It’s where our body returns unwanted substances so they can be rendered harmless and excreted; but it also has a storage and manufacturing function as well. For instance, about 50% of our body’s cholesterol requirements are made in the liver.

There’s a lot of bad press about cholesterol; however, cholesterol is an important component in the structure of our body. It’s an important part of every cell membrane, and it’s a building block for oestrogen, testosterone and the so-called adrenal hormones.

The liver also converts substances in digested foods into proteins, fats and carbohydrates. Sugars are stored in the liver as glycogen; and then, when needed, they’re released into the bloodstream as glucose – our energy booster.

These are all pretty good reasons why we should look after our liver. Instead, we bombard it with all kinds of chemicals certain to put our liver under stress. Probably alcohol is the most significant liver killer, although there are quite a few other drugs which have the potential to cause liver problems too. And there are several forms of hepatitis which can cause both short term and long term liver damage.

Hepatitis simply means inflammation of the liver – from any cause. Hepatitis commonly results from a viral infection; and most commonly one of the five hepatitis viruses –A, B, C, D and E. This month the Australian Government through the Department of Health and Ageing is conducting a community awareness campaign about hepatitis C.

Hepatitis C is transmitted via blood to blood contact – and most often through injecting drug use; that is by the sharing of contaminated needles. Other possible routes of transmission include tattooing and body piercing, needle stick injuries, accidental exposure to infected blood or blood products and mother-to-baby transmission. Sexual transmission or transmission by way of contaminated household articles (such as razors or toothbrushes) is very rare.

Unlike the other common hepatitis viruses A and B, there is no vaccine available to protect against hepatitis C. So, the aims should be prevention strategies, managing symptoms and reducing the risk to more severe liver damage – cirrhosis or cancer.

Attention to lifestyle is essential. A healthy diet is a high priority; alcohol intake should be strictly limited; regular light to moderate exercise should be undertaken; and smokers should definitely quit.

Special subsidized antiviral therapy is available under certain conditions for people with confirmed hepatitis C infection, however these medications are potent and not without possible interactions and side effects. Your pharmacist can give you more details.

Although complementary medicines are popular with many people in treating hepatitis C, there is very little scientific evidence to support the claims for benefit. Milk Thistle, the product most commonly used, is thought to reduce liver inflammation. Despite the possibility that it may cause gastro-intestinal problems or allergic reactions, it is generally well tolerated; but high-quality clinical trials have found no evidence that it is effective. Some herbal medicines can harm the liver and should be avoided. These include black cohosh, chaparral, kava and senna (in large doses).

Muscle and joint pain, and pain in the area of the liver, is frequently a symptom of hepatitis C; so appropriate use of pain relievers needs to be considered. Paracetamol and the non steroidal anti-inflammatory pain relievers can be used (in no more than the recommended doses and not in advanced liver disease); and heat packs and massage are also good options. Skin moisturisers, lubricating eye drops and saliva substitutes are helpful to relieve the dryness caused by hepatitis C.

You can get more advice about hepatitis C from pharmacies providing the Pharmaceutical Society’s Self Care health information. For the nearest location log onto the website www.psa.org.au and click on Self Care Pharmacy Finder.

©2010 Pharmaceutical Society of Australia

In fact, the move from rural areas towards the more populated towns and city centres is a worldwide phenomenon. While those places of high-density living themselves begin to sprawl, there is greater pressure on services such as transport, education and health.

It’s no coincidence, therefore, that this year World Health Day (7 April) focused on urbanisation and health – an initiative of the World Health Organization (WHO) to make cities healthier places to be.

Another WHO sponsored event this month is World Malaria Day (25 April).

Most cities of the Western world are now malaria free. However, that wasn’t always the case. Malaria is one of the oldest diseases in human history. There is some evidence that it plagued populations pretty much throughout the world as far back as 6,000 BCE. As recently as several centuries ago malaria spread from the Arctic town of Archangel in Russia to Argentina and what is now Australia in the southern hemisphere.

According to the WHO Roll Back Malaria website there are now 109 so-called malarious countries in four regions throughout the world – chiefly the tropical and sub-tropical areas of Africa, Asia the Middle East and Latin America.

During the Middle Ages malaria was widespread throughout Europe and the UK. Henry VIII suffered malaria as a young man. Lord Nelson during the Battle of Trafalgar had to contend with the fever of malaria as well as his regular bouts of sea sickness. Another sailor of renown, J. F. Kennedy, contracted malaria, apparently while in the Solomon Islands in the 1940s.

Malaria is a life threatening disease caused by parasites that are transmitted to humans through the bites of infected mosquitoes. Malaria is preventable and curable; but still people die – about 1 million each year – mostly children in Africa.

WHO states that approximately half of the world’s population is at risk of malaria, particularly those living in lower-income countries; but travellers from malaria-free areas to disease “hot spots” are especially vulnerable to the disease.

The English word malaria comes from the Italian expression meaning bad air and the French word for malaria is derived from the Latin for lagoon. So there was early recognition that the disease emanated from swamps, marshes and stagnant water. But it wasn’t until the late 19th century that the role of mosquitoes was identified.

Ancient remedies included the wearing of a large fish tooth to ward off the evil spirits. Later treatments proved more successful. The Peruvian cinchona bark was taken to Rome by Jesuit priests and introduced into England in the 1650s (although suffering badly from malaria, Oliver Cromwell is said to have refused the bark treatment, maybe because of its intensely bitter taste).

Quinine, the active ingredient from cinchona is still used as a treatment today, however, more effective, especially against drug-resistant malaria, are the combination products containing artemisinin, originally extracted from the ancient herb “sweet wormwood”.

Today, except for the occasional case, Australia is malaria free; but for how long? Climate change, population growth and migrating mosquitoes could alter that situation. Scientists in Victoria, Queensland and Papua New Guinea are currently collaborating on the development of malaria vaccine. Meanwhile prevention is the best course of action.

If you’re travelling overseas, check whether anti-malarials are recommended. Be sure to apply insect repellent, cover up after sun-down and use bed-nets at night. No mosquito bite – no malaria.

You can get more information about malaria and other travel health issues from pharmacies providing the Pharmaceutical Society’s Self Care health information. Log onto the website, www.psa.org.au to find the nearest location.

©2010 Pharmaceutical Society of Australia

However, it’s not just older people who are affected by the flu. The fact is, rates of flu infection are highest among young children; although children under the age of five are less likely to show typical symptoms of the flu – the fever and the cough – so you may not know that your child has actually contracted the infection.

Most children generally cope pretty well with the flu but young children are especially vulnerable to new strains of the flu such as the “swine flu” which was first identified last year; their underdeveloped immune systems can’t manage the invading virus.

So the flu virus picks its victims, singling out those people least able to resist the adverse effects. The greatest concern for doctors and patients alike is the danger, not just of the flu itself, but of severe complications such as pneumonia and the effect of influenza on existing medical conditions.

People with chronic heart, kidney or lung disease, diabetes or other long-term illnesses are particularly at risk. The stress caused by influenza can worsen these conditions and even cause premature death.

Today, prevention is our major weapon against influenza. You can help protect yourself by making sure your lifestyle is healthy with regular exercise you enjoy and a daily diet that includes the widest possible variety of foods. And, of course, annual vaccination against the flu is recommended for all people in high risk categories.

Everyone 65 years or older should have the flu vaccine. As well, at any age, you should be vaccinated if you have an ongoing illness such as diabetes, kidney disease, asthma, heart or circulation problems, or compromised immunity as a result of HIV, cancer or longer-term steroid use.

Now there is also a special effort to ensure people who might spread the infection to the above groups are vaccinated. This includes health workers – doctors, dentists, nurses, pharmacists, carers and even children. There is now mounting evidence that widespread vaccination of children against influenza slashes infection rates in both children and the more vulnerable elderly.

The formulation of influenza vaccine for use in Australia is determined by the Australian Influenza Vaccine Committee based on information and recommendations from the World Health Organization (WHO). The composition of this year’s vaccine includes killed strains of the viruses first identified in Brisbane in 2008 and in Perth last year as well as the so-called H1N1 swine flu.

As in previous years the Australian Government will provide flu vaccine free of charge to everyone 65 years plus; and this year the “free allocation” has been extended to include pregnant women, indigenous people 15 years and over, all residents of nursing homes and long-care facilities and anyone six months of age and over with a condition “pre-disposing to severe influenza illness” – such as heart or lung diseases.

Even if you have already had the vaccine for swine flu, it will still be wise to have the seasonal flu vaccine as well. You can get more advice about whether the flu vaccine is right for you from pharmacies around Australia providing the Self Care health information. Phone the Pharmaceutical Society (PSA) on 1 300 369 772 for the nearest location, or visit the website at www.psa.org.au and click on Self Care Pharmacy Finder.

And while you’re at the doctors for the flu vaccine, ask about the benefit of pneumonia vaccine – recommended every five years or so for those of us in the high risk groups.

©2010 Pharmaceutical Society of Australia

More recently, these same rats – or at least members of their family – are being trained by APOPO for use in neighbouring Tanzania to more easily and more quickly detect one of the world’s most deadly infectious diseases – tuberculosis (TB).

The organism which causes TB is carried by two billion people – almost a third of the world’s population – and there are an estimated two million deaths every year. The World Health organization (WHO) has declared TB to be a global health emergency and designated 24 March each year as World TB Day.

TB is a contagious disease which spreads through the air. When infectious people cough, sneeze, talk or spit they propel the TB organisms into the air. Only a small number of these organisms (called bacilli) need to be inhaled for people to become infected. In poorly ventilated and enclosed environments bacilli can remain airborne for hours.

Of course TB is not new. Genetic evidence gathered from archaeological excavations in the eastern Mediterranean has indicated strains of TB existed 9000 years ago; and fragments of spinal column from Egyptian mummies from 2,400 BCE show definite signs of TB.

In the early eighteenth century it was suggested that TB could be caused by “wonderfully minute living creatures” and 150 years later the actual organism (mycobacterium tuberculosis) was identified by Robert Koch.

Up until then and indeed really until the middle of the last century, so-called sanatorium care – rest, fresh air and good nutrition – provided the only even mildly effective treatment. Real success came in the 1940’s with the development of the antibiotic streptomycin. Though streptomycin has potentially side effects; and monotherapy (treatment with one drug) quickly results in resistant strains of the bacteria.

However, with proper treatment almost all cases of TB are curable. Generally a TB patient must take four different antibiotics for at least two months then two antibiotics for four more months. But because the medicines often cause unpleasant side effects and patients start feeling better a month or so, not everyone completes the full course. As well, in many less developed countries where TB is most common, drug supplies may be inadequate.

According to the Global Tuberculosis Institute at the New Jersey Medical School in the US, while wealthy industrialised countries with good public health systems can be expected to keep TB under control, in much of the developing world a catastrophe awaits.

Hopes that TB might be eradicated by 2025 have all but evaporated as a variety of medical and social factors resulting in the emergence of multi-drug resistant strains present a new challenge in the battle against TB.

In contrast to most of the rest of the world, Australia is fortunate in having a relatively low but nevertheless constant pattern of TB. There is an average of around 1,000 cases a year. This is primarily due to re-activation of a dormant infection in people who were first infected in another country before emigrating to Australia; or who may have been originally infected during their childhood in Australia when the TB rates among the general community were much higher.

But wherever TB exists, successful treatment will depend on early and accurate diagnosis, correct selection of medication and patient adherence – that is taking the right dose for the appropriate length of time.

Naturally these principles apply to the treatment of all medical conditions, especially infectious diseases.

For more advice about the use of antibiotics, ask for a fact card at one of the two thousand pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. For the nearest location, log on to www.psa.org.au and click on Self Care Pharmacy Finder. And if you want more information about World TB Day, go to the WHO website www.stoptb.org

©2010 Pharmaceutical Society of Australia

There are claims that the first association between Valentine’s Day and romance was referenced by Chaucer writing in the 14th century. In any event, there was a certain element of romance by the time Shakespeare wrote Hamlet in 1600.

Paper Valentines, the beginnings of the Valentine Day cards, became popular in the early 1800s; so popular it was written that “St Valentine’s Day” had virtually become a “national holy day” in the USA.

Whilst around the time of Valentine’s Day 2010 our thoughts may still turn to romance, those romantic thoughts may not be so likely if you’re afflicted with an annoying cold sore.

Your friends and family probably won’t find cold sores all that appealing either; a fact confirmed by a survey conducted a few years ago by one of the pharmaceutical companies involved with the marketing of a cold sore relief cream. Cold sores were shown to be more off-putting than tinea, dandruff or even bad breath!

In this warm summer weather, cold sores will be more common. Dry, burnt lips present the ideal conditions for a cold sore to break out.

Nevertheless, there are effective products to treat cold sores and some excellent information from your local pharmacy on how to prevent them from occurring.

Pharmacies which provide the Pharmaceutical Society’s Self Care health information have a recently updated “fact card” on cold sores. It tells you all you need to know, and more, about these annoying little skin infections – what cold sores are, how they occur, what medicines help and how best to use them.

Cold sores are caused by one of the viruses from the herpes family, known as herpes simplex (HSV). There are two types of HSV infections. HSV-1 usually causes infections on the face, such as cold sores around the lips and nose, whereas HSV-2 usually causes genital herpes.

Unfortunately, cold sores come back time after time because, as with all the herpes infections, the virus “hides” in the nerve cells in the skin at or near the original site. A range of triggers can then reactivate the virus to cause another cold sore – as well as sunburn, other triggers can include cold weather, fever, illness, and fatigue; in fact just about anything that puts our immune system under some stress.

There are formulations containing so-called immune system boosters: ascorbic acid, zinc and the amino acid lysine; but there is little evidence to support the use of other herbal or vitamin products in the prevention and treatment of cold sores.

Mild and occasional cases of cold sores can be treated with anaesthetic and analgesic ointments, creams and lotions. Topical antiviral preparations containing acyclovir or penciclovir will help if applied frequently and from the first sign of the lesion – that is when the itch or tingle is first noticed. Severe or recurrent cold sores respond well to oral antiviral medications which are currently available as prescription products.

Cold sores are easily transferred from person to person, and they can be particularly dangerous if caught by babies or people taking medicine that affects their immune system. Cold sores are not the kind of condition that you can kiss better – kissing’s a sure fire way of spreading them around. In fact kissing’s probably very much off the agenda anyway. With cold sores you’re almost certain to get the cold shoulder as well.

There may be no permanent cure for cold sores, at least not yet (not even St Valentine has the answer); but you need to know how best to prevent them and how best to treat them when they do occur – so your social life won’t become “no social life at all”. Phone the Pharmaceutical Society (PSA) on 1300 369 772 or visit the website www.psa.org.au to find the nearest pharmacy providing the Cold Sore fact card and have a talk with your pharmacist.

©2010 Pharmaceutical Society of Australia

Since then, World AIDS Day has been established as one of the world’s most successful commemorative days. It is now recognised and observed by millions of people in more than 190 countries. And the day has also become an opportunity to highlight the need for continued development of education and prevention strategies.

HIV stands for human immunodeficiency virus. It is primarily transmitted in blood, semen and vaginal fluids via unprotected sex or sharing injecting equipment. HIV belongs to a group of viruses called retroviruses known for the capacity to copy their genetic blueprint onto the genes of the host person’s cells. HIV has been identified as the virus that causes AIDS.

AIDS (acquired immune deficiency syndrome) is not a single disease. It is a broad range of conditions that occur when a person’s immune system is seriously damaged after years of attack by the HIV. The terms HIV and AIDS are not interchangeable. It is important to remember that a person who is infected with HIV does not necessarily have AIDS. However, all people with AIDS have been infected with HIV.

HIV damages the body’s immune system and renders the body vulnerable to other diseases and infections – its symptoms are most commonly similar to those of any chronic viral infection. During advanced stages of HIV infection, a person may develop any of a number of so-called opportunistic infections considered to be AIDS defining illnesses.

The ability of HIV to live outside the body is very limited and, therefore, HIV is not particularly easy to transmit. It is a communicable disease, but it is not contagious like air-borne viruses such as influenza. HIV cannot be transmitted by hugging, shaking hands, coughing or sneezing. Nor can it be transmitted by sharing glasses, cups or utensils or by insect bite.

There are three main modes of HIV transmission: unprotected anal and vaginal sexual intercourse; sharing drug injecting equipment; and mother to child transmission during pregnancy, birth or breast feeding.

Exposure to HIV contaminated blood is another potential route of transmission. Injecting drug users who share needles and syringes are at risk of HIV infection because there is often a small amount of blood left in the syringe after injection. This type of exposure can also occur during skin piercing and tattooing procedures if equipment has not been properly sterilised after having previously being used on someone with HIV. Body piercing or tattooing should always be undertaken at licensed studios that use new ink pots for each procedure and disposable needles or an autoclave to sterilise equipment.

Worldwide, the prevalence of HIV infection has progressed to generalised epidemics, occurring mainly through unprotected heterosexual contact. There are about 35 million people living with HIV, two thirds of whom live in sub-Saharan Africa. Somewhere in the world, every 12 seconds another person contracts HIV infection.

The theme for World AIDS Day this year is “human rights and access to treatment” – two issues, in Australia, we tend to take for granted. Nevertheless HIV/AIDS is still a major concern in Australia where transmission continues to occur primarily through sexual contact between men. Among newly acquired HIV infection, male homosexual contact was reported in 86% of cases. Between 1981 and 2008 there were over 28,000 diagnoses of HIV infection, more than 10,000 diagnoses of AIDS-related illness and nearly 7,000 deaths.

Wherever we live we can combat AIDS by “respect and protect”. By respecting and protecting ourselves and others we can stop the spread of the HIV and put an end to prejudice. Check out the World AIDS Day website at www.worldaidsday.org and two excellent Australian websites www.worldaidsdaynsw.org and www.aidsday.org.au

Or you can get more information about HIV and AIDS from pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. Ask for the HIV/AIDS fact card.

©2009 Pharmaceutical Society of Australia

While UTIs can affect any one at any stage in life, they are more common with advancing age and affect more women than men. In fact nearly one in three women will need treatment for a UTI before the age of 24.

The very descriptively titled Wee Week (19-25 July) aims to promote the benefits of a healthy urinary tract as well as the importance of early recognition and treatment of urinary tract infections.

UTIs can involve just about any part of the urinary tract – the body’s plumbing, filtration and liquid waste disposal system. The kidneys and the bladder can be affected, as can the ureter and the urethra – the “pipes” which carry urine to and from the bladder.

Bacteria which normally live harmlessly in the intestine or the bowel are the usual suspects for causing UTIs. If these bacteria manage to spread from the anus (the back passage) into the urethra and then further into the urinary system, they can cause some rather nasty and discomforting conditions.

Urethritis is the medical term describing the infection when just the urethra is affected. If the infection spreads to the bladder causing the bladder lining to become raw and inflamed the condition is known as cystitis; whereas pyelonephritis is the name for the infection if it spreads to the kidneys.

All these conditions can cause a prickly, scalding or burning sensation when passing urine, and the urge to urinate frequently. If the bladder and kidney are affected, the urine might be cloudy or bloody and you may experience lower abdominal or back pain. Kidney related infections are potentially very serious and need prompt treatment to avoid kidney damage.

Mild cystitis can sometimes be treated effectively by drinking plenty of fluids (preferably water) to flush the bugs out the system, whilst often a urinary alkaliniser – something to make the urine less acid – will also help. Some studies have shown that cranberry juice or cranberry extract tablets may assist in preventing symptoms of cystitis in people who are susceptible to repeat infections. It seems cranberries contain a substance that can help prevent bacteria from sticking to the walls of the bladder. However, results from the studies are not so positive for elderly men and women.

Women, generally, are more likely than men to suffer with UTIs because the urethra is so short. Also, female hormones can affect urine acidity making it more likely the offending organisms can thrive – especially at certain times of the menstrual cycle, during pregnancy and menopause or after a hysterectomy. Sexually active women are more at risk because sex can push the bacteria into the urethra.

Men with prostate problems may have difficulties with urine flow and bladder emptying and so allow the bacteria more time to reproduce. Older people, or people with another chronic medical condition such as diabetes, where the immune system is already under stress, are also more likely to get UTIs.

Recently the Pharmaceutical Society has produced a Urinary Tract Infection Fact Card which has some self help hints on how to reduce the risk of urinary tract infections. It’s all about developing good habits of personal health and hygiene. The best advice is to drink plenty of water – around eight glasses a day. It helps to keep your plumbing system nice and clean. And, if you have an urge to go to the toilet, do so as soon as convenient. Don’t hold on!

Most importantly, if you think you have a UTI and the simple non-prescription products are not successful, see your doctor promptly. An appropriate antibiotic will usually give the desired results quickly and safely. And you’ll avoid any possible serious consequences. Meanwhile, if you would like some more information about UTIs, pick up a Urinary Tract Infection Fact Card from any one of the 1,650 Self Care pharmacies around Australia. Phone the Pharmaceutical Society on 1300 369 722 for the nearest location, or check out the PSA website: www.psa.org.au and click on Self Care Pharmacy Finder.

©2009 Pharmaceutical Society of Australia

Swine flu also remains a problem in Australia, and precautions to help prevent the spread of infection are highly important. Nevertheless, the use of masks is just one aspect or risk reduction. Personal attention to hygiene is vital. Regular handwashing and the use of disposable tissues to capture coughed or sneezed viruses are essential.

However, the flu – whether it’s the swine or seasonal variety – is not the only infectious disease we should be concerned about – nor the only cause of cough.

For instance, already 14,000 cases of whooping cough have been notified in Australia this year. Whooping cough numbers have fluctuated over the last 15 years; but even in the epidemics which have occurred every three or four years, the total number of cases has been around 10,000.

This year NSW has been particularly badly hit, reaching the 8,000 mark by mid-year, compared with a total last year of 7,000.

Whooping cough (which is known medically as pertussis) is a serious, contagious bacterial infection. Early symptoms are similar to those of a cold. Then the typical cough or “whoop” develops which gives the condition its common name. This sound is due to a deep breath at the end of a bout of coughing. Vomiting after coughing is also common.

In young babies symptoms can be severe and even life threatening. According to the Victorian Government’s Better Health website, one in every 200 babies who contract whooping cough will die.

Early diagnosis and access to antibiotics is necessary for effective treatment and to minimise the spread among family and close contacts. Strict adherence to Australia’s immunisation schedule will prevent whooping cough. The vaccine is given, along with vaccination against other common infectious diseases, at two, four and six months of age; and then again at four years of age.

To be fully protected adolescents should receive a booster dose of pertussis vaccine (together with diphtheria and tetanus) between the ages of 15 and 17 years – or about year 10 in high school.

But, vaccination against whooping cough does not confer lifetime immunity, and large numbers of cases continue to occur in older people. Unvaccinated adult carriers of the whooping cough organism can put the lives of children at risk, so a booster dose of pertussis vaccine is recommended for healthcare workers or those caring for young children.

With sometimes sensationalised or misguided stories about immunisation side effects, parents and carers can become understandably concerned and confused. In fact, immunisation strengthens the body’s immune system. It’s a simple, safe and effective way of protecting children (and adults) against disease. Your GP can give you more information.

You can also get more advice and information about whooping cough from pharmacies around Australia, providing the Pharmaceutical Society’s Self Care health information. Phone 1300 369 772 or check out the website at www.psa.org.au to find the nearest location. Ask for the Childhood Immunisation Fact Card. you can also get details about immunisation generally from the Commonwealth Government’s website

©2009 Pharmaceutical Society of Australia

April 25 is World Malaria Day.

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Malaria was once much more widespread, but it was successfully eliminated from many countries with temperate climates during the mid 20th century. With long term warmer weather apparently creeping southwards from the equator and insects becoming frequent flyers by hitching a ride on international airlines, countries like Australia might again become high risk areas.

Malaria is a life threatening parasitic disease transmitted by mosquitoes; specifically the female of the Anopheles family of mosquitoes. Currently it affects mainly people living in the poorer countries. Ninety percent of deaths due to malaria occur in Africa south of the Sahara, mostly among young children. Malaria kills an African child every 30 seconds.

Before the real cause of malaria was discovered in the 1880s, the disease was thought to emanate from the dank smell and dampness of field marshes – hence the name: mal aria or “bad air”.

So, bad air has nothing to do with malaria, but bad air that we personally produce results in many more deaths. It’s the cigarette smoke filled air we inhale that causes so much damage. In fact tobacco smoking is the single greatest cause of preventable disease in the world. Even passive smoking – inhaling someone else’s second hand smoke has been proven to be a problem.

There would hardly be a man, woman or even child in Australia who doesn’t know about the dangers of smoking. So why would anyone still be a smoker?

There are probably many reasons why people begin to smoke – peer pressure is a particularly relevant factor in young women – and the reality is, once you start smoking it’s mighty hard to stop. Nearly two thirds of smokers would like to stop smoking, but fewer than 1 in 20 people who try to quit will actually remain non-smokers after three months.

The problem, therefore, is not just beginning the quit process, but staying the distance as a non-smoker. If you are one of those thousands of Australians who want to stop smoking; if you’re very willing, pretty much ready and just wanting to be enabled to quit for good, then there are some new strategies which might make your job a whole lot easier.

Recent research, published in the British Medical Journal, has shown the benefits of a gradual reduction in smoking before quitting for good. This “cut down then quit” method may suit some smokers who find it hard to stay a non-smoker. The combination of patches an gum together may be what some smokers need to prevent the cravings; and a new mini lozenge is now available with a quicker release of nicotine.

As well, it is now recognised that nicotine replacement therapy can be a useful tool for just about everybody to assist with smoking cessation; that is everybody regardless of age, sex or medical history. We know that using nicotine replacement therapy to quit is always safer than continuing to smoke.

There are many myths and misconceptions about the effects of nicotine and nicotine replacement therapy (NRT). Make sure you get the facts and the right advice on what products will suit you best. Ask for the fact cards on Smoking and Staying a Non-smoker from one of the pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. Phone 1300 369 772 or check out the website at www.psa.org.au for the nearest location. May 31 each year is designated by WHO as World No Tobacco Day. Maybe it’s a good time to consider quitting for good and clearing your personal air space.

©2009 Pharmaceutical Society of Australia

Tinea on the toes and elsewhere on the foot – commonly called “athlete’s foot” – is probably the best known of all the fungal infections. It’s caused by a group of fungi called “dermatophytes”. Areas of the body other than the feet can be affected. Fungal nail infections which are notoriously difficult to treat are generally caused by this kind of fungus.

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Other forms of fungal infections are caused by yeasts and moulds. The infection known as candidiasis, or thrush, is caused by the Candida species of yeasts. Candida infections may be easily confused with other fungal infections such as tinea or bacterial infections such as impetigo or even non-infectious skin problems such as eczema or psoriasis.

Candidiasis commonly affects those parts of the body where skin rubs against skin, especially if the environment is warm and moist. If the patient – man, woman or child – is overweight or obese, the risk is even greater still. So, the areas where you are likely to see those beasty yeasts multiply (or rather where you would like to avoid seeing them), are the groin, under the breasts, the armpits and maybe beneath the beer gut.

Candidiasis of the skin usually responds well to topical treatments. Products containing nystatin are effective but the broader spectrum imidazoles (such as Canesten, Clonea, Daktarin, Mycospor, Nizoral, Pevaryl or Resolve) will be a better choice if infection with dermatophytes (tinea) is also suspected.

If the area is inflamed or itchy, a combination of one of the imidazole antifungals plus hydrocortisone might be useful (products such as Hydrozole or Resolve Plus which are available directly from your pharmacist). In most cases of nappy rash, Candida infection is present, so one of these creams is an appropriate treatment.

A regular routine associated with nappy changes will help reduce the risk of thrush infection: change nappies frequently and do not use plastic overpants or nappy liners which prevent the skin from drying; use a soap substitute and dispersible oil for bathing; use a damp cloth or baby wipes that do not contain alcohol; and apply an emollient such as zinc and castor oil cream after each nappy change – your pharmacist can recommend a suitable product.

Oral thrush is also common in babies; but not only babies. Older people (with a less competent immune system) and denture wearers are at increased risk, as are smokers and people with a chronic dry mouth condition. People who use so-called corticosteroid preventer puffers for asthma may also be at risk if the mouth is not rinsed properly after using the puffer.

Various antifungal gels and drops are available to treat oral thrush. If dry mouth is a trigger factor, then saliva stimulatory products will be useful. Specially formulated mouthwashes, gels, gums and toothpaste can help. Oral thrush in adults can sometimes be a sign of a more serious underlying condition; so it needs to be investigated.

Vaginal thrush can be particularly uncomfortable, and recurrence is common. Creams and pessaries are available to treat vaginal thrush; and they come in seven day, three day or single dose therapy. The single dose treatments are usually only effective for the first or infrequent episodes. A single dose oral treatment (fluconazole) is now also available and may be chosen when the topical treatments (creams and pessaries) have not been successful, or if the preference is for oral therapy.

Thrush symptoms can be very distressing but they can be treated effectively and comparatively easily. A summary of the causes, the aggravating factors, the treatment and the self help hints to reduce the risk of re-infection, is printed on the recently updated Fact Card titled Thrush.

The card is available from all pharmacies around Australia which provide the Pharmaceutical Society’s Self Care health information. Check out the nearest Self Care pharmacy at www.psa.org.au or phone the Pharmaceutical Society on 1300 369 772.

©2009 Pharmaceutical Society of Australia