Dr Charlize Smit

10/10/2025

26/09/2025

🦴🦴We don’t talk about this enough. 🦴🦴

Osteoporosis. ( skeletal with decreased bone mass and micro architecture deterioration of bone tissue resulting in less bone tension and strength and increase in fragility fracture)

🥼Since Osteoporosis is asymptomatic early diagnosis can help decide treatment strategies and prevent disease progression.

📈Prevalence: worldwide, osteoporosis causes > 8.9 Million fractures annually with the greatest number according in Europe commonly the hip, vertebrae and distal forearm. But can also affect other sites like (humerus, ribs and tibia, pelvis femoral fractures)

Women 🤷🏻‍♀️are affected more than men 🙋🏼‍♂️

However there is an increased prevalence of osteoporosis- related fractures in men, there is increased need to raise awareness and knowledge.

Here are a few tips

Sufficient Dietary Calcium + Vitamin D and sunlight ☀️
1. Hi breastfeeding mommy - remember to take 1,000-1,300 mg of calcium daily to support bone health, with the exact amount depending on age.
2. mommies with growing kids. - Don’t overuse Aspelone/betadexamine it contains cortisone which can cause osteoporosis or poor growth. Only use it when prescribed by your doctor and mention the amount of times your child has been on it if consulting a new doctor.
Side Effects of to much cortisone in children: 👦🏻
⚠️weight gain.
⚠️roundness of the face.
⚠️mood changes (irritability, hyperactivity)
⚠️ SLOWER growth rate.
⚠️loss of calcium from the bones (osteoporosis)
⚠️development of cataracts (clouding in the eyes)
3. Post menopausal women can supplement with HRT and Calcium and Vit D supplements.
4. Exercise, exercise exercise especially resistance training and bearing weights. Walking is not effective in osteoporosis prevention
5. Decrease intake in junk food as its absence of Vitamin K results in impairment of the calcium removal process and increases the risk of calcification of the blood vessels. Increase Vit K2 could be a means to lower calcium associated health risk.

Disclaimer: not for diagnosis but for educational purposes. Please consult with your family doctor.

12/09/2025

Hi its Spring!
We are open tomorrow 🌻🦋

26/08/2025

22/08/2025

Asthma
* Paroxysmal and reversible obstruction of the airways
* History of recurrent episodes of ✅wheezes✅chest tightness, ✅breathlessness, and/or ✅cough, especially at night/early morning
Specific triggers may be present: (e.g. 🌺pollens, 🐕‍🦺 pets, ❄️cold air or perfumes)

💊Symptoms may worsen after taking 💊
• beta-blockers
•aspirin
•NSAIDS → Paracetamol is safe
Side effects of atenolol (wheezing)

Evidence of variable airflow obstruction seen on tests such as peak expiratory flow measurement

Acute asthma
Bronchospasm (smooth muscle spasm narrowing airways)
Excessive production of secretions (plugging airways)

Risk factors
A combination of 🧬genetic & environmental factors 🌻

🧬Personal history of atopy (genetic tendency to develop allergic diseases) such as eczema
🧬Family history of asthma or atopy
🏠Inner city environment
🤰prematurity and low birth weight and maternal smoking
🚬 smoking

Presentation:
✅ cough
✅ shortness of breath
✅ wheezing
✅chest tightness

How do doctors diagnose Asthma
1. Symptoms of Asthma
2. PULMONARY FUNCTION TEST (SPIROMETRY) - initial diagnosis
3. Day-to-day peak flow showing diurnal cycle - treatment monitoring and adjustment
4. Post- dilator improvement of > 12% in FEV1| FVC
5. Unexplained peripheral blood eosinophilia

😷 MILD ATTACK
Slight fast heart rate above >100, slight fast breathing
Classically expiratory wheezes

😷 Acute Severe attack
* use of accessory muscles of respiration
* Inability to complete a sentence in one breath
* Intercostal retractions

In children
* HR > 125 (> 5 years) or HR > 140 (2-5) years
* RR> 30

Disclaimer: this information is for educational purposes and not for self-diagnosis please discuss symptoms with your family doctor.

13/08/2025

Dementia 🧠

The most common causes are:
•Alzheimer disease
•vascular dementia
•a mixture of the 2
•Lewy body dementia
• frontotemporal dementia.

Dementia is also recognised as a complication of Parkinson disease.

Medication history is important to rule out drug-induced cognitive impairment. 💊 doctor 👩🏻‍⚕️

* Anticholinergic side effects of medications can lead to cognitive impairment. 😷
* Having multiple prescribers, a
common occurrence in elderly patients, is a risk factor for polypharmacy with anticholinergic agents.

Examples of drug classes commonly associated with anticholinergic
effects are:
1. Drugs used for nausea and vomiting e.g antiemetics/antivertigo agents
2. antihistamines
3. antimuscarinics, e.g., oxybutynin,
4. antipsychotics e.g., tricyclic antidepressants e.g.amitriptyline,
paroxetine

An association between the long-term use of benzos and dementia incidence has been demonstrated 💤

Physical examination is needed to identify the cause

Other tests:
Laboratory tests: CBC, electrolytes, kidney function, TSH, vitamin B12, calcium, blood glucose, Thiamine.

In order to assess for prodromal dementia or “very early Alzheimer disease without dementia,”

Study 📖: researchers have
attempted to use plasma and cerebrospinal fluid biomarkers (e.g. amyloid beta, tau protein)
❎Neuroimaging (usually CT head scan) if:
✔️60 years of age
✔️new onset
✔️rapid progression
✔️post-head injury
✔️focal or lateralizing signs
✔️history of cancer
✔️use of anticoagulants
✔️early urinary incontinence and gait disorder
✔️unusual cognitive symptoms

🙏🏼 Prevention of Dementia
Most clear evidence on the work done on dementia shows, especially in old age, the risk of dementia and cognitive decline is related to overall health.

It’s important for the general health be optimized.

🫀One important aspect of this is cardiovascular health; cardiovascular risk factors increase the chance of all causes of late-life dementia, including Alzheimer disease.

Evidence from t

05/08/2025

It’s our Mental Health Awareness month. 🫶Trauma needs treatment - not all treatment is pharmacological.

Asking for help should be normalised.🤝

Today we share some symptoms or PPD.

05/08/2025

Weekend hours for August 📞🥳

05/08/2025

Bipolar disorder 🩺

It is a complex, recurrent mood disorder that affects 1-2% of the population.
It is defined as having either a manic episode with or without a history of major depressive episode or hypomanic episode (with a current of past history ot major depression)

Symptoms of mania:
1. Grandiosity
2. More talkative 🗣️
3. Excessive involvement in pleasurable activities that may have poor consequences
4. Less need of 💤 sleep
5. Flight of ideas
6. Distractibility
7. More goal directed activity ✅
8. In some severe cases psychotic symptoms

Duration: At least 1 wk, present most of the day, causing significant distress/disability

Hypomanic episode: mood same as mania, but milder and not disabling, no psychotic symptoms

Bipolar 1 disorder: lifetime history of at least 1 clear cut manic episode, with or without episodes of hypomania or depression

Bipolar 2 disorder: history of hypomanic episodes and major depressive episode with no history of full manic episode.

Major depressive episode:

Mood: depressed most days or marked diminished interest or pleasure (anhedonia)

Duration at least 2 weeks
Plus 4 of the following
1. Insomnia or hypersomnia
2. Significant weight loss/gain or change in appetite
3. Fatigue or loss of energy
4. Psychomotor retardation or agitation
5. Worthlessness or excessive guilt
6. Impaired thinking, concentration or making decisions
7. Recurrent thoughts of death, suicidal ideation or attempt/plan.
Therapeutic choices:

1. Non-pharmacological choices: •Psychoeducation consisting of information about the illness as well as training in copying strategies and recognition of episodes early in their genesis.Www.beatingbipolar.org. www.moodchart.org. wwwwhatsmym3.com
2. Pharmacological choices: varies based on the type and stage of the episodes. Since treatment in this condition is lifelong.
3. Moderate and severe mania is treated in hospital

Disclaimer: This post is purely for educational purposes and not for self diagnosis, please consult with your family doctor for individual treatment 📞

23/07/2025

OSA syndrome in children 👧🏽👦🏻
Can be caused by enlarged tonsils & adenoids

Present with: 🩺
• snoring
• mouth breathing
• witnessed apneic episodes
NB! NB! Sleep deprived children tend to become hyperactive with reduced attention and labelled as difficult or disruptive or even ADHD. They may not be doing well at school due to poor concentration.
adults they have increase daytime sommolence and increased risk of having Diabetes Mellitis and hypertension or already have the condition.

What investigation a doctor can do:
Simple studies such as pulse oximetry and overnight study of beeathing pattern.

The gold standard is overnight in-laboratory polywomnography.

Epworth sleepiness scale can be done with you general family doctor.

Treatement can start with conservative managment such as weight loss and decrease alcohol intake.
Continuous positive airway pressure equipment and in rare caes surgery to remove obstruction e.g pharyngeal obstructiok such as tonsillectomy

Remember your an individual and individual treatment os best determine by an inperson consultation and examination with you medical practitioner and this information is not ment for online diagnosing.