Health column with Dr Pondicherry Sen, President of Arogya Mantra

1. What problems are commonly seen at the GP in the summer?

- Many patients come into the clinic with insect bites, food poisioning, heat stroke and dehydration. You do not often see patients coming in with sunburn but it is one of the bigger problems associated with summer as it leads to skin cancer.

2. Lets start with the smaller problems - do we need to be wary of mosquito bites?

- Most insect bites in new zealand are not serious
- They are only serious if they carry a serious virus but this is uncommon
- Most insect bites will look like a red itchy bump
- If it is painful if it’s generally a spider bite

3. What do you do if you have insect bites?

- Clean the bite daily and moniter it- should go away in 2 weeks
- Keep nails short and avoid scratching
- If your bite is very irritated -soak in water or aloe vera to soothe
- Avoid reccurance by using insect repellant
- If your bite mark develops pus, gets larger or persists for longer than 2 weeks see your GP

4. Why do we get more food poisoning in summer?

- Summer time is full of picnics where food is brought out into the open and heat for long periods of time. Avoid an outbreak of food poisoning this summer by following simple guidelines about food safety and food handling!

5. How do I know I have food poisioning and not another disease?

- E-coli, campylobacter amd listeria, all common bacteria found in food poisioning cause symptoms such as diarrhoea, fever, abdominal cramps and vomiting

- Sometimes symptoms thought to stem from a food borne illness might actually be reactions to food intolerance due to irritable bowel syndrome, celiac disease or enzyme deficiencies.

- Though these other diseases have similar symptoms, they can usually be seperated from food poisioning by characteristic differences;

- Celiac disease- you will find an intolerance to wheat, barley and rye – a patient wiill typically experience flatulence, bloating and diarrhoea after consumption of these products

- Irritable bowel syndrome - you will find your bowel works very fast (hyper motility) and you have odd bowel motions (both diarhhea and constipation) and tummy pain but only during the day

- Enzyme deficiency- lactose intolerance is very common in Indians and many find they experience gas and bloating after eating dairy products. These symptoms often worsen with age.

- If you think your upset tummy is more than food poisioning – consult your GP.

6. Why do we need to be careful in the sun?

- In New-zealand we do not have the same ozone protection as we do in India. Because of this, harmful rays of light such as Uvb enter our atmosphere in larger numbers and reach us in a shorter period of time.

- UVb damages our skin by breaking the destroying the DNA in our skin cells. Damaging DNA is very dangerous and leads to the development of cancer. For this reason we require a second layer of protection ontop of our skin – sunscreen!

7. If I have coloured skin, am I still at risk of skin cancer? What should I look out for?

- Yes, everyone can get skin cancer. Most skin cancers are associated with UV radiation from the sun or tanning beds, and many people of color are less susceptible to UV damage thanks to the greater amounts of melanin (the protective pigment that gives skin and eyes their color) darker skin produces. But people of color can still develop skin cancer from UV damage.

- Additionally, certain skin cancers are caused by factors other than UV — such as genetics or other environmental influences — and may occur on parts of the body rarely exposed to the sun. For example, darker-skinned people are more susceptible to acral lentiginous melanoma, an especially virulent form of melanoma (the deadliest type of skin cancer) that typically appears on the palms of the hands and soles of the feet.

- Different ethnicities are at higher risk for particular skin malignancies: Latinos, Chinese, and Japanese Asians tend to develop basal cell carcinoma, the most common skin cancer. But the second most common, squamous cell carcinoma is more frequent among African Americans and Asian Indians.

- I advise people of all ethnicities to do a monthly skin self-exam, looking for lesions that bleed, ooze or crust, don’t heal, or last longer than a month; these may indicate basal cell carcinoma. Squamous cell carcinomas may appear as non-healing ulcers, growths, and sores next to scars or areas of previous physical trauma/inflammation, particularly if they appear on the legs. New or existing moles (brown, pink, black, red, or flesh-colored spots) that are asymmetric, have an irregular border, change in color, are larger than a pencil eraser, or change in any way may indicate melanoma. Any of these warning signs should be examined by a dermatologist, including growths on the hands, soles, or under the nails. Such spots could signify acral lengitinous melanoma.

- Because many doctors and patients believe people of color are immune to skin cancer, diagnosis is often delayed, sometimes until the disease is advanced and potentially fatal. Furthermore, dangerous skin cancers such as the fast-moving acral lentiginous melanomaand a metastasizing (spreading) form of squamous cell carcinoma are more common among darker-skinned people. So while skin cancer is much more common among lighter-skinned people, it tends to be more deadly among people of color.

Arogya Mantra is a registered charity run by young health professionals to improve the health and wellbeing of the south Asian community. We run non-profit exercise and health classes as well as free health talks and health screening.