Michelle Obama's arms: the nine minute secret

When Mrs Obama first stepped on to the international stage, her arms made almost as many headlines as her husband's policies.
How does a woman of 45, an age at which most ladies banish sleeveless items to the furthest recesses of the wardrobe, maintain triceps that would not look out of place on an Olympic athlete?
The beans were spilt by Cornell McClellan, Mrs Obama's long-time personal trainer. She began exercising at his Chicago fitness studio in 1997 and he estimates that she has notched up 1,872 workouts since then. Most of these sessions were conducted at 5.30am, as the exercise-loving Obamas are famously early risers.
"She's truly committed herself to the importance of health and fitness," Mr McClellan said.
The "utimate arm-shaping superset" is a mix of tricep pushdowns, using a pulley as resistance, and hammer curls done while holding a pair of dumbbells. Two or three sets of 15 repetitions are enough to banish 'bingo wings' and give the arms definition, according to Mr McClellan. Do them and you too could be carrying off a sleeveless shift and pearls, as Mrs Obama did in her official White House portrait.
The arm exercises come at the end of a punishing workout routine for Mrs Obama which also involves weight training, rope-jumping and kickboxing.
Details of her fitness plan were featured in the October issue of US magazine Women's Health, accompanying an interview in which Mrs Obama discussed her attitude to food and fitness.
"I do love a good burger and fries. French fries are my favourite food in the whole world. If I could, I'd eat them at every meal - but I can't," she said. "My whole thing is moderation. If I make good, healthy choices most of the time, then having what I love every once in a while won't hurt. I have to exercise and eat in a balanced way. If I start ignoring both, I will put on weight.
"For me, getting enough sleep, eating right and exercising reduce my stress levels. And a really good workout is a great stress buster."
Mrs Obama said her toned figure did not come naturally. "I am fortunate in that I'm 5' 11', so it takes a while for the weight to be seen, but it'll come. If I didn't exercise and eat right I would be heavier, and I have been."
The Obamas have instilled the healthy living ethos in their daughters Malia, 11, and Sasha, eight. Mrs Obama explained: "I'm the mom, so I monitor - I am with the kids every single meal. But Dad is no slouch either. He doesn't believe that the kids should have dessert every single night; that should be a weekend treat."

What should I do if I have symptoms of swine flu ?

The WHO Director-General has raised the level of influenza pandemic alert from phase 5 to phase 6 on 11 June.
WHO has renamed “Influenza A (H1N1)” as “Pandemic (H1N1) 2009” since 1 July 2009.

According to latest update of WHO on 4 September, 182 countries/territories/areas have officially reported over 254,206 cases of pandemic (H1N1) 2009 including at least 2,837 deaths (http://www.who.int/csr/don/2009_09_04/en/index.html).


How to prevent human swine influenza?
􀁹 Wash hands frequently with soap and water or apply alcohol handrub.
􀁹 Avoid touching the mouth, nose and eyes.
􀁹 Cover nose and mouth when sneezing or coughing.
􀁹 Maintain good ventilation.
􀁹 Avoid visiting crowded or poorly-ventilated places. If you must do so, minimise the duration of stay, and consider putting on a mask if you are at risk of influenza related complications.

Persons at risk of influenza related complications
􀀹 Pregnant ladies
􀀹 Children aged less than 6 years
􀀹 Adults aged 65 years or above
􀀹 Persons with chronic illnesses
􀀹 Persons with weakened immunity from diseases or drugs

What should I do if I have symptoms of swine flu?

􀁹 Put on a face mask.
􀁹 Visit one of the designated fever clinics (DFCs) and follow doctor’s prescription.
􀁹 Stay home, in a separate room if possible.
􀁹 Do not go to work or school, and avoid having contact with others until your illness is over.
􀁹 Step up personal and environmental hygiene.
􀁹 Watch out for warning signs that might call for urgent medical attention.

Seek medical care right away if the sick person :
􀀹 has difficulty in breathing or chest pain
􀀹 has purple or blue discoloration of the lips
􀀹 is vomiting and unable to swallow liquids
􀀹 has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry
􀀹 has seizures
􀀹 is less responsive than normal or becomes confused
Consult your doctor if in doubt.


What should I note if I care for a sick person with swine flu?
Patients with mild symptoms may rest at home and be taken care of by family members. The following suggestions will be helpful:
􀁹 In caring for the patient
− Assign an adult to take care of the patient to prevent spread of disease to other household members.
− Persons at risk of influenza related complications should avoid taking care of sick persons
− Keep the patient in a separate room if possible.
− Remind/assist the patient to put on a face mask if possible.
− Minimise contact between the patient and the family.
− Remind/assist the patient to take medications according to doctors’ prescriptions.
− Encourage the patient to get plenty of rest and fluid to speed recovery.
− No sharing of linens, eating utensils and personal items between the patient and the rest of the family, unless such items are washed thoroughly.
− Watch out for warning signs that may call for urgent medical attention.

To protect yourself,
− Observe and remind other family members to step up personal hygiene practices.
− Maintain household and environmental hygiene by cleaning with diluted bleach (1 part of 5.25% household bleach in 99 parts of water), especially in areas where the patient stay, to prevent disease spread.
− When coming into contact with the patient (e.g. entering the patient’s room),
􀁹 Wash hands before and after contact
􀁹 Wear a face mask
􀁹 Avoid face-to-face contact with the patient to prevent catching the disease through coughs and sneezes, e.g. when holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.
− Pay attention to your own health condition. If symptoms such as fever, cough, runny nose, sore throat, shortness of breath or diarrhoea occur, you must wear a mask and seek medical advice.

Malaria

Causative agent

Malaria is a serious and sometimes fatal disease caused by a group of malaria parasites, namely Plasmodium vivax, Plasmodium falciparum, Plasmodium ovale, and Plasmodium malariae. It is commonly found in many parts of tropical and sub-tropical areas where the climate is warm, like Africa, South-East Asia and South America.

Clinical features

Symptoms of malaria include intermittent fever, chills, sweating, headache, tiredness, poor appetite and muscle pain. In typical cases, the fever comes, then subsides for 1-3 days and then comes again in a cyclical pattern. Complications include anaemia, liver and kidney failure, seizures, mental confusion, coma, and death if the disease is not treated promptly.

Mode of transmission

Malaria is a vector-borne communicable disease transmitted by an infected female Anopheline mosquito. When the mosquito bites a malaria patient, the mosquito becomes infected and will pass on the disease when it bites another person. Malaria is not transmitted from person to person. However, malaria can be transmitted through contaminated blood or blood product transfusion, organ transplant, or shared needles or syringes. Malaria may also be transmitted from a mother to her foetus/newborn baby before or during delivery.

Incubation period

The incubation period varies with different plasmodial species. This usually ranges from 7-30 days but may be up to months or even longer after the bite of an infected Anopheline mosquito.

Management

There are effective drugs against malaria but early diagnosis and prompt treatment are crucial. The doctor would prescribe a course of anti-malarial drugs with other supportive measures. The patient should complete the whole course of medication to ensure clearance of the malaria parasites.

Prevention

Take measures to avoid mosquito bite. There are no vaccines against malaria. If you travel to areas where malaria is common, consult your doctor or the Port Health Office two to three weeks beforehand for preventive measures and obtain anti-malarial drugs for prophylaxis if necessary. You should start taking the drugs before the trip, continue throughout the journey and for four more weeks after leaving the malarious area. During your visit abroad or after coming back to Hong Kong, if you have symptoms of malaria, seek medical advice immediately and inform the doctor of the places you have visited. Urgent blood tests may be performed and prompt treatment is vital. Malaria infection during pregnancy can have adverse effects on both the mother and the foetus. Therefore, pregnant women should not visit malarious areas unless this is absolutely necessary.


General Measures on Preventing Mosquito-borne Diseases

1. Wear long-sleeved clothing and trousers, and apply effective insect repellents containing DEET to exposed parts of the body and clothes. Repeated application may be required. Concentration of DEET should not exceed 35% for adults and 10% for children.

2. Use mosquito screens or nets when the room is not air-conditioned.

3.Apply household pesticide to kill adult mosquitoes with a dosage according to the label instructions. Do not spray the pesticides directly against functioning electrical appliances or flame to avoid explosion.

4. Place mosquito coils or electric mosquito mats / liquids near possible entrances, such as windows, to prevent mosquitoes from entering.

5.Prevent the accumulation of stagnant water Put all used cans and bottles into covered dustbins. Change water for plants at least once a week, leaving no water in the saucers underneath flower pots. Cover tightly all water containers, wells and water storage tanks. Keep all drains free from blockage. Top up all defective ground surfaces to prevent the accumulation of stagnant water.