His mother says the couple have had “no control” over their son’s life or death.

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Asthma Expert

Professor Keertan Dheda has received of several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others.Read his full biography at the University of Cape Town Lung Institute

Let’s face it; most of us need to work to put food on the table. Some of us are lucky enough to work for ourselves, but the rest of us have an employer who needs us to be productive in order to keep the business afloat.

In South Africa, workers may take the number of days they would normally work in a six-week period for sick leave on full pay in a three-year period. In the first six months that you work, however, you are entitled to one day’s paid sick leave for every 26 days that you worked. 

But what if you have a disease that will keep you out of the office for much longer, and does this mean that your employer can fire you if you are forced by illness or disability to spend more time away from work?

Section 6 of the Employment Equity Act prohibits unfair discrimination against employees on the grounds of disability or illness. This basically means that an employer may not simply dismiss a sick employee, and is required to first consider treatment. 

Here are five diseases or conditions that can cause you to exceed your normal sick leave:

1. Back injuries and problems

Back pain is second only to headache as the most common cause of pain. It can be acute, intermittent or chronic and is mostly caused by minor injuries, slipped discs, facet joint problems or arthritis.

Sprains, strains and minor injuries do not involve serious damage and are often referred to as “simple” back pain. This usually lasts only a few days and is unlikely to keep you off work for more than a few days. 

Intervertebral disc lesion, commonly known as a “slipped disc”, is the result of  wear and tear or strain and may cause a spinal disc to bulge, tear or rupture (herniate). The disc’s gelatinous filling protrudes and presses against sensitive nerves from the spinal cord. The pain from a slipped disc may be severe enough to keep you from working for a long period of time.

2. Mental illness

Between 1% and 3% of the South African population are likely to suffer from a mental health problem that’s severe enough to require hospitalisation. Unipolar depression, alcohol use, bipolar affective disorder, schizophrenia and obsessive-compulsive disorder are among the ten leading causes of disability world-wide.

Patients suffering from mental health problems like milder forms of depression can be effectively treated with medication, which will not interfere with productivity. In the case of more serious forms of mental disease, it may however be impossible for patient to work and require lengthy periods of absence. 

3. Heart disease and stroke

Heart disease and stroke are the number one killers in South Africa. One in three men and one in four women will suffer from cardiovascular disease before they are 60 years old.

Right now, the total direct and indirect costs related to death and disability from heart disease and stroke in this country exceed a whopping R8 billion per year.

When non-fatal, heart attacks and stroke often result in severe disability and consequent impoverishment for entire families when the affected person’s ability to work is compromised. 

4. Cancer

One in six South African men and one in seven South African women will get cancer during their lives.

Campaigning for Cancer is an advocacy organisation that was formed in 2008 to give South African patients and those affected by cancer a voice.

The organisation has collaborated with key stakeholders to develop a written Cancer@Work Programme, the first of its kind in South Africa, which offers amongst other things employer and employee workshops, step-by-step guides on handling cancer in the workplace and access to resources with information about legal rights relating to employment.

5. HIV/Aids

The Acquired Immune Deficiency Syndrome (Aids) is caused by infection with the Human Immunodeficiency Virus (HIV). HIV attacks and gradually destroys the immune system, which protects the body against infections.

It may take years for a person’s immune system to deteriorate to such an extent that the person becomes ill. There are drugs that can dramatically slow down the disease in an infected person, so chances are that a worker’s HIV positive status will not influence their ability to perform a job. 

If a person develops full-blown Aids they are susceptible to a range of opportunistic diseases which can compromise their ability to work. Employers may however not discriminate against workers on the basis of their HIV status.

^{All pictures provided by iStock}

We have been brainwashed by marketing tactics to shop for groceries that are labeled as “sugar-free” or “low fat”. Yet, these products are not all that it’s cracked up to be and will not be beneficial for weight-loss or your overall health in the long run.

Many people will tend to overeat on these foods, because it’s “good” for you. Also, while an effort has been made by manufacturers to lower the calories, these foods contain many additives that are not good for you at all.

Here are five to cross off your shopping list:

1. Diet soda

Rethink your drink and skip the diet soda. Research done at Purdue University shows that drinking lots of soda with artificial sweeteners can boomerang and cause weight gain and even diabetes. Opt for water or herbal tea to stay hydrated and curb appetite between meals. Health24 also elaborated in the past that diet soda can increase your risk for kidney diseases. Another study also found that diet soda can increase the risk of stroke and heart disease.

2. ‘Low-fat’ foods

The process behind “low-fat” food is exactly what the name says: the actual percentage of fat on the label might be low, but high in several other ingredients, such as sugar. and other additives to make up for taste and density. So while something might contain zero fat, the chances are great that the sugar content is much higher. In a previous article, Health24 explored this notion, and mentioned that people should be focusing on the quality of the food, rather than the actual fat-content. Skip all diet foods that replace fat with sugar, like low-fat cookies. Keep in mind that even healthy-sounding foods like no-fat yogurt can be guilty of this and might be containing more sugar.

3. Reduced-fat peanut butter

Stop being afraid of the fat content in your products. Ditch the reduced-fat peanut butter, which replaces good-for-you mono-unsaturated fats with sugar. Peanuts and peanut butter is also a great source of biotin which is essential for hair and nail growth. Opt for regular, no-sugar-added peanut butter and remember watch portion sizes, because it’s still high in kilojoules.

4. Margarine

The debate whether margarine or butter is better for you has been going on for decades. The dangers lurking in margarine have also been discussed on Health24; even one teaspoon of trans fats more than usual can dramatically increase your risk for a heart attack. Margarine is often marketed as a good substitute for butter, but the ingredients in a block of margarine are hardly healthy. The better alternative to both is extra virgin olive oil, which is a plant-based fat without any nasty ingredients.

5. Multigrain bread

Multigrain bread sounds great, but unless it’s made from a variety of whole grains, you’re getting refined flours without the original nutrients or the appetite-satisfying effect of fibre. Ditto with granola, which also has lots of carbs (often from added sugars), but not necessarily whole grains. Most people believe that multigrain breads are still better for us than white bread, but a recent study discussed on Health24 actually proved this wrong. However, if your digestive system can tolerate wholewheat or multigrain products, you shouldn’t have to steer clear completely; just be label-savvy and know how much fibre content and grains are actually present in your loaf of bread. 

To shop smart, always read the labels on all packaged diet foods to see whether high-fat, high-calorie ingredients were replaced with healthy ones.

^{All images provided by iStock}

In a cover story interview with Vanity Fair, 41-year-old actress Angelina Jolie opened up about life after her divorce from Brad Pitt, as well as her health struggles after being diagnosed with Bell’s palsy, a condition that causes partial facial paralysis.

What is Bell’s palsy?

Bell’s palsy is a temporary neurological disorder that occurs when a set of nerves in the face (usually the 7^th cranial nerve) is temporarily damaged. It may result in the partial drooping of some facial features.

Bell’s palsy occurs when the nerve that controls the facial muscles is swollen, inflamed, or compressed, resulting in facial weakness or paralysis. The causes of Bell’s palsy remain unclear, although blood vessel involvement, infections, and genetic, and immunologic causes have all been considered.

A non-life-threatening disease, Bell’s palsy affects 15 to 40 people out of 100 000 in the South African population. The onset is sudden, and can affect the left or right side of the face.

Here  are seven other celebrities who also suffered from Bell’s palsy:

1. Sir Andrew Lloyd Webber

Composer Andrew Lloyd Webber, famous for musicals such as Evita, Cats and Phantom of the Opera suffered from Bell’s palsy back in 2002. One morning when he woke up, he found his face paralysed.

2. Pierce Brosnan

Irish actor Pierce Brosnan, known for his four roles in James Bond films, suffered from Bell’s palsy in his youth and has since fully recovered.

3. George Clooney

American actor George Clooney, winner of three Golden Globes and famous for his roles in Oceans Eleven, had Bell’s palsy in middle school. That sultry half-smile is an after effect of the condition.

4. Tony Gonzalez

Former American NFL football player Tony Gonzalez had a bout of Bell’s palsy during his off-season in 2007. He has since embarked on a healthy, organic lifestyle and diet.

5. Rick Savage

Musician Rick “Sav” Savage who is known as the bassist for Def Leppard, suffered from Bell’s palsy in 1994. This caused severe weakening of his facial muscles, and the effect of the condition remains visible.

6. Roseanne Barr

When the American actress and comedian was only three years old, she woke up one day to find the left side of her face paralysed. She recovered two weeks later.

7. Sylvester Stallone

Sylvester “Sly” Stallone, famous for his role in Rocky, is especially known for his slurred speaking and his crooked smile, which are both residual effects from Bell’s palsy.

^{All images from Wikimedia Commons}

Marelize Wilke

 A quicker, simpler test for tuberculosis (TB) in people living with HIV is not being used widely enough in South Africa, despite new evidence of its benefits, according to international humanitarian organisation Doctors Without Borders (MSF).

The TB LAM test can quickly diagnose the disease in HIV patients – providing a result in as fast as 33 minutes, compared to conventional tests which can take up to two days. This was revealed at the 9^th International Aids Society (IAS) Conference on HIV Science in Paris.

Advantages over sputum tests

It is effective for patients with CD4 counts (the measure of a person’s immunity) of 200 and below, and uses urine instead of sputum to detect TB bacteria. It is only effective in this group because people who are very sick excrete a high amount of bacteria in their urine – enough for the test to detect.

At only $3 (±R39) per test it is also an affordable option and does not require a laboratory or special expertise and can be performed by nurses and even trained lay people.

“The TB LAM test has advantages over sputum tests for patients with late stage HIV who don’t present with the usual signs of TB and usually find it difficult to produce sputum,” MSF’s Dr Amir Shroufi told Health-e News.

“There have been concerns over its accuracy but for patients with severe immunosuppression (very weak immune systems), our experience plus a rapidly evolving evidence base shows that this is a useful test that can help clinicians make quick decisions to start advanced HIV patients on treatment, when any delays have serious consequences.”

But he said South Africa has been slow to act on this evidence and scale-up its use.

Most deaths in people living with HIV in South Africa are caused by TB.

Good for very vulnerable patients

Shroufi said researchers in Stokholm are working on a more sensitive version of the test so it can be used for all patients – regardless of their health status. 

Deputy Director General at the Department of Health (DoH) Dr Yogan Pillay said that the reason for the delay in scale-up is that the DoH had to develop an algorithm for its use and pilot it before it could advise provinces on how to implement it.

“We had a consultation about the algorithm about two weeks ago and we have adopted it for use across the country. So LAM is in, and it’s currently being scaled up. We just need to get the traction of the hospital CEOs and the clinicians to start using it,” he said.

Sekai Chenai Mathabire-Rucker, a Zimbabwean researcher who won an award for her research on the TB LAM test in Paris this week, said that the test has significant advantages for very vulnerable patients.

“Patients who come in with low CD4 counts are often so sick they can’t walk, some are even unconscious. These patients often cannot provide sputum and need treatment as quickly as possible. Unlike with sputum tests, the TB LAM test can provide results in under an hour and patients can be started on treatment the very same day. This quick time-to-treatment saves lives,” she said. – Health-e News.

Amy Green

In partnership with SA’s top medical aesthetic companies

Visible signs of sun damage such as loss of elasticity, wrinkling, excess pigmentation, as well as damage from acne, stretchmarks or scarring need more intense exfoliation with deeper medical peels – using agents such as Trichloroacetic Acid (TCA), salicylic acid (BHA) and vitamin-A derived retinoic acid. They act by penetrating to the skin’s upper dermis, producing dramatic and lasting improvements.

The added bonus: they have a general firming and tightening effect as they stimulate healthy collagen and elastin as well as resurfacing the skin, for a smoother, more radiant complexion.

Vital to know: Skin Renewal firmly believe that a doctor or trained skincare professional must assess your skin, your needs and your medical condition before recommending the correct chemical peel for you, as not all skin types can have the same treatment, and it can be a dangerous procedure with permanent unwanted consequences if not applied correctly. For this reason, you should also always have a trusted, reputable medical peel brand.

Unfortunately, penetrating this deeply does increase the risk of some discomfort both during treatment and in recovery, with some downtime – visible skin flaking and redness – for up to a week. You may need some pre- and post-peel care, which you should follow diligently.

Peel options

Obagi legendary Medical Blue Peel, applied by a trained doctor, gets its blue hue from a dye solution that ensures the TCA is released slowly into the skin, so it is less irritating and penetration and depth of peeling is controlled, making it a very safe option to use. Obagi recommend a prep and maintenance skin care range for lasting results, and one peel once a year.

The benefits of the Yellow Peel is that it can be used on all skin types and treats post-inflammatory hyperpigmentation, uneven texture (including areas such as the elbows, knees and legs), back acne and sun damaged areas.

Need to know: Its downtime lasts 3 to 4 days, and it may be repeated every 4 weeks. A series of 4 peels is recommended.

The 3D Peel series is your option for more advanced skin. Performed by a trained medical doctor, Modified Jessners solution (Lactic Acid, Salicylic Acid, Resorcinol), TCA and Retinoic Acid are used to treat, among others,  sun damage, pre-cancerous spots, post-inflammatory hyperpigmentation and superficial acne scarring. It achieves similar results to far more aggressive and invasive peels, is more controlled, comfortable and well tolerated.

Need to know: 3D peel is not suitable for all skin types, and is not recommended for use if you have certain medical conditions (confirmed by the doctor at your consultation). It has a seven-day downtime.

The lights fantastic

When you have more extensive sun damage or deep, severe pigmentation, you need to act in the deeper layers of the skin’s dermis without damaging surrounding skin. This is where light technology plays its role.

The state-of-the-art Fraxel™ DUALlasergives you 2 lasers in 1: the original 1550nm Restore wavelength targets skin texture and improves deep lines and acne scars, while the 1927 Thulium laser treats all forms of pigmentation. Approved by the American FDA, this gentle treatment resurfaces the skin from the inside out with dramatic reversal of sun damage and pigmentation with hardly any downtime. 

Need to know: Suitable for all skin types and tones, the two lasers can be used together or separately, and show results in as little as 2-3 treatments.

Pearl rejuvenation laser targets fine lines, uneven texture and discoloration. It gives you very targeted skin resurfacing with a revolutionary new wavelength and computer-guided scanning device that is programmed to remove specific layers of tissue uniformly – offering mild to very aggressive peeling to treat a variety of conditions from age spots to deep wrinkles and scars.

Resurfacing results are seen in as little as one treatment, but 2-3 may be recommended for severe conditions.

Need to know: Suitable for fair to medium-depth complexions only. A local anaesthetic is applied before treatment.

A natural protective dressing forms on the surface, protecting the treated skin from weeping and minimising downtime.

The CO2 (Carbon Dioxide) laser removes the outer layers of damaged skin, simultaneously stimulating the regeneration of healthy skin underneath. It is used to treat deeper facial lines, wrinkles, uneven pigmentation, scarring and sun damage on the face, around the eyes and mouth, on cheeks, hands, neck and chest.

Need to know: Not recommended for darker skins such as skin types 5 and 6 (see the Fraxel DUAL treatment for darker complexions).

Local anesthetic is applied before treatment to relieve any potential discomfort.

A full skin consultation with a Skin Renewal doctor is absolutely vital in order to discuss suitability for this treatment.  

There is some downtime: skin will be red and ooze slightly for 5 to 7 days, so you may not want to be seen. No make-up may be used until skin has healed.

Home Care

Besides using recommended home care products that enhance the benefits and soothe your skin post peel, exfoliation treatments make your skin more sun-sensitive. Sunscreen of SPF 50 should be used daily, and sun exposure avoided.

To find out more about exfoliation treatments suitable for your skin type and the four pillars to addressing ageing skin, visit Skin Renewal at www.skinrenewal.co.za, or contact 0861 SKIN SA (7546 72) to book your individual assessment.

Take the quick Beyond Beauty Survey and you could win a R2000 Skin Renewal voucher to spend in our online store, with free delivery within South Africa. T&Cs apply.