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Dr Chiba Hiroshi.   Photo courtesy of Family Medical Practice

By Dr Chiba Hiroshi*

Let’s say you are suffering from long-lasting body pain. You’ve tried drugs from the pharmacy or tried yoga classes, but nothing seems to help. What should you do in this situation?

To get better control, you need to know the basic principles of pain.

When a part of the body is damaged due to injury or illness, the sensory nerves around the injured tissue instantaneously send electrical signals to the brain, signaling the body’s injury as pain. Pain is essential information for quickly detecting abnormalities in the body and protecting yourself from further danger. The pain at this time is called nociceptive pain.

Paracetamol and NSAIDs (which stands for Non-Steroidal Anti-Inflammatory Drugs like aspirin, ibuprofen, etc.) are prescribed against nociceptive pain. You can even buy them as over-the-counter medicine at pharmacies. Damaged cells release small particles called prostaglandins, which can intensify pain or generate fever. These drugs exert their analgesic effect by blocking prostaglandins. Topical as well as oral medications may be useful.

However, suppose the pain persists even after taking paracetamol or NSAIDs for a certain period. In that case, it is necessary to consider other possibilities as the cause of the pain.

At first, we need to consider whether the pain is caused by treatable diseases.

Diseases such as migraine and polymyalgia rheumatica have particular medications that can control the pain through treatment if accurately diagnosed. Doctors should be on the lookout for these diseases. Malignant cancers can also cause long-lasting pain, so a thorough investigation is necessary.

Pain that lasts for more than three months without such a manageable disease is called chronic pain. Paracetamol is known to be ineffective in treating osteoarthritis and chronic back pain.

Next, consider the possibility of neuropathic pain. Neuropathic pain is a condition in which the sensory nerves get damaged. They transmit electrical signals to the brain that causes pain. Even if there is no damage to the body, the brain receives the electrical signals and feels the pain. NSAIDs and acetaminophen are ineffective for neuropathic pain.

Furthermore, when there is long-lasting pain, sensitisation for pain may occur.

Sensitisation for pain means that the brain or nerve functions have been altered by prolonged pain so that even the slightest stimulus is perceived as pain. There is no test to detect sensitisation. Doctors have to diagnose it solely based on the patient’s complaints, clinical course, and some basic examinations. Therefore, it is difficult to diagnose the pain caused by sensitisation. Even if it can be diagnosed accurately, it takes a long time to treat because of the brain and nerves’ structural changes. Therefore, multidisciplinary treatments using various medications, cognitive therapy, mindfulness, or other practical means like yoga, are necessary in many cases.

Medications to ease neuropathic pain or sensitisation are antidepressants or anticonvulsants, which act on the malfunctioning brain or nerves. It does not necessarily mean that you have epilepsy or depression.

In general, opioids such as oxycontin and fentanyl would not be prescribed for chronic pain. Although opioids effectively treat pain caused by malignant cancers, they are withheld from non-cancer chronic pain for concerns about dependence unless there is no other option.

Lastly, let’s look at the side effects of these medications.

Acetaminophen is an extremely safe drug and has few side effects as long as it is taken in the proper dosage. However, taking too much of it can damage the liver.

It is well known that NSAIDs can cause gastric mucosal damage. In particular, aspirin can inhibit hemostasis, so for example, avoid taking it if you have dengue fever. When you get seasonal flu with fever, taking NSAIDs can cause Rye syndrome, a severe complication.

Antidepressants and anticonvulsants have the side effect of making you drowsy since they affect the central nervous system.

Opioids have various side effects such as drowsiness, constipation, and the formation of physical and psychological dependence, which is a risk of making pain control more difficult.

Thus, to keep pain under control and get your life back, it is crucial to take the proper medication to treat and alleviate the cause of pain. Family Medical Practice

*Dr Chiba Hiroshi is a Japanese Family Doctor with 20 years of experience working in Japan and Cambodia, specializing in primary care, travel medicine, and urgent care. He graduated from Tohoku University school of medicine in 1998 and received his PhD in Geriatrics in 2004. He provides consultation on a wide range of health problems for all age groups. Other areas of specialties and interests include infectious disease, infection control, and medical education.

Family Medical Practice was the first foreign-owned primary healthcare provider in Việt Nam, and has consistently remained at the forefront of international-standard medicine since 1995. It offers extensive healthcare and emergency medical services nationwide to Vietnamese, expatriate and corporate customers.

For more advice on any medical topics, visit Family Medical Practice Hanoi at: 298 I Kim Mã, Ba Đình District . Tel: (024) 3843 0748.  E: [email protected] .

FMP’s downtown Hồ Chí Minh City location is: Diamond Plaza, 34 Lê Duẩn, District 1; 95 Thảo Điền, District 2. Tel: (028) 38227848. E: [email protected]

FMP Đà Nẵng is located at 96-98 Nguyễn Văn Linh, Hải Châu District, Đà Nẵng. Tel: (0236) 3582 699. E: [email protected] .

Police force patrol on Hà Nội-Hải Phòng Expressway. — VNA/VNA Photo

HÀ NỘI — Prime Minister Phạm Minh Chính has issued a directive urging ministries and government agencies to ensure traffic safety during the national holidays marking Reunification Day and May Day.

The directive was sent to the ministries of public securities, transport, information and communications, the National Committee for Traffic Safety, news agencies and provincial and municipal people’s committees.

Under the directive, PM Chính said efforts are needed to improve the capacity of public transport services to meet increasing demand for travel during the holidays.

Transport companies, stations, airports, railway stations, terminals and inland waterways were required to strictly comply with the traffic safety regulations; promote the application of electronic ticket sales; improve service quality; reduce traffic jams, delays and illegal price hikes and at the same time, strictly comply with regulations on prevention and control of the pandemic.

The PM asked the ministries and agencies to strengthen security and order at the major traffic routes, shopping centres, entertainment venues and major tourist and festival destinations. Illegal bus stations, vehicles that fail to meet technical safety standards and carry more than the prescribed number of people will be punished, the PM said.

Traffic infrastructure will be checked, including signals, warning signs and warning equipment in places that have a high risk of traffic accidents. Tollbooths will assign more workers to collect fees quickly to reduce traffic jams.

Drivers must ensure passenger safety by driving more carefully on steep roads and through level crossings, he added.

Increased inspections should be used to strictly punish traffic regulation violators, especially those who cause traffic accidents.

Public order disturbances, illegal racing and violations against public servants on duty should be strictly dealt with, at the same safety of COVID-19 prevention for enforcement forces and people need to be ensured.

Local departments of transport were also asked to remind people of the importance of wearing helmets and obeying regulations to minimise accidents and strictly comply with anti-virus protocols.

Hotlines to receive traffic complaints should be widely publicised, he added.

The PM also requested news agencies to regularly update traffic accidents, traffic jams, information to support travel guidance during the holidays and encourage citizens to strictly comply with traffic safety regulations.

Reports on these efforts will be sent to the National Committee for Traffic Safety before 3pm on May 3 to submit to the Prime Minister. — VNS

With a history of 132 years backed by a series of iconic projects across Asia, Hongkong Land is continuing to write its chronicle with luxury real estate projects in Viet Nam, and The Marq certainly cannot go without mention.

More than 130 years ago, Sir Catchick Paul Chater, who was orphaned just before his ninth birthday, moved to Hong Kong to build a bullion and land trading business. Little did he know that he would become one of Hong Kong’s most famous real estate tycoons. The young Sir Paul surveyed the Victoria Harbor by dropping a maritime plumbline to measure its depth and successfully persuaded the colonial government of Hong Kong to reclaim the land at the riverbank, marking his first step in the real estate business. In 1889, Sir Paul formed a real estate company, The Hongkong Land Investment & Agency Company, Limited, together with Jardine, Matheson & Company’s Scottish businessman, James Johnstone Keswick, laying the first bricks to build the famous Hongkong Land empire of today.

Hongkong Land – its 132-year history illustrated by a series of iconic projects

The asset of long-standing history and heritage has traditionally been associated mostly with luxury maisons. Hongkong Land breaks the norm with its 132-year legacy expressed through the creation of architectural masterpieces in major capitals of Asia.

Since its establishment in 1889, which instigated the famous Praya Reclamation Scheme that turned 65 acres of wasteland into Hong Kong’s leading commercial centre, Hongkong Land has grown to be one of Asia’s most familiar and trusted property investment, management, and development groups. Hongkong Land currently owns and manages more than 850,000 sq.m of prime office and luxury retail property in key Asian cities, principally in Hong Kong, Singapore, Beijing and Jakarta. The Group also has a number of high quality residential, commercial, and mixed-use projects under development in cities across Greater China and Southeast Asia.The addition of Singapore’s prosperity symbol, Marina Bay Financial Center, and Jakarta’s architectural marvel, World Trade Center, underscore Hongkong Land’s leading position in the region.

Hongkong Land owns and manages many prime offices and luxury retail properties in key Asian cities

Hongkong Land’s impressive mark in Viet Nam

In the Vietnamese market, Hongkong Land is one of the few pioneering brands in the field of investment and development of luxury real estate projects.

In HCM City, Hongkong Land marked its presence with the completion of The Nassim – a luxury apartment project located at the much-coveted Thao Dien peninsula. For the first time in Viet Nam, the private elevator concept was introduced via this project. A highly-sought privacy perk for wealthy residents, it was certainly a cherry atop a series of other top-notch facilities.

The Marq, Hongkong Land’s latest luxury apartment project in the heart of District 1, is another interesting addition to Hongkong Land’s collection of luxury residential projects in Viet Nam.

Luxuriate in the upscale in The Marq

The Marq – Refined Luxury Living

Situated along the dreamy street of Nguyen Dinh Chieu, a peaceful avenue hidden under a canopy of trees, where heritage is imbued with modern lifestyles, The Marq enhances its surroundings with its refined contemporary touches. Not just on the outside, modern elements run inside, from the soaring high ceilings to top-of-the-line appliances, private lift lobbies, and a wealth of recreational facilities crowning the rooftop. This masterpiece is dedicated to wealthy lifestyle connoisseurs seeking true value of life. As Hongkong Land’s latest gem, The Marq is set to be another trademark of Hongkong Land, staying true to its name (The Marq is combining the word Mark – meaning imprint – and the letter Q – an abbreviation for Quintessence).

While Hongkong Land focuses on developing high-end real estate, its parent company, Jardine Matheson Group, owns a well-diversified portfolio in various sectors of the Vietnamese market, from finance (ACB Bank) to automotive manufacturing (THACO), infrastructure (REE), and food and beverage (Vinamilk, Starbucks, KFC).

Both Hongkong Land and Jardine Matheson will certainly bring a lot of synergised value to their projects in Viet Nam, including luxury real estate projects like The Marq.

A collaboration between The Marq & BMW (THACO)

The launch of The Marq’s new show unit and the release of a new selection of units for sale will be held in April 2021, right at the project site. Customers who register their interest will be granted 1 Starbucks voucher worth VND2,000,000. In addition, all customers who successfully sign the sale or lease agreeement will be eligible to take part in a special lucky draw and stand to win a BMW X7-xDrive40i-Pure Excellence valued at VND6,889,000,000. Don’t miss your chance with “New home, new luck” by The Marq.

Developed by Hongkong Land, The Marq is a luxury residential high-rise building located in the heart of District 1. The development will provide 515 opulent residences comprising 1- to 4-bedroom condominiums and penthouses offering stunning views of HCM City and a true luxury lifestyle for discerning investors.

For more information, visit www.themarq.com.vn or http://www.facebook.com/themarqdistrict1 .

A disappointing game was settled 10 minutes after the interval as the in-form Nigerian striker slotted at the second attempt after good work by Jamie Vardy.

* Mason Greenwood continued his fine run of form with a second-half brace which helped Manchester United to a 3-1 home win over Burnley in the Premier League on Sunday and kept them on course for a top-four finish.

* Arsenal substitute Eddie Nketiah struck deep into stoppage time to cancel out Josh Maja’s second-half penalty in a 1-1 draw with relegation-threatened Fulham in the Premier League on Sunday.

* Sevilla came from behind to win 2-1 at Real Sociedad on Sunday (Apr 18) and stay in contention for an unlikely La Liga title bid.

* Borussia Dortmund striker Erling Haaland scored twice in four minutes on Sunday, ending his seven-game goal drought in all competitions, to help his team to a 4-1 win over Werder Bremen in the Bundesliga and revive their hopes of a top four finish.

* Juventus slipped to a last-gasp 1-0 defeat at Atalanta on Sunday as Gian Piero Gasperini’s side leapfrogged the champions into third place in the Serie A standings. Juve, missing Cristiano Ronaldo due to injury, struggled to break down the in-form hosts without their Portuguese talisman and were forced to defend for much of the second half against Serie A’s top scorers.

* Christian Eriksen’s first league goal of the season earned Inter Milan a 1-1 draw at Napoli on Sunday (Apr 18), moving the league leaders nine points clear at the top of the Serie A standings.

* AC Milan secured a first home Serie A win for over two months with a nervy 2-1 victory over Genoa on Sunday to boost their hopes of a top-four finish.

* Paris St Germain stayed in the hunt for a fourth successive Ligue 1 title after Mauro Icardi scored in the dying seconds of stoppage time to secure a dramatic 3-2 win over St Etienne on Sunday.

* Miami will host a Formula One race from next year as part of a 10-year-deal announced by the sport and local organisers on Sunday (Apr 18). The grand prix at Hard Rock Stadium in Miami Gardens, home of the Miami Dolphins NFL team, will be a second Formula One race for the United States in addition to the one in Austin, Texas.

* Yamaha’s Fabio Quartararo claimed a second consecutive MotoGP victory after leading almost from start to finish at the Portuguese Grand Prix on Sunday as six-times world champion Marc Marquez finished seventh in his first race in nine months.

* Twelve of Europe’s most powerful clubs announced the launch of a breakaway European Super League on Monday (Apr 19) in a potentially seismic shift in the way football is run. Six Premier League teams – Liverpool, Manchester United, Arsenal, Chelsea, Manchester City and Tottenham – are involved, alongside Real Madrid, Barcelona, Atletico Madrid, Juventus, Inter Milan and AC Milan.

* Paris St Germain ended Olympique Lyonnais’ five-year reign as European champions as they progressed to the women’s Champions League semi-finals on away goals after securing a 2-1 win on Sunday.

* Roger Federer will kickstart his claycourt campaign at next month’s Geneva Open as he steps up his preparations for the French Open, the 39-year-old Swiss wrote on Twitter on Sunday. After missing more than a year following two knee operations, Federer returned on Tour at last month’s Qatar Open, where he suffered a quarter-final defeat by Georgia’s Nikoloz Basilashvili.

The water level of Nậm Liệp-Minh Lương Stream in the northern mountainous province of Lào Cai rose due to heavy rain. VNA/VNS Photo Hồng Ninh

LÀO CAI — At least three people were killed in a flash flood that swept through Văn Bàn District, in the northern mountainous province of Lào Cai, over the weekend.

The bodies of two people were recovered on Saturday evening, while one remains missing.

The Steering Committee on Natural Disaster Prevention and Control of Văn Bàn District reported that the sudden floods affected 25 households, with furniture, motorbikes and construction materials damaged.

Two houses were swept away and dozens of others were damaged.

Prime Minister Phạm Minh Chính issued a dispatch asking localities to focus resources on dealing with the consequences of floods and heavy rain in the northern mountainous region since Friday.

In the dispatch to the people’s committees of the six northern mountainous provinces of Lai Châu, Yên Bái, Sơn La, Hà Giang and Tuyên Quang, the Central Steering Committee for Flood and Storm Control, National Committee for Disaster Response and Search and Rescue, and relevant ministries and agencies, the PM extended his condolences to families of the victims, and asked the local authorities to help locals fix houses and clean the environment, and provide them with food and essential goods.

He also asked the localities to keep a close watch on developments of flooding and rain, and to review and assess the safety of homes, especially in areas at high risk of flash floods and landslides, while preparing forces, vehicles, and equipment to deal with any circumstances.

The media will continue to provide information on developments of the natural disaster, damage, and response efforts, according to the dispatch.

A super typhoon called Surigae is edging closer to the eastern part of the Philippines.

At 7am on Sunday, it was 400km from the coastal area of the central Philippines.

It is predicted to intensify its power and affect the East Sea (internationally known as South China Sea).

The Central Steering Committee for Flood and Storm Control ordered authorities of coastal localities from Quảng Ninh to Cà Mau to closely follow the typhoon and report the typhoon’s development to ships offshore in the East Sea area. — VNS