Dr. Willie T. Ong, The Philippine STAR, January 31, 2012

Body odor can be an embarrassing problem. This unpleasant smell comes from a mixture of sweat and bacteria. Normally, our sweat should have little odor. However, it’s the bacteria on the skin that causes one’s perspiration to smell sour.

Have you wondered why people sweat? Actually, our bodies perspire to lower the body temperature and keep us cool. We sweat more during hot weather, when we exercise, and when we are nervous. There are also other hereditary causes of sweating, especially those with sweaty palms and feet.

Two Kinds of Sweat Glands:

Our bodies have two kinds of sweat glands, the not-so-smelly kind and the smelly kind. This refers to the eccrine glands and the apocrine glands, respectively. Eccrine glands are found all over the body and have little smell. Apocrine glands, however, are found in hairy parts of the body like the armpits, scalp and groin. Apocrine glands excrete a fatty kind of sweat that when it comes in contact with bacteria, develop a particularly foul smell. This is why the armpits, groin and head area smell more compared to the forearms and legs.

Now that you know these smelly body parts, let’s look at some tips to help control body odor.

1. Use an antiperspirant for the underarms. Antiperspirants contain aluminum-based chemicals that block off the pores of our sweat glands. This is really the simplest solution to your body odor problem. The less you perspire, the less you will smell.
2. You can use a commercially-available deodorant or roll-on. Deodorants work by eliminating the odor but not the sweating. These are usually alcohol-based products that turn your skin acidic, making it less favorable for bacteria. Deodorants have fragrances that mask the odor. Commercially, there are preparations that combine both antiperspirants and deodorants.
3. As a home remedy, try an alcohol and baking soda mixture for your underarms and feet. Since the bad smell comes from bacteria, then placing 70% rubbing alcohol will instantly kills the bacteria and reduce the smell. You can also use alcohol for your feet to lessen fungal infections like athlete’s foot. Alternatively, you can try the local tawas. Find which preparation works best for you.
4. Take a bath daily. Wash and scrub the whole body well, especially the smelly parts. Bathing will reduce the number of bacteria on the skin.
5. Wash your underarms, groin and feet twice a day. The sweat that comes from these body parts is different from the sweat in other areas.
6. Use an anti-bacterial soap. Choose a soap that works for you. There are some anti-bacterial soaps that keep you fresher throughout the day. Shop around.
7. Dry your feet and underarms after you take a bath. Bacteria grow more in dark and damp places, particularly the area between the toes. Use a foot powder or sprinkle baking soda to dry the feet.
8. If your feet are really smelly, try to change socks twice a day. Did you know that our feet secrete an equivalent of a glassful of sweat per foot every day? Wear cotton socks, too.
9. Choose shoes that allow your feet to “breathe.” Closed shoes make your feet sweat more and thus smell more. You can opt to wear sandals and open-toed footwear. You can also “air” your feet from time to time by going barefoot or removing your shoes for awhile.

10.  Take note: Avoid foods that make you smell. Minimize spicy and hot foods. Avoid eating too much garlic, onions, curry and smelly fish. It’s true that we are what we eat, and some of these foods’ components are excreted out of our sweat glands. If you like chili, fish sauce and fish paste (bagoong), your sweat could smell like these sauces, too.

11.  Drink 8 to 12 glasses of water daily. Water cleanses the body and dilutes the smell of our sweat and urine. The more water you drink, the less smelly will be your sweat. So drink more.

12.  Wear cotton shirts, pants and underwear. Cotton-made clothing makes it easier for the sweat to evaporate. Hence, it makes you feel cool and fresher. Avoid nylon clothing because it makes your sweat stick to you.

13.  Wash your clothes well. Indeed, clean clothes make the man. It also lessens your body odor. Change your shirt and socks daily. And please, no reusing of old clothes.

14.  Don’t sweat too much. If you know you have an afternoon meeting, then don’t exercise and jump around in the morning. Try to reschedule your meetings in the morning (when you’re fresher), and do your outside chores in the afternoon.

15.  If you really need to smell fresh before a meeting, try bringing extra clothes and socks. Wash your underarms, neck and face in the bathroom before wearing your new clothes.

16.  Relax and take it easy. The more fidgety and nervous you are, the more you will sweat. Keep cool beside a fan or air-conditioner.

Finally, if your body odor persists despite these measures, you might need to see a doctor. The doctor will rule out medical problems like an overactive thyroid or kidney disease.

There’s also a disease of excessive sweating, medically called hyperhidrosis. Treatment for this condition is similar to the tips mentioned above. Doctors may also prescribe a special antiperspirant (like Aluminum chloride).

For extreme cases of over sweating, there’s a surgical procedure that cuts the nerve that causes the sweating. Don’t worry about it because it’s rarely done. For the majority of people, the above 16 tips are all you need to smell cleaner and fresher. Good luck!

Dr. Willie T. Ong, The Philippine STAR, January 17, 2012

Everyone feels dizzy sometimes. Dizziness is a general term used to describe anything from a mild unsteadiness to severe vertigo. Vertigo is a severe form of dizziness wherein you feel the environment is spinning around you.

There are different causes of dizziness. Majority are harmless, while some forms of dizziness can be serious. Let’s check on the less serious causes first.

1. Eye problems – If you have blurred vision, astigmatism or other eye problems, you can get dizzy while reading. Have your eyes checked by an optometrist or ophthalmologist and get some eyeglasses. If you’re working on a computer for a long time, you may also get dizzy. Rest your eyes and look at a distant object every ten minutes or so.
2. Anxiety or nervousness – Nervous persons often say they feel dizzy. This is like a panic attack. If you feel an attack is coming, all you have to do is stop what you’re doing and rest for awhile. Doctors may prescribe you a sedative like Bromazepam 1.5 mg (Lexotan) to relax you.
3. Hunger – Dizziness can be caused by hunger and low blood sugar. Take some bread, juice or a banana to keep your blood sugar up.
4. Change in weather – Going to an air-conditioned room after being out in the sun can cause headache and dizziness.
5. Motion sickness -  Swaying movements from airplane, boat and car rides can cause dizziness.
6. Lack of oxygen – Some people get dizzy and may even pass out in crowded areas like a church or a rally. Give the person some room and bring him to a well-ventilated area.
7. Inner-ear problems – This is the most common cause of vertigo. Our inner ear has a vestibular system, which controls our balance. If you have a cold or flu, this organ could become inflamed, causing severe dizziness lasting for weeks (called Labyrinthitis). Moreover, any sudden change in head position can cause crystals in the ear to break loose and cause dizziness. This is called Benign Positional Vertigo. Consult an Ear, Nose, and Throat (ENT) doctor to be sure. In the meantime, check out our advice for reducing dizziness.

18 Tips To Reduce Dizziness:

1. If you feel dizzy, try to grab hold of a steady object beside you. When you are standing up, the brain can get mixed messages regarding your balance. Holding on to a firm object, like a chair, table or wall, can help your brain refocus and regain its balance.
2. Get up slowly from bed. When you wake up in the morning, be sure to give yourself a minute or two to become oriented. Be sure your arms and feet are “awake” already and not numb. Shake your hands and legs to get the blood circulating back to your limbs. Sit up for awhile before attempting to stand.
3. If you feel a severe attack of dizziness coming, sit down for a while and don’t move. By staying steady, you may limit the severity of the dizziness.
4. For mild dizziness, you may continue with your regular routine. Go on your walks and perform light exercise. It’s important to maintain your body’s muscle strength to keep your balance.
5. Wear flat shoes or rubber shoes. Avoid wearing high heels because there is too little contact between the heel and the floor, causing you to feel unsteady. Flat rubber-soled shoes are the best shoes for walking. It’s good for your knees and feet, too.
6. Keep a flashlight handy. When walking at night, be sure there is enough lighting in the area. At night, you may like to keep a nightlight on just in case you need to go to the bathroom. A dim environment can confuse your brain and make you feel off balance.
7. Avoid walking on carpets or soft ground. Thick carpets make it difficult for the brain to assess its balance.
8. Make your homes accident-proof. Install handles in the bathroom, and place a rubber mat on your shower area. Most accidents occur in the bathroom area.
9. Decrease your salt intake. By lessening the amount of salty foods you eat, you will also reduce the amount of fluid your body retains. Too much fluid can not only lead to feet swelling, but also inner-ear swelling, which can cause dizziness.

10.  Avoid alcoholic drinks. Dizziness and alcohol intoxication are the worst combination. It’s an accident waiting to happen.

11.  Consider taking anti-dizziness medicines like meclizine 25 mg tablets (Brand name Dizitab o Bonamine).

12.  Drink a ginger mixture (salabat) as a natural remedy. Combine ginger, honey and warm water. This is a very effective treatment for dizziness. In fact, studies show that ginger solutions are as effective as drugs.

13.  Avoid texting while walking. A patient of mine was busy texting on his way down the stairs. Well, when he woke up, he was already in the MRI room of a hospital. The patient fell and lost consciousness. Luckily, he survived with just a broken elbow.

14.  Drink 8 to 12 glasses of water. If you are dehydrated, your blood pressure could also drop, causing dizziness.

15.  Sleep 7 to 8 hours a day. Lack of sleep is a common cause of unsteadiness during the day.

16.  Limit stress and relax. A nervous person often feels dizzy for no reason. Try to relax by taking slow and deep breaths several times during the day. Try to imagine that you’re in a peaceful environment.

17.  Pinch the skin between your eyebrows. This technique sometimes works for dizziness and headaches. Try it. This skin area is a known acupressure point.

18.  Check your medicines. Some medicines, like aspirin, blood pressure medicines and diabetes drugs, may sometimes cause dizziness. Ask your doctor about it.

When should you consult a doctor?

There are some instances when dizziness can have a serious cause. If your blood pressure is higher than 140 over 90, you can become dizzy and experience nape pains. If your blood pressure is too low, less than 90 over 60, this is likewise a dangerous cause of dizziness. See a doctor immediately.

If you have irregular heartbeat, weakness, numbness or severe headaches, you should consult a doctor. Strokes and brain tumors can also bring about dizziness.

Learn more about dizziness, and you’ll be better prepared to handle them in the future. Good luck!

Dr. Willie T. Ong, The Philippine Star

Tuberculosis (TB) is an infection caused by bacteria that usually affects the lungs. These bacteria, called Mycobacterium tuberculosis, can spread to another person through tiny droplets spread by coughing and sneezing. Even the accidental spread of saliva though laughing, singing and spitting can pass on the TB bacteria.

In the Philippines, TB is the number 6 leading cause of death, with 73 Filipinos dying every day from TB. Let us look at 10 facts about TB:

1. An estimated 200,000 to 600,000 Filipinos have active TB. This condition makes the person sick and contagious to others. Active TB can occur in the first few weeks after infection with the bacteria, or it can occur a few years later. Signs and symptoms of active TB include cough, phlegm (sometimes with blood), unexplained weight loss, fatigue, afternoon fever, night sweats, chills and loss of appetite. See your doctor if you have these symptoms.
2. The danger of TB is real. Out of 196 countries, the Philippines has the distinction of being included in the top 22 high-burden tuberculosis countries in the world. This report is according to the World Health Organizations (WHO) which ranks the Philippines at number 9 worldwide. Together, these 22 countries (including the Philippines) contribute 80% of the global TB burden. TB is a disease of poverty and the high TB burden is a reflection of our economic status. On the other hand, some people consider being number 9 as “good news” since we came from number 7 worldwide! In fact, after China, the Philippines had the second highest number of TB cases in the WHO Western Pacific Region in 2007.
3. Each person with active TB can spread the disease to 10 other Filipinos each year! This is alarming since there are between 200,000 to 600,000 Filipinos with active TB. Multiply this by 10, and just imagine how much TB is being spread yearly. Hence, whenever someone in the household has been diagnosed with TB, all the other members of the household should get tested (like a Chest X-ray) for TB, too. The usual treatment course for TB is between 6 to 9 months of continuous medicines. The good news, however, is that once active TB is treated with the appropriate drugs, the person is no longer contagious after 3 weeks. That is why those who are being treated for TB are advised to rest during the first month.
4. Another alarming fact: An estimated 80% of Filipinos have latent TB. Because of the huge TB burden in the country, most of us already have the so-called “latent TB.” Yes, that in all likelihood means you and me. In this condition, we already have the TB infection in our bodies, but the TB is still in the inactive state. Hence, we feel no symptoms and we are not contagious to other people. Some countries, like the U.S., will treat those with latent TB with medicines. But we can’t help it because we are born in the Philippines. We just need to observe a healthy lifestyle, or else the TB infection might reactivate.
5. Tuberculosis can affect other organs of the body, such as the kidneys, spine or brain. Symptoms depend on the organ affected. TB of the spine causes severe back pain, while TB of the kidneys can cause bloody urine. Hence, TB should be checked and treated as early as possible.
6. Treatment of TB may not change your chest x-ray results back to normal. Thus, many Filipinos cannot pass job tests for abroad because of past or present TB infection. Studies show that once treatment for TB is completed, a repeat chest x-ray may show the following results: 30% of chest x-rays will revert to normal (good news), 30% of chest x-ray will improve but will still show a scar (still can’t pass job test), 30% of chest x-ray will remain the same. This just goes to show that the TB burden in the country is also affecting the employment of our people.
7. The BCG vaccine against TB is not 100% effective. Although the WHO recommends that BCG be given to all infants and young children in countries with high TB burden, the vaccine does not always protect people from TB. In addition, the protection given by the BCG does not seem to be effective as the person becomes an adult. Still, the BCG appears to protect the person from a more serious TB disease and should be a part of the immunization program.
8. Beware of Multiple Drug Resistant Tuberculosis (MDR-TB). Another challenge is the emergence of a new drug-resistant strain of TB, called MDR-TB. This new “superbug” probably arose because TB patients did not adhere to their drug regimen, which means that they didn’t take their medicines religiously for the usual 6 months. Because of this, the TB bacteria developed a resistance to the first-line drugs like Isoniazid and Rifampicin. MDR-TB is difficult and expensive to treat. Worldwide, in 2008, there were an estimated 440,000 new cases of MDR-TB and 150,000 deaths from MDR-TB. Estimates show that 3.3% of new TB cases are really MDR-TB.
9. Have you heard of XDR-TB? If having the multi-drug resistant TB is bad enough, scientists have discovered a third more terrible strain of TB. These nasty bacteria are called “extensively drug-resistant TB” or XDR-TB. This means that XDR-TB is resistant even to the special drugs developed for MDR-TB. Be forewarned: The WHO has reported that XDR-TB cases have been confirmed in 58 countries, including the Philippines.

10.  Finally, some good news. Despite the high TB incidence, significant developments have been made in increasing case detection and treatment in the country. In 2007, the Philippines achieved a TB case detection rate of 75 percent, exceeding the WHO target of 70 percent. The Directly Observed Therapy Short Course or DOTS is the internationally recommended strategy for TB control. DOTS simply means asking a relative or a health worker to directly observe the patient taking the anti-TB medicines daily. The Philippines’ DOTS treatment success is at around 88%, which is higher than the WHO target of 85 percent. Fortunately, international agencies, like the Global Fund and USAID, are helping the country combat TB.

Despite these accomplishments, many factors still need to be addressed such as reducing the stigma of TB patients, and increasing the public’s awareness on the disease, especially the need for treatment. Some infected TB patients still refuse treatment and continue to pose a danger to people around them.

I appeal to our policy makers, health workers and media to further strengthen our campaign against this terrible scourge.