing the burden on emergency and acute care services while promoting mental well-being for all.

• Promoting for Programme Changes
  Educating the public can foster an environment where people promote necessary programme changes that support UHC, such as the expansion of healthcare coverage, improved health infrastructure, and equitable distribution of healthcare resources.

• Improving Health Literacy
  Health literacy is essential for individuals to make informed decisions about their health. Public health education improves people’s ability to understand medical information, which is necessary for following treatment plans, understanding prescription instructions, and making health decisions that are aligned with the resources available in their healthcare system.
  In summary, public health education serves as a foundation for achieving UHC by promoting informed, health-conscious populations, reducing preventable health issues, and empowering individuals to take control of their health. It creates a more equitable healthcare system and also takes the opportunity to promote a healthy life.

References
- https://www.who.int/health-topics.universal-health-coverage 

- https://www.cdcfoundation.org/what-public-health

- https://www.sciencedirect.com/topics/social-sciences/public-health-education

Source: The Global New Light of Myanmar

IT STARTED with a plate of sushi. The delicateslices of raw fish gleamed under the dim lights of a seaside stall, paired with a dab of soya sauce and a curl of ginger. I was at a bustling street market in a small coastal town, the sort where vendors shout over each other and the air hums with life. I didn’t think twice before tucking in. It was delicious – until it wasn’t.
Two weeks later, my skin turned a sickly yellow, my energy drained away like water through a sieve, and I found myself staring at a doctor who said three words that flipped my world upside down: “You have Hepatitis A.”
Hepatitis A Virus (HAV) is one of the most common types of hepatitis viruses that cause liver inflammation and jaundice. This type has been around for a long time – longer than we have been alive, lurking in the shadows of human history. In recent years, its increase has been largely linked to unclean water and food, overcrowding, and poor sanitation, especially concerning toilets. If you think about it, you may have noticed that the number of infectious diseases has increased in recent years. I certainly didn’t – until it hit me personally. My story isn’t just about bad sushi; it’s about how an invisible enemy travel, how it hides in plain sight, and how I fought it off with lessons I’ll never forget.
Hepatitis A spreads mainly through consuming water or food contaminated with the faeces of an infected person. Yes, it’s as grim as it sounds. The virus doesn’t need a handshake or a sneeze – it hitches a ride on something as innocent as a piece of sushi or a sip from a glass. That’s why people are often urged to avoid eating street food that isn’t prepared or cooked hygienically. But it’s not just street food – even in large restaurants, if food isn’t prepared cleanly, it can still pose a risk. My sushi came from a vendor with a weathered wooden stall and a grin, but I didn’t notice the flies buzzing nearby or ask how the fish was washed. I didn’t know then that HAV thrives in places where cleanliness takes a back seat.
Back home, I’d always prided myself on being careful – washing my hands, boiling water when camping, avoiding dubious roadside stalls. But travelling? That’s when my guard slipped.
The town I visited wasn’t dirty by any stretch—just busy, crowded, and alive. Yet, behind the scenes, overcrowding and poor sanitation were brewing a perfect storm. A single infected person, a poorly washed hand, a bucket of unboiled water – it only takes one weak link. And I was the unlucky domino that fell.
When the doctor explained how I’d got sick, I started replaying every bite I’d taken on that trip. Since the spread is reportedly high right now, you should be cautious about these types of food, he warned me:
• Foods that flies have landed on (those buzzing pests around my sushi were a red flag I ignored).
• Foods left uncovered and exposed (the fish sat out, absorbing more than just the salty air).
• Foods that aren’t fully cooked (raw seafood and half-cooked skewers were staples that week).
• Foods handled or prepared without clean hands (who knew where those hands had been?).
• Raw foods like seafood, fruit, or vegetables (my beloved sushi was the smoking gun).
It was astonishing to realize how vulnerable we are to what we eat. I’d always thought of food as fuel, a source of joy – not a po-
tential assassin. But HAV doesn’t care about our love for sushi or our trust in a friendly vendor. It’s a stowaway, sneaking into our
system through the simplest of mistakes. I learned the hard way that flies aren’t just annoying – they’re couriers for a virus that can knock us flat.
The symptoms crept up like a thief in the night. As the name suggests, Hepatitis A causes liver inflammation and jaundice (yellowing of the skin). That was the first clue – my reflection in the mirror started looking like a stranger with a sickly glow. Then came the pale stools and dark urine, a bizarre duo I’d never noticed before. My abdomen ached on the upper right side, where my liver was silently screaming for help. Other symptoms were typical of viral infections: fever that left me shivering under blankets, fatigue that made lifting a spoon feel heroic, muscle aches that turned my body into a battlefield, and a loss of appetite paired with nausea that made food my enemy.
I didn’t connect the dots at first. I thought it was jet lag or a stomach bug from the trip. But when my friends started joking about my “new tan,” I knew something was wrong. The doctor’s diagnosis was a gut punch — not just because I was ill, but because it was preventable. If I’d known what to look for, if I’d been more cautious, I might have dodged this bullet.
Hepatitis A is highly contagious, but it can be easily controlled. It spreads primarily through eating or drinking something contaminated with the virus. If we focus on keeping four things clean – food, water, hands, and toilets – we can prevent this disease. That’s it. Four simple rules I’d broken without realizing.
The science is astonishingly straightforward. At 85°C for just one minute, the virus dies. Boiling water reaches 100°C, so cooking food thoroughly or boiling it already acts as prevention.
If bottled water isn’t available, boil our drinking water – drinking it after boiling is safe. I wish I’d insisted on bottled water that day or checked if the ice in my drink was clean. Wash our hands regularly. Even if we haven’t used the toilet, we could touch something handled by an infected person who didn’t wash their hands, and it could end up in our mouth.
So, wash our hands thoroughly before eating every time. I’d scrubbed my hands before meals at home, but on the road? I got lazy. Big mistake.
To stop the virus from spreading via toilets, make sure ours is fly-proof and clean. Doing this can prevent infection. The guesthouse I stayed at had an open latrine with flies buzzing in and out – another clue I overlooked. Prevention isn’t rocket science; it’s about discipline. And I’d let mine slip.
Since it’s a virus, there’s no definitive cure. Treatment involves plenty of rest, eating a nutritious diet, and using medication to relieve symptoms.
With rest, hydration, and proper nutrition, our immune system can fight off the virus. My doctor sent me home with a prescription for rest – literal bed rest – and a stern warning: avoid alcohol entirely – it can further damage the liver. That part was easy; I didn’t even want to look at a glass of anything.
Recovery was slow. I spent weeks on the sofa, sipping water and nibbling bland crackers while my body waged war. My mum brought me broth, and my friends sent memes to cheer me up, but mostly, I slept. The fatigue was crushing – like someone had unplugged my battery. But little by little, the yellow faded from my skin, my appetite crept back, and the pain in my side dulled to a memory.
Months later, I’m back to normal. My skin’s its usual shade, my energy’s returned, and I can eat sushi again (though I inspect it like a detective now). But Hepatitis A left its mark – not on my liver, which healed, but on my habits. I boil water obsessively when I travel. I wash my hands until they’re raw. I ask vendors questions that make them blink – Where’s your water from? How’s
this prepared? I’ve become that person, and I’m fine with it.
So, here’s my plea: don’t wait for the yellow skin to wake you up. Check your water. Scrub your hands. Cook your food. It’s not glamorous, but it’s powerful.
Because the next time I bite into a piece of sushi, I’ll know I’m the one in control – not the invisible enemy.

Source: The Global New Light of Myanmar

At the phrase ‘Emergency Department’, everyone will surely feel formidable. 

Patients and their family members, in particular, will be chilled to the bones. It will be repellent even to the hospital staff for its 24-hour service provision and overburdening nature. In contrast, the negative phrase ‘Emergency Department’ bears a positive sense to a patient afflicted with serious diseases or traumatic injuries and to the philanthropic hospital staff who relish saving the lives of the patients wrestling with death.

The Emergency Department is the first point of contact for many patients with a hospital. Delivering immediate, life-saving, high-quality care, it acts as an oasis for the patients experiencing life- threatening medical, surgical or orthopedic emergencies such as severe heart attack, hypertensive crisis, stroke, perforated ulcers of duodenum and stomach, perforated appendix, traumatic head injuries and fractures of bones. Moreover, it is instrumental in fighting against public health emergencies - disasters, epidemic outbreaks and mass casualty incidents. 

It will be safest for a patient, if he or she is transported to the hospital in an ambulance equipped with the advanced life-support devices and staffed with a paramedic who provides pre- hospital care to the patients on the way. When a patient and his or her accompanying family members arrive at the Emergency Department, they will have to meet the hospital staff of various sorts - security staff, general workers, receptionists, medical record staff, a triage team including doctors and nurses, an emergency team comprising emergency physicians and nurses, an orthopedic team consisting of orthopedic surgeons and nurses, a medical team composed of general physicians and nurses, a surgical team formed of general surgeons and nurses, radiologists, imaging technicians and lab technicians.

On reaching the entrance to the Emergency department, the patient and his or her family members will be greeted by the security staff, who create a safe environment for all comers. Then, they will meet the general workers, who usher them into the department and take their patient in a wheel- chair or a trolley. As they take some steps into it, they will meet the receptionists, who welcome them from the reception counter, respond to their enquiries and direct them to the triage area. On the way to the triage area, throwing a sweeping glance around the department, they will find the atmosphere charged with a sense of stress and urgency: the family members of the patients waiting nervously at the waiting areas, doctors and nurses hurrying from room to room for treating the patients, some attendants comforting their patients in front of the lab and imaging rooms, and some patients being cautiously taken to the admitted wards. 

When this patient and the family members get to the triage area, they will meet the triage team including doctors and nurses, who quickly assess the severity of their patient’s condition by evaluating the chief complaints, the history of the present illness, underlying diseases, vital signs measurements and then, prioritize care for him or her. Meanwhile, one of the family members will have to rush to the medical record counter to meet the medical record staff, who register the patient and issue an emergency patient record booklet. At the triage area, if the condition of the patient under examination does not require resuscitation, he or she will be sent to the medical assessment unit or the surgical observation unit for further treatment.

But, if this patient’s condition demands emergency resuscitation, he or she will be unhesitatingly taken into the resuscitation room. There, the family members of the patient will meet the emergency physicians and nurses. The emergency physicians, very important actors in saving the lives of emergency patients, will carry out all the necessary resuscitative measures including cardiopulmonary resuscitation to reverse the patient’s deteriorating condition. If the use of a ventilator or a defibrillator or both is needed, it will be upon these physicians. The emergency nurses will follow their instructions and assist them by providing the patient with the medications, intravenous infusions, oxygen therapy, using patient monitor devices and doing ECG drawings. The emergency team will coordinate and cooperate with many other specialists if necessary.

If the patient is a victim of a disaster, a road traffic accident or a mass casualty incident, the orthopedic team, in league with the emergency one, will treat his or her traumatic injuries and bone fractures. If the severity of the patient’s condition calls for an emergency operation, the surgeons on duty will perform it urgently in the operation theatre of the department. If the patient contracts the illness from an epidemic outbreak, he or she will be kept under surveillance and then provided with necessary treatment.

Now, if the condition of the patient in the emergency room has stabilized, he or she will be transferred to the medical assessment unit or the surgical observation unit. There, the family members of the patient will meet a medical team headed by general physicians or a surgical team led by general surgeons, who monitor the patient’s situation and instruct him or her to get necessary investigations. So, the patient and the family members will have to scurry to the imaging rooms, where the radiologists and the imaging technicians take and interpret the radiological images of the patient, and to the lab, where the lab technicians, under the guidance of a pathologist or a microbiologist, carry out the lab tests for him or her. Indeed, the role of investigations is of paramount importance for arriving at a confirmed diagnosis and administering the most effective treatment to a patient.  

At the medical assessment unit or the surgical observation unit, if the condition of the patient being investigated and treated is improving satisfactorily, the doctors will discharge him or her home, with their guidance on the follow-up care. Now, to everyone’s delight, the patient and the family members experience a happy ending here. But, if his or her situation is stagnant or worsening, he or she will be admitted to a suitable ward in the hospital for further treatment. 

If the patient is poor, the family members will have to meet the medical social staff, who can help the patient by making contact with the social welfare organizations and seeking the necessary support for him or her. Moreover, these staff will involve in the discharge planning of the patient and counsel him or her for further support after leaving the hospital. 

In fact, the family members of a patient arriving at the Emergency Department are overcome with their untold social problems and immense concern for the patient. Therefore, all the staff of the department should understand their emotional outbursts and treat them kindly and forgivingly. The staff should be endowed with good public relation skill and foster social harmony with the family members. The staff should practise patience, sympathy and empathy towards them. The staff should respect the patient’s dignity and keep his or her confidentiality. The treatment team should engage the family members in making decision on how to treat the patient. 

In conclusion, it is generally found that the staff of the Emergency Department in a hospital offer timely, comprehensive, efficient services to the patients as much as they can, that they can, in most cases, save the lives of the patients on death-bed, and that they can thus enhance the image of the hospital. Hence, the Emergency Department can be, undoubtedly, supposed to be a haven for a patient attending it, but not a scary place. However, it should be made more easily accessible to the patients and turned into a safer and more secure and relaxing atmosphere for them. On the other hand, there should be enough efficient staffing and up-to-date physical facilities in the Emergency Department because this can prevent the burn-out or collapse of the staff caused by overwork and, at the same time, help it operate successfully.

It's a story I've heard many times before. A woman in her mid-fifties, who we'll call Jess, has long struggled with her weight and last year decided to start taking a revolutionary weight-loss drug.

These appetite suppressing injections originally an off-label use of the diabetes treatment Ozempic and later including Wegovy and Mounjaro – help patients lose up to a fifth of their bodyweight in just over a year. It can also be a massive boost to their overall health, lowering their risk of long-term conditions such as type 2 diabetes, heart disease, cancer, and Alzheimer's.

But Jess is not seeing the dramatic weight loss she hoped for. Understandably, she is distraught. She worries that she is destined to be overweight for ever.

There is also the financial cost to consider. The NHS can currently only prescribe these drugs to the most overweight and unwell patients. Going private means paying as much as £300 a month.

For that, you would expect to see results. But, as I tell Jess, there is always hope. As dieticians and nutritionists for the healthy lifestyle coaching company Liva Healthcare, it's our job to consider what other factors might be behind this lack of progress.

We are one of seven digitally led weight-management services recommended by health chiefs to help support patients prescribed weight-loss drugs on the NHS.

We also support those accessing these medicines privately through Boots' online service – called Boots Online Doctor. And, in these situations, there is always one question I ask first: what are you eating?

These drugs, also known as glucagon-like peptide-1 receptor agonists (GLP-1s), trick the body into feeling full. However, while GLP-1s may cause patients to eat less, they do not make patients eat more healthily.

Many on the drugs say that, most of the day, they will go without food, but when the urge to eat strikes they turn to comfort items such as biscuits or crisps.

There are many reasons for this – it might be habit, that cooking can be time-consuming, or because such foods are just so tasty.

However, the reason these foods are so pleasing to eat is because they are packed with sugar and fat. And this means that just a few biscuits can often have as many calories as a proper meal.

It's important to remember it's not just about weight loss. There is also a concern that patients on GLP-1s can become malnourished. Most of us do not get enough fibre, while millions have diets deficient in vitamins and minerals such as calcium, as well as vitamins A, B, and C.

To get these nutrients, we need to eat a varied diet, which includes a spread of vegetables, fruit, pulses and – in moderate amounts – protein sources such as meat and eggs.

Studies show that, over time, malnutrition can have serious consequences, including raising the risk of bone breaks, digestive problems and serious infections.

Malnutrition can be an issue among overweight people too, because many – but not all – have poor diets. If people with full appetites struggle to get adequate nutrition, just imagine how hard it is for someone on an appetite-suppressing drug? Many patients also tell us they plan to use the drug to aid initial weight loss and then, once they've lost enough, they will stop the injections.

However, unless a patient ensures their diet really is healthy, they run the risk of putting the weight back on. Research shows that more than half who come off the drugs regain at least two thirds of the weight they lost.

Nearly one in five put all the weight – or more – back on.

We find that patients who focus on eating in a balanced way on the jabs put less weight back on once they stop. This is because, usually, they continue to eat like this. Of course, diet is not the only thing to consider when trying to lose weight on GLP-1s. At Liva Healthcare we also guide patients on how to create an exercise routine – another crucial factor.

So too is exploring why people eat. Do patients eat out of boredom or sadness? What can be done to change these habits?

We are able to guide people through these challenges. But diet is almost always the most important factor in weight loss.

The good news is GLP-1 drugs give patients the chance to reset their diet: some describe them as taking away the constant 'noise' of food. Our advice tends to follow a few simple rules. Half the plate should be made up of vegetables – and the more colourful the better. A quarter should be carbohydrates, such as potatoes or pasta; if it's wholegrain even better.

And the final quarter should be protein, such as meat or plant-based products like tofu. Meat should be lean, such as chicken or white fish, rather than fatty red meat, pork, or processed meat.

The goal is to make each meal packed with nutrients so, even when eating small portions, patients are getting all they need. Meals should also be easy to cook and packed with flavour. If someone has a reduced appetite, they want meals to look forward to.

With all this in mind, I have created four recipes exclusively for Mail readers who are taking a weight-loss drug. For breakfast, I recommend a berry and vanilla protein parfait. This yogurt-based meal has multiple sources of protein – crucial for building muscle in place of fat.

The berries and seeds provide plenty of fibre, which is needed for a healthy gut. It is also packed with calcium, a bone-health nutrient which many GLP-1 patients are deficient in.

Our lunch option is a green shakshuka, a twist on the classic Middle Eastern egg dish, which contains plenty of iron-rich spinach. Iron is vital for the transport of oxygen around the body, as well as maintaining healthy skin, hair and nails. The eggs and feta provide high-quality protein.

I've also created a snack, to graze on throughout the day. This is a roasted chickpeas, seeds and cashew mix, which contains protein, zinc and iron.

Finally, for dinner, I've suggested a chipotle-lime chicken bowl. The smoky chipotle flavour enhances the taste, the pickled onions help digestion and the avocado provides healthy fats for energy. The chicken is the protein that should keep patients satiated until the morning.

I'm not saying you should consume only these, but it gives a flavour of the tasty and healthy meals it's possible to eat while losing weight.

Common drugs taken by up to 10million Americans for anxiety and high blood pressure may lower the risk of stroke in some at-risk people, a study suggests. 

Propranolol, a type of drug known as a 'beta blocker' which dampens the effects of adrenaline, reduced the risk of stroke by up to 50 percent in women with chronic migraines.

Researchers from Vanderbilt University combed through more than 3million medical records and found while the drug made a notable difference for women, there was no effect in men with migraines. 

Scientists believe migraines lead to spasms in the brain's arteries and, over time, these block blood flow to the brain, increasing the risk of blood clots and strokes.

It's thought propranolol prevents blood vessels from dilating and causing spasms.

The findings, therefore, suggest using propranolol, which costs less than a dollar per pill, to treat migraine in women may lower their risk of stroke.

Stroke is one of America's leading causes of death, striking 800,000 Americans each year, or one every 40 seconds. About 160,000 people die from a stroke every year. 

Dr Mulubrhan Mogos, lead study author and assistant professor at Vanderbilt University School of Nursing, said: 'Migraine is an often-ignored risk factor for cardiovascular issues. Until recently, preventive treatments for people who have migraines were not available.' 

Dr Mogos continued: 'Many women suffer from migraines, and it’s important to note that propranolol may be beneficial for these women... This is an important discovery for those dealing with migraines.' 

About 28million adult women in the US - one in six  - are thought to deal with regular migraines. 

Propranolol is a beta blocker, a type of drug typically prescribed to treat high blood pressure and irregular heart rhythms. 

It has also been shown to stop the effects of anxiety, such as shaky hands and a wobbly voice, which is why doctors also prescribe it for performance anxiety.  

It works by relaxing blood vessels and slowing heart rate, which improves blood flow and lowers blood pressure. 

This allows blood to flow to the brain more easily, preventing clots and strokes.  

In the new study, which will be presented at the upcoming International Stroke Conference next week, researchers reviewed 3million electronic health records spanning 15 years from two large databases.

The study included men and women with migraine who were divided into two groups: those who had suffered a stroke after their first migraine and those who did not have a stroke.

The team then looked at if the patients were treated with propranolol for migraine. 

The team found propranolol lowered the risk of ischemic stroke in women with migraine by 52 percent in one analysis and 39 percent in the other.

However, the medication made no difference for men. 

There are multiple types of stroke, but the most common is ischemic stroke, which occurs when a blood clot blocks an artery in the brain, cutting off blood supply and depriving brain cells of oxygen, causing them to die. 

The team said it's possible no effect was seen in men because migraine has been more closely associated with stroke in women than men, though the exact mechanism for the difference is unclear. 

Women are between two to four times more likely than men to have migraine. One 2023 study found 43 percent of women and 18 percent of men have had at least one. 

The researchers said propranolol's low cost - around $10 to $20 for a month's supply - could provide a more accessible solution for treating migraines and, in the long term, stroke.

Dr Mogos said: 'Our findings indicate that women and health care professionals should discuss the advantages of preventive migraine interventions. 

'For under-resourced individuals who bear a greater burden from this condition and may lack access to new treatments, we must ensure these treatments are available to them. This approach can help reduce health disparities.'

The study findings could be significant given the number of people, especially young people, having strokes has surged in the last several years.

There has been about an eight percent increase overall in strokes, with a 15 percent increase in people 18 to 44 years old.  

While propranolol may prevent strokes, additional research suggests other common medications like blood thinners, anti-psychotics, and opioids could increase the risk of stroke. 

Anti-psychotic medications like clozapine and haloperidol, taken by 3.8million adults in the US, have been shown to cause weight gain, which in turn can raise blood pressure and lead to the narrowing of arteries, increasing stroke risk. 

Additionally, blood thinners like warfarin - taken by 8million Americans - reduce the blood's ability to clot. However, blood being too thin can lead to hemorrhages in the brain, another form of stroke. 

Source: Myawady Web Portal

In contemporary times, with an increasingly fast-paced lifestyle and a modern approach to healing tactics, we unknowingly keep accumulating micro assaults on our immune system without allowing our body to address them. Here’s how the ancient albeit simple practices of yoga can be utilised to boost our immunity and lead a healthier life.
The human body to a great extent is a self-regulating, preserving, repairing and maintaining entity. Nature has designed this wonderful machinery with an inherent capability to heal; provided the natural laws of healing are allowed to operate, our health is in its entirety, a natural outcome of all the encounters we have in life. This healing capacity that we are endowed with is called vitality or immunity. Our body has a self-reliant system of protecting its tissues against assaults by bacteria, viruses, harmful proteins and oxidative stress through an interplay of nervous, endocrine and immune systems.
In today’s world, these systems are constantly challenged due to our fast-paced lifestyle, stress, unhealthy eating habits and a lot of exposure to pathogens. Yoga asanas and pranayama can reduce stress and improve the body’s immune response to fight infections and allergies. Yogic practices have been known to improve human body’s immunity.

Yoga and immunity
Yoga can help to modulate this immune response in an appropriate way. Yoga as a mind-body intervention has been used globally to combat these lifestyle-related diseases where stress is believed to play a role. Yoga helps calm down the mind, bring stability and balance the vital energies. Studies have shown yoga to improve immunity in the population during influenza epidemics. Yoga is a system of holistic living, having its roots in Indian traditions and culture. It is a discipline to develop one’s inherent power in a balanced manner. Now it is being practiced as a part of healthy lifestyle. Yoga is popular globally because of its spiritual values, therapeutic credentials, its role in the prevention of diseases, promotion of health and management of lifestyle-related disorders.
One of the most useful and popular mode of yogic exercises which provides the benefits of Asanas, Pranayama and Mudras altogether is the Surya Namaskar. It consists of a series of twelve postures which are performed early in the morning facing the rising Sun. Each step of Surya Namaskar is accompanied by regulation of breath. Its regular practice energises all systems of the body and ensures perfect harmony between them. It makes the body flexible and improves immunity. Our body has its own set of immuno-responses, amongst them, inflammation is the most common. A natural counter which is often helpful when it comes to healing injuries and infections, inflammation often becomes chronic under constant psychological and physical stress, thereby weakening our immune system. Most asanas involve systematic stretching that alleviates inflammation and increases flexibility. The immunity-boosting capabilities of even basic yogic practices also find mention in a new research published in the Journal of Behavioural Medicine. Today, even Western researchers vouch for yoga’s benefits. The Harvard Medical School Guide to Yoga: 8 Weeks to Strength, Awareness, and Flexibility, says that regular practice of yoga can lead to greater muscle and bone strength, improved sleep, better stress management and resilience, strengthened immune system and enriched brain health.
Nadi Shodhana Pranayama (Alternate Nostril Breathing):
The main characteristic feature of Nadi Shodhana Pranayama is alternate breathing through the left and right nostrils without or with retention of breath (kumbhaka). Sit in a comfortable posture. Keep the spine and head straight with eyes closed. Relax the body with a few deep breaths. Keep the left palm on the left knee in Jnana mudra and the right palm should be in Nasagra mudra. Place the ring and small fingers on the left nostril and fold the middle and index finger. Place the right thumb on the right nostril. Open the left nostril, breathe in from the left nostril, close the left nostril with the small and ring fingers and release the thumb from the right nostril; exhale through the right nostril. Next, inhale through the right nostril. At the end of inhalation, close the right nostril, open the left nostril and exhale through it. This completes one round of the Nadi Shodhana Pranayama (Alternate Nostril Breathing). Repeat for another 4 rounds. The duration of inhalation and exhalation should be equal for beginners. Breathing should be slow, steady and controlled and not be forced or restricted.

Benefits of Pranayama
The main goal of Pranayama is to nourish the body as a whole by cleansing the main channels that distribute energy throughout it. In addition to boosting vitality and lowering stress and anxiety levels, this technique promotes calmness and improves focus. Pranayama can also help with coughing, mental calmness, and concentration. Its advantages go beyond boosting immunity, making it a comprehensive strategy for general health.

Cleansing with kriyas
Cleansing techniques called kriyas also help in removing excess mucous and restore mucosal immunity. Shatkriyas are yogic cleansing techniques used to purge the internal organs and systems of the body. These are a part of the process of detoxification. These techniques are classified into six divisions as under: Neti (nasal washing); Dhauti (stomach washing); Basti (colon washing); Kapalbhati (purificatory yogic breathing); Nauli (isolation of abdominal recti muscles) and Trataka (yogic visual gaze).
These kriyas cleanse, activate and revitalise organs and develop deep internal awareness. The practice of Surya Namaskara, deep breathing exercises, pranayama, meditation and deep relaxation is also highly beneficial. Pranayama is the fourth constituent of Ashtanga yoga, which deals with the regulation of Prana and energy, grossly translated as breath. It is a practice which helps to regulate vital energies through the regulation of breathing. The main purpose of Pranayama is to gain control over the autonomous nervous system and through it to influence the mental functions. Regular practice of Pranayama makes the mind calm.

Understanding immunity
Though exposure to pathogens help build adaptive immunity, surviving such an exposure may sometimes become fatal. Research has shown that there is a heterogeneity in susceptibility to infections during a flu epidemic. Psychologic stress, fitness and physical activity, nutrition, sleep, comorbid conditions and lifestyle play a vital role in shaping this immune response. A growing body of evidence identifies stress as a co-factor in infectious disease susceptibility and outcomes. It has been suggested that the effects of stress on the immune system may mediate the relationship between stress and infectious disease. Stress increases stress hormones that dampen immune response and also reduce the ability of the cells to repair the damage caused due to infections.

Meditate on wellness
The process of keeping one’s attention focussed with sustained concentration on an object is commonly known as meditation. It is an integral part of all yogic practices and is beneficial for psychological and spiritual growth. Over the years, the stress relieving benefits of regular meditation have been known to achieve a sense of calm which has a positive impact on an individual’s health and promotes a healthy lifestyle. It has been known to be beneficial when it comes to overcoming addictions of tranquilizers, reducing hypertension, insomnia, migraines, depression, anxiety, and other psychosomatic illnesses. It stabilises the mind, increases awareness, concentration and will power while simultaneously improving memory and alertness. It is an effective tool for rejuvenation of the mind, body and soul, and even helps in coping with the stressful situations of everyday life.

Dr Raghavendra Rao M, BNYS, PhD is the Director, Central Council for Research in Yoga & Naturopathy (CCRYN), under the Ministry of AYUSH, Delhi. He has completed several research projects on the use of both yoga and naturopathy interventions.

Source: The Global New Light of Myanmar

Photo: Pinterest

AVIAN influenza, caused by the H5N1 virus, began spreading globally in 2008. The virus initially spread among animals and then to humans who came into contact with infected animals. Severe cases of avian influenza can be fatal.

In early October, Vietnamese state media reported that dozens of tigers died in southern Vietnam zoos following a bird flu outbreak. Since August, 47 tigers, three lions, and a panther have succumbed to the H5N1 virus at Vuon Xoai Zoo near Ho Chi Minh City and My Quynh Safari Park in Long An province. No human infections were reported.

In 1997, as bird flu claimed lives in Hong Kong, approximately 1.5 million chickens were culled to prevent an outbreak in the region. In early 2004, a significant bird flu outbreak occurred in Thailand, Vietnam, South Korea, and Japan, leading to the deaths of 21 people. According to surveys, between 2003 and 2024, a total of 889 people across 23 countries were infected by the H5N1 virus. Of these, 463 died, representing 52 per cent of those infected, as reported by the World Health Organization.

Currently, people worldwide are facing outbreaks of infectious diseases. Of these, 75 per cent of the diseases that have emerged globally in the past two decades were zoonotic, meaning they were transmitted from animals to humans. As a result, it has become increasingly difficult to separate animal health from human health due to the unexpected rise in infectious diseases.

Biosecurity is crucial in poultry farming. Farmers must follow animal health protocols from relevant authorities to protect both their animals and themselves from dangerous viruses. By prioritizing biosecurity for chickens, ducks, quails, and other livestock, farmers can safeguard their animals and their own health.

The Department of Livestock Breeding and Veterinary in Myanmar has issued guidelines for operating animal farms. Farmers and farm workers must wash their hands with soap after working with chickens, ducks, and quails. Additionally, people should thoroughly cook meat and eggs to ensure they are safe for consumption. Following these practices can help prevent bird flu infections in daily life. 

Practising personal hygiene and keeping poultry farms neat and tidy are crucial to preventing bird flu and cutting the chain of infection in the community. Local authorities have to take preventive measures whenever they receive information about bird flu from all over the world and warn the breeders of bird flu infection in time.