Hepatitis is inflammation of the liver, usually an infection caused by one of three viruses.

Type A hepatitis is what we previously called infectious hepatitis. This virus is shed in the faeces and spreads from person to person by contamination from faecal matter. It has an incubation period of about 30 days.

The virus has recently been identified and can now be grown in culture and a vaccine to protect against this form of hepatitis may be available soon.

To protect immediate contacts of those with this type of hepatitis, an injection of gamma globulin may be given. This is prepared from human serum collected by the Blood Bank and, in Australia, extracted at the Commonwealth Serum Laboratories. It contains antibodies to the virus and can give short-term protection over two to three months.

Type  hepatitis, formerly called serum hepatitis, is due to a different virus and has a much longer incubation period, around 90 days. It is usually spread by contact with the blood.

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Persistent indigestion may be due to an ulcer, to irritation of the stomach or to the presence of what is called an hiatus hernia.

We now realise that it is not the presence of the hernia itself, but of the associated reflux of acid into the gullet which causes the trouble.

The gullet or oesophagus runs through the chest, then passes through a gap or hiatus in the diaphragm, the sheet of muscle which separates the chest from the abdominal cavity. Once through this hiatus, it widens out to become the stomach.

In hiatus hernia, this gap is widened and allows a portion of the stomach to push up or herniate through the diaphragm into the chest.

Hiatus hernia becomes increasingly common as we age. Symptoms do not seem to correlate with the size of the hernia.

Associated with the hernia is gastro-oesophageal reflux. The distortion in the anatomy allows the acid contents of the stomach to regurgitate into the lower part of the gullet and this irritates the lining and is responsible for the symptoms.

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The Rh antibodies should also be checked at 28 and 34 weeks of the pregnancy. Following delivery, the antibodies are again checked and so is the blood group of the child.

Should Rhesus antibodies be found in the mother’s blood, the doctor will consider inducing labor earlier than the due date. This is because the risk of the baby being affected increases as the birth date is approached.

However, if the child is delivered too soon, it has to face the risks of prematurity.

Amniocentesis is a procedure where a needle is inserted through the womb into the amniotic sac that surrounds the baby, and fluid is removed for examination to determine if the child is affected and how severely.

Those women who are already sensitised have to rely on the skill of their obstetrician and the paediatrician to save their babies.

Those other women who are Rhesus negative and conceive an Rh positive child should have anti-D globulin after each pregnancy and particularly after spontaneous or induced abortion. In this way, the frequency if not the severity of this disorder can be greatly reduced.

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Once the mother has formed these antibodies, they readily cross the placenta to enter the baby’s circulation and can destroy the baby’s red cells.

If the baby is severely affected, this can lead to death in the womb or soon after birth. Destruction of the red cells can also cause anaemia and jaundice due to an excess of bile pigment from the broken-down cells.

Destruction of the baby’s red cells, with a rapid onset of severe jaundice, is more likely in the first few hours after birth. If the jaundice is severe, it can lead to brain damage.

If Rhesus iso-immunisation occurs and the baby is severely affected, it is possible to treat by the technique of exchange transfusion.

In this, most of the baby’s blood is withdrawn and replaced by Rh negative blood. In this way, the Rh antibodies from the mother which are circulating in the child’s blood are washed out and those which remain are destroyed by the baby’s own immune system. While this is happening, the transfused Rh negative cells do the work of transporting oxygen and are not affected by the antibodies.

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Like hair, nails have become items of cosmetic and sexual significance. Nails must be long and strong to be attractive. To be fashionable, their colour must match that of the lipstick or of the clothes. It is also desirable for the lunula to be visible, and so the cuticle is pushed back. Consequently, there are a multitude of commercial preparations available to help achieve these artificial aims. Large amounts of gelatin and calcium are consumed throughout the world in the mistaken belief that the nails will become harder, longer and healthier. Unfortunately, as we have seen, calcium is present in only insignificant amounts in nails. Certainly bones and teeth may benefit from the calcium, but not the nails. Gelatin is certainly a protein but it is an extremely poor quality one which has no effect on keratin, a high-grade protein. Severe protein deficiencies may result in brittle nails, but as such cases are extremely rare in our society -individuals with this condition would also exhibit thin, brittle hair and body wasting—this deficiency may be virtually dismissed as a likely reason. Another popular misconception is that vitamin deficiencies may be a cause of brittle nails—this is not so.

Nail hardeners, developed to prevent nails from chipping, breaking and peeling, are very popular products. They contain formaldehyde, or ingredients that gradually release formaldehyde. Reactions to formaldehyde are unfortunately quite common, and because more and more people are being exposed to this chemical in permanent press fabrics, allergies are becoming more frequent. With nails, these reactions may be manifested as discolouration or bleeding under the nail, pain, dryness and, most commonly, as lifting and loosening of the nail.

Over-zealous manicuring, particularly pushing back the cuticle, may cause damage to the cuticle in the lunula area. This may result in ridges appearing along or across the nail, which will take months to grow out. Alternatively, infections of the nail surrounds—paronychia—may occur.

The use of nail polishes and, in particular, of polish removers, are thought to contribute significantly to the frequency of nail disorders in women. Brittle and flaking nails especially appear to be at least aggravated by the frequent use of polish removers, which are strong solvents. It is better to patch up the chipped polish than to regularly remove and reapply it. Lifting of the nails has also occurred due to the use of nail polishes or base coats containing certain synthetic resins.

There are two types of artificial nails currently in vogue. Either may cause significant problems. Pre-formed artificial nails are made from synthetic materials similar to those used in the manufacture of dentures. They are attached to the natural nails with an adhesive, or simply pressed on, and then filed to shape. The adhesive used to attach the nails may cause an allergic reaction to the skin surrounding the nail. The artificial nail itself may cause damage if left on for more than a few days: for instance the natural nail may soften and lift off because of moisture accumulating under the impermeable plastic Artificial nails may also be formed as extensions of the natural nails, using plastic acrylic material. Here a liquid acrylic is mixed with a powder, which thickens, and is then moulded around the natural nail. This hardens rapidly, to form an artificial nail which is firmly attached to the natural nail which ‘grows with it’, lasting for about a month. This product may cause severe – and painful – nail damage. If such damage occurs, the nails will not return to normal for many months, if at all.

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Because of the cosmetic and sexual importance attributed to hair, and because of the variability of hair growth among individuals, hair care and cosmetics is a multi-million-dollar business. In the United States more money is spent annually on cosmetic products for the hair than for all medical research in the country. Unfortunately, the multitudinous preparations and treatments promoted are in the main quite useless.

What type of shampoo should one use? The requirements of a shampoo are that it should cleanse the hair and scalp, rinse out without difficulty, be non-irritating and cosmetically acceptable, and leave the hair manageable. Often a mild soap will be just as effective in meeting these criteria. A shampoo is basically detergent, water, a fatty material, and possibly some additive. The main ingredient to perform the cleansing function is the detergent. Those shampoos marketed for oily hair simply have more detergent and less fatty material than those for dry hair. It is the detergent which loosens the dirt and oil, which are then rinsed off. Any other additive in the shampoo also ends up down the drain, not on the hair. There are a number of popular additives which may smell nice, look pleasant, or feel good, but which have no significant effect on the hair. Lemon oil, for instance, does not remove oil any better than detergent alone. Egg or egg yolk is merely rinsed out, without providing any additional bonus. Various herbal shampoos possess characteristic odours, but provide no other benefits. Beer makes hair easier to set if used in the final rinse, but mixed in and rinsed off with shampoo it does nothing. Apart from egg and beer shampoos there are a number of other protein shampoos marketed which supposedly mend split ends. Tests have proven such a claim to be quite misleading, the only effective treatment for split ends being to cut them off.

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What to make for dinner is the perennial question. When organising the ingredients in your mind for a main meal, think of them appearing in the following order.

I. First choose the carbohydrate. Which will it be? Potato, rice, pasta, grains, legumes or a combination? Could you add some bread or corn?

2. Add vegetables—and lots of them.

Fresh, frozen, canned—whatever you have, the more the merrier. Refer to the vegetables list under lunches for inspiration, or use your favourites. Think of a bowl of crisp salad with a sprinkling of chopped sun-dried tomatoes plus 1 tablespoon Vinaigrette dressing.

3. Just a little protein for flavour and texture. Remember, we don’t need much—some slivers of beef to stir-fry, a sprinkle of tasty cheese, strips of ham, a dollop of ricotta, a tender chicken breast, slices of salmon, a couple of eggs, a handful of nuts, or use the protein found in your grains and legumes.

4. Hunk twice about using any fat. Check that you are using a healthy type (a monounsaturated or a polyunsaturated) and reduce the quantity if you can.

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1. Quick Thai Noodle Curry. Stir-fry some strips of onion, red capsicum, baby corn and snow peas (or any stir-fry vegetable mix) in a large pan or wok. Add a tablespoon of red curry paste. Prepare a packet of instant noodles according to directions. Add the noodles to the vegetables with enough of the liquid to make a sauce. Stir in a tablespoon of coconut milk, heat through and it’s ready to serve.

Tip Canned coconut milk or cream, can be poured into ice-block trays, frozen and then kept in a plastic bag, making it easy to add just a tablespoon to a dish. Alternatively coconut milk powder can be kept in the pantry and mixed as needed.

2. Speedy Spaghetti. Bring a large pot of water to the boil, add the spaghetti and cook according to the directions on the packet. Meanwhile, open a jar of chunky tomato pasta sauce and heat. Make a green salad with lettuce, spring onions and cucumber or a bag of mixed lettuce. Serve the spaghetti, topped with the pasta sauce, a good sprinkle of Parmesan cheese and a green salad with vinaigrette alongside.

3. Fast Fish and Tiny Taters. Take a boneless fillet of fresh fish. Dust it with seasoned flour. Heat a non-stick pan with a film of oil and pop the fish in to fry. Wash a handful of tiny new potatoes and microwave or steam them until tender. Squeeze lemon juice over the fish once you have cooked both sides and sprinkle with pepper. Serve immediately with the potatoes and a salad or mixed vegetables.

4. Quick Pita Pizza. Spread a round of pita bread with pesto or tomato paste. Top with sliced tomato, mushrooms, roasted capsicum, black olives, chopped spring onions and a sprinkle of Parmesan cheese. Heat through under the grill or in a hot oven.

5. Oriental Noodle and Vegetable Stir-Fry. Stir-fry 2 rashers of diced bacon (all fat removed) or ham. Add a packet of oriental stir-fry frozen vegetable mix, cooking according to the directions on the bag. Mix in some fresh egg noodles or prepared instant noodles a few minutes before the end of cooking time and heat through before serving.

Tip Look for the packets of frozen stir-fry vegetable mixes that have noodles and a sauce sachet included.

6. Time-saving Tortellini. Boil a packet of spinach and cheese (or your favourite filling) tortellini according to packet directions. Heat some bottled tomato pasta sauce and serve this on top of the tortellini with a sprinkle of Parmesan cheese. Add a salad and vinaigrette alongside.

7. Racey Rice and Lentils. Put some Basmati rice on to cook. Heat a heavy-based frypan with a little oil. Add a finely diced onion, crushed garlic and a couple of teaspoons of minced chilli. Saute until the onion is soft. Meanwhile dice a tomato. Open a packet of Quickpulse™ ready-to-eat lentils and add to onion with the tomato. Add ground cumin, salt and pepper to sea-con, heat through and serve alongside the rice.

8. Easy Chicken Pasta. Set half a packet (125 g) of shell pasta on to boil. Meanwhile, thinly slice half a red capsicum, a handful of button mushrooms and a stick of celery. Chop some leftover barbeque chicken into bite-size pieces. Drain the pasta, add the capsicum, mushrooms, celery and chicken and pour over some ‘low oil’ creamy salad dressing. Top with chopped spring onions and serve.

9. Tomato and Tuna Pasta. Set some pasta on to boil. In a small pan saute some chopped parsley, garlic and chilli (optional) in a little oil until aromatic. Add a can of chopped tomatoes (undrained) and small can of flaked tuna. Season with pepper and heat through. Serve the tuna and tomato sauce over pasta.

10. Mexican in Minutes. Brown a handful of lean minced meat and a finely diced onion in a pan. Add a small can of Heinz Mexi Beans™ and taco seasoning if desired. Heat through. Serve with tomato salsa, shredded lettuce, avocado and grated cheese in taco shells or pita bread.

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1. All measures used should be appropriate to the individual and their situation, taking due concern for the privacy and sensitivity concerns of the individual.

2. A variety of tests specific to the client and based on individual characteristics, needs and requirements is preferable to any one single measure.

3. Minimum measurements should include weight, height, (calculated) BMI, and waist and hip circumference (calculated WHR).

4. Measurements should be carried out using standard protocols from recognised bodies such as the Society for Anthropometric Measurements or from the anthropometric standardised reference manual.

5. The validity, reliability and interpretation of all tests carried out should be known and, if required, related to the person being measured. This is especially important for the more high tech measurements such as BIA and MR.

6. All measurement should, where possible, relate to appropriate norms within the population and ethnic group being tested. Where these are not available, ‘next best’ norms should be used with the possible inadequacies of this being explained to the client.

7. Care should be taken to ensure equivalent levels of hydration and digestion at different measurement periods (especially for BIA measures).

8. Body fat percentages should not be inferred from skinfold measures with very overfat or obese people.

9. Clients should be discouraged from weighing themselves too frequently (i.e. more than once per 1-2 week), because of me effect of fluid changes on body weight.

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Technological developments in the area have led to a number of different machines now being available for directly or indirectly measuring body fatness. Some of these are extremely expensive and would not be used in the normal day-to-day counseling situation. Others are now becoming more portable and more accessible and provide at least an opportunity for adding to other measures. The current range of machines include: underwater weighing, bio-impedance analysis, etc.

Computerised tomography (CT) scans. Computerised tomography is another radiography technique of body fat assessment which has limitations because of its relatively high level of radiation exposure and cost. In the past, this has been used for assessing other forms of body tissue such as tumours, but it is also possible to assess body fat. The expense of the procedure, however, is unlikely to make it readily available. Also CT scans only do regional assessments rather than a total body fat record.

Magnetic resonance imaging (MRI). MRI is a technique based on the manipulation of protons and electrons in body atoms to give colour pictures of different body tissue. MRI machines are used for medical diagnosis such as the detection of cancers and, as such, are usually based in hospitals and are extremely costly. The future use of CT and MRI for more accurate measurements of abdominal fat is likely, but still only in a research context.

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