Obesity

Causes
Obesity occurs when your body consumes more calories than it
burns. In the past, many people thought that obesity was simply caused by
overeating and under-exercising, resulting from a lack of will power and self-
control. Although these are significant contributing factors, doctors recognize
that obesity is a complex medical problem that involves genetic, environmental,
behavioural, and social factors. All these factors play a role in determining a
person's weight.

Symptoms and Complications

The health risks associated with obesity include:

 breathing disorders (e.g., sleep apnea, chronic obstructive pulmonary disease)

 certain types of cancers (e.g., prostate and bowel cancer in men, breast and
uterine cancer in women)

 coronary artery (heart) disease

 depression

 diabetes

 gallbladder or liver disease

 gastroesophageal reflux disease (GERD)

 high blood pressure

 high cholesterol

 joint disease (e.g., osteoarthritis)

 stroke

Treatment and Prevention

Changing your lifestyle
Obesity is managed and treated to decrease the health risks caused
by obesity and to improve quality of life. An appropriate weight
management program usually combines physical activity, healthy diet, and
change in daily habits. Other programs may also involve psychological
counselling and, in some cases, drug therapy. Losing weight and keeping it off
is very challenging because lifestyle and behavioural changes are required.

Medications
Commonly prescribed weight-loss medications include orlistat (Xenical), lorcaserin
(Belviq), phentermine and topiramate (Qsymia), buproprion
and naltrexone(Contrave), and liraglutide (Saxenda). You will need close medical
monitoring while taking a prescription weight-loss medication

Influenza (flu)
Diagnosis

Your doctor will conduct a physical exam, look for signs and symptoms of
influenza, and possibly order a test that detects influenza viruses.

The most commonly used test is called a rapid influenza diagnostics test, which
looks for substances (antigens) on a swab sample from the back of the nose or
throat. These tests can provide results in about 15 minutes. However, results
vary greatly and are not always accurate. Your doctor may diagnose you with
influenza based on symptoms, despite having a negative test result.

More-sensitive flu tests are available in some specialized hospitals and labs

Treatment

Usually, you'll need nothing more than bed rest and plenty of fluids to treat the
flu. But in some cases, your doctor may prescribe an antiviral medication, such
as oseltamivir (Tamiflu) or zanamivir (Relenza). If taken soon after you notice
symptoms, these drugs may shorten your illness by a day or so and help
prevent serious complications.

Oseltamivir is an oral medication. Zanamivir is inhaled through a device similar

to an asthma inhaler and shouldn't be used by anyone with respiratory
problems, such as asthma and lung disease.

Antiviral medication side effects may include nausea and vomiting. These side
effects may be lessened if the drug is taken with food. Oseltamivir has also
been associated with delirium and self-harm behaviors in teenagers.

Some strains of influenza have become resistant to amantadine and

rimantadine (Flumadine), which are older antiviral drugs.

Cavities/tooth decay
 Overview

Types of cavities
Cavities are permanently damaged areas in the hard surface of your teeth that
develop into tiny openings or holes. Cavities, also called tooth decay or caries,
are caused by a combination of factors, including bacteria in your mouth,
frequent snacking, sipping sugary drinks and not cleaning your teeth well.

Cavities and tooth decay are among the world's most common health problems.
They're especially common in children, teenagers and older adults. But anyone
who has teeth can get cavities, including infants.

If cavities aren't treated, they get larger and affect deeper layers of your teeth.
They can lead to a severe toothache, infection and tooth loss. Regular dental
visits and good brushing and flossing habits are your best protection against
cavities and tooth decay.
Symptoms

The signs and symptoms of cavities vary, depending on their extent and
location. When a cavity is just beginning, you may not have any symptoms at
all. As the decay gets larger, it may cause signs and symptoms such as:

 Toothache, spontaneous pain or pain that occurs without any apparent cause

 Tooth sensitivity

 Mild to sharp pain when eating or drinking something sweet, hot or cold

 Visible holes or pits in your teeth

 Brown, black or white staining on any surface of a tooth

 Pain when you bite down

ANALGESICS

Non-narcotic analgesics are the most commonly used drugs for relief of
toothache or pain following dental treatment as well as fever. The commonly-
used medications used are:

ibuprofen (Advil, Nuprin, Motrin), acetaminophen (Tylenol), and aspirin (for

example, Bayer);

corticosteroids such as Orabase-HCA, Oracort, and Oralone are anti-

inflammatory medications that are used to relieve discomfort and redness of the
mouth;

and for severe pain conditions, narcotic analgesics such as codeine or

hydrocodone (Vicodin) may be given. Codeine formulations usually include
acetaminophen for increased efficacy, for example, Vicoprofen and Tylenol #3.
Diabetes

Diabetes mellitus is a metabolic disease characterized by high blood

sugar (glucose) levels that result from defects in insulin secretion or the body’s
ability to use insulin.

Normally, blood glucose levels are tightly controlled by insulin, a hormone

produced by the pancreas. Insulin lowers the blood glucose level. When the
blood glucose elevates (for example, after eating food), insulin is released from
the pancreas. This release of insulin promotes the uptake of glucose into body
cells. In patients with diabetes, the absence of insufficient production of or lack
of response to insulin causes hyperglycemia. Diabetes is a chronic medical
condition, meaning that although it can be controlled, it lasts a lifetime.

In type 1 diabetes, the pancreas cannot produce insulin. Type 1 diabetes was
formerly known as juvenile diabetes or insulin-dependent diabetes. Type 2
diabetes is more a result of insulin resistance (cells not being able to use insulin
effectively or at all. It was formerly known as adult-onset diabetes or non-
insulin-dependent diabetes

Medications for type 2 diabetes

Sulfonylureas

Medications that increase insulin output by the pancreas belong to the class of drugs called
sulfonylureas. Older generations of these drugs include chlorpropamide (Diabinese) and
tolbutamide were abandoned due to association with higher risk of cardiovascular events.

The newer sulfonylurea drugs include glyburide (DiaBeta), glipizide (Glucotrol),

and glimepiride(Amaryl).

These drugs rapidly lower blood sugar, but can cause abnormally low blood
sugar (called hypoglycemia). In addition, sulfonylureas contain sulfa and should be avoided by
those who are allergic to sulfa. Weight gain is a possible side effect of the sulfonylurea drug

Meglitinides
Like the sulfonylureas, meglitinides is a class of drugs that work by promoting
insulin secretion from the pancreas. Unlike the sulfonylureas, which last longer
in the body, repaglinide (Prandin) and nateglinide (Starlix) are very short acting,
with peak effects within one hour. For this reason, they are given up to three
times a day just before meals.

Since these drugs increase circulating insulin levels they may cause
hypoglycemia. Weight gain is also a possible side effect.

Thiazolidinediones
Thiazolidinedione drugs lower blood glucose by increasing the sensitivity of the
cells to insulin (improving target cell response to insulin). Examples
include pioglitazone (Actos) and rosiglitazone (Avandia)

These drugs have been linked to serious side effects like an increased risk
of heart failure and bone fractures. Weight gain is another possible side effect.
These medications are not usually given as a first-line treatment but may be
helpful for some people.