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By | Beals

The CDC and Texas Medical Association has shared reports of a rise of West Nile, Dengue, and Chikungynya infections in Texas this season. Dr. Roberta Beals of the Healthy Skin Clinic in Lubbock says “Zika is also a concern when it comes to these pesky pests. We can all take steps to help avoid infection.” To help keep the community safe, avoid mosquito bites and to reduce mosquito populations, such as:

  • Regularly applying EPA-registered insect repellent while outdoors.
  • Dumping out all standing water inside and outside homes and businesses so mosquitoes can’t lay eggs.
  • Using air-conditioning or making sure window and door screens are in good repair to keep mosquitoes out.
  • By covering-up skin with long sleeves and long pants to help prevent bites.

DEET (N,N-diethyl-3-methylbenzamide) better known as insect repellant has specific recommendations for use from physicians. The more mosquitos you’re exposed to the higher concentration of DEET you need to use. A product containing 10 to 35 percent DEET is adequate in most circumstances, with higher concentrations reserved for situations in which: insect infestation is high, the repellent may be partially washed off, or time outdoors will exceed three to four hours. Microencapsulated formulations are preferred, as these protect longer with lower concentrations of active repellent. DEET should be used carefully and only as directed. It can be used safely by pregnant women and applied once daily to children older than two months of age (Breisch, UpToDate, 2019). Twenty percent picaridin (aka Saltidin) is a good alternative for people who wish to avoid the unpleasant characteristics of DEET and are willing to accept a somewhat shorter-acting repellent. For concerns about their health or information on insect repellants such as Saltidin plant-based alternatives to DEET, people can call or text the Healthy Skin Clinic at 806.790.5964.


By | Beals
Alarmed at the recent media coverage, Dr. Roberta Beals of the Healthy Skin Clinic in Lubbock wants to help warn the local community about the dangers that cosmetics can cause to children. “We want to remind parents to be wary of the products in their homes and provide some recommendations to avoid misuse by children to keep them safe,” says Dr. Beals. “Great products can still cause great problems when in the hands of children.”
Newsweek reports that research indicates “encounters with everyday cosmetic products from shampoo to deodorant land a child in the [emergency department] every two hours in the U.S.” The study found that “between 2002 and 2016, an estimated 64,686 children below the age of five visited emergency rooms across the country for injuries caused by cosmetic products.”
CBS News reports that investigators “found 75 percent of injuries from cosmetic products occurred when a child swallowed a product, while 19 percent occurred when a product made contact with a child’s eyes.” The study indicated that “the three most common types of products that caused injuries in young children were nail care, hair products, and skin care.”
Dr. Beals recommends that:
  • Everyone keep their cosmetics and other handheld -or smaller- toiletries at a safe distance out of reach from children particularly aged five and below.
  • Make-up always be kept in closed, lid-covered containers. Child proof lids are also helpful but are not always found on sample size products. These containers will help to corral the clutter on counters, drawers and cabinets that draw the attention of children.
  • Have mom or dad teach or openly show kids aged 5 and up how they use their toiletries when they grow up, to avoid misuse in the meantime or down the road.
For concerns about the safety of specific products, people can call or text the Healthy Skin Clinic at 806.790.5964
Anterior Lumbar Interbody Fusion (ALIF)

Anterior Lumbar Interbody Fusion (ALIF)

By | Nesterenko
Anterior Lumbar Interbody Fusion (ALIF)


Anterior lumbar interbody fusion is a surgical procedure done through the abdomen to remove a diseased intervertebral disc and replace it with a spacer, thus restoring the disc height, decompressing the nerves, correcting deformity and fusing the vertebrae together in the corrected position.  



Three main indications for ALIF:

  • Degenerative disc disease causing disc collapse with compression of the nerves and back pain
  • Spondylolisthesis, which is instability between the spine bones, when two vertebrae shift next to each other
  • Recurrent disc herniation

What are the goals of ALIF?

There are three main goals:

  • Restore height of the disc space and remove pressure from the surrounding nerves
  • Correct alignment of the bones
  • Remove abnormal movement by fusing the bones together


Backpack Safety Awareness Day

National Backpack Awareness Day

By | Nejat

With school back in session the importance of backpack safety should be top of mind. Adults and children need to be aware of the consequences of carrying a backpack incorrectly. There are some basic guidelines to follow when wearing a backpack. Carrying a backpack incorrectly can cause back pain and damage to the spine. The guidelines below will help in preventing damage and pain from occurring.

  • Make sure your child’s backpack weighs no more than 5 to 10 percent of his or her body weight. A heavier backpack will cause your child to bend forward in an attempt to support the weight on his or her back, rather than on the shoulders, by the straps.
  • The backpack should never hang more than four inches below the waistline. A backpack that hangs too low increases the weight on the shoulders, causing your child to lean forward when walking.
  • A backpack with individualized compartments helps in positioning the contents most effectively. Make sure that pointy or bulky objects are packed away from the area that will rest on your child’s back.
  • Bigger is not necessarily better. The more room there is in a backpack, the more your child will carry-and the heavier the backpack will be.
  • Urge your child to wear both shoulder straps. Lugging the backpack around by one strap can cause the disproportionate shift of weight to one side, leading to neck and muscle spasms, as well as low-back pain.
  • Wide, padded straps are very important. Non-padded straps are uncomfortable, and can dig into your child’s shoulders.
  • The shoulder straps should be adjustable so the backpack can be fitted to your child’s body. Straps that are too loose can cause the backpack to dangle uncomfortably and cause spinal misalignment and pain.
  • If the backpack is still too heavy, talk to your child’s teacher. Ask if your child could leave the heaviest books at school, and bring home only lighter hand-out materials or workbooks.
  • Although the use of rollerpacks – or backpacks on wheels – has become popular in recent years, we are now recommending that they be used cautiously and on a limited basis by only those students who are not physically able to carry a backpack. Some school districts have begun banning the use of rollerpacks because they clutter hallways, resulting in dangerous trips and falls.
Polycystic Ovarian Syndrom (PCOS)

PCOS: Metabolic Disorder vs. Gynecological Disorder

By | Devani
Polycystic Ovarian Syndrom (PCOS)

It is likely that you or someone you know has Polycystic Ovarian Syndrome (PCOS), as it is becoming more and more prevalent among women of all ages. In fact, it is estimated that up to 20% of women (1 in 5 women) have this disorder. The sheer mention of PCOS comes hand in hand in the context of challenges that are highly distressing, such as becoming pregnant or having signs of excess male hormones (androgens), producing unwanted hair growth or acne, for instance.

Historically, PCOS was described as mostly a reproductive problem. The first mentions of this syndrome in current medical literature came from Stein and Leventhal, who described the classical triad of polycystic ovaries (or multiple cysts on the ovaries), hirsutism (signs of excess androgens) and oligo-amenorrhea (having too few or no menstrual cycles).

However, as we have made significant strides in understanding this disorder, we are understanding that PCOS is better described as an endocrine or metabolic disorder, and that PCOS is more of a harbinger of endocrine diseases like Type 2 Diabetes and metabolic syndrome, rather than the originating disease itself.

Some now consider insulin resistance as central to the origins of this condition. As a result of insulin resistance, insulin levels rise and sex hormone-binding globulin (SHBG) made by the liver decrease, resulting in an increase in bioavailable, active androgens. Insulin may also increase appetite, contributing to weight gain. This leads to a number of downstream effects, such as metabolic syndrome, nonalcoholic fatty liver disease and sleep apnea. Furthermore, PCOS sufferers are more likely to have depression and anxiety and experience miscarriages or other pregnancy complications.

Unfortunately, PCOS is to this day, highly underdiagnosed.

We are finding that PCOS can present itself clinically in a variety of ways. For instance, while phenotype A has the classical high androgen, low ovulation and polycystic morphology, other phenotypes may not include any one of these criteria. Thus, women with PCOS may endure a variety of symptoms, including, but not limited to:

  • infertility
  • irregular periods, including more frequent periods
  • long lapses between periods
  • acne
  • weight gain
  • unwanted hair on the upper lip, chin, neck, upper chest, abdomen, back, arms and thighs
  • hair loss on the temporal regions of the scalp
  • thinning of hair or hair loss
  • darkening of the skin around the armpits, groin or back of the neck

Further, testing results are highly variable. Testing may include a number of lab tests, such as testosterone levels, thyroid hormone levels, progesterone levels and an oral glucose challenge test; however, it is not necessary to have abnormal results of bloodwork or imaging, like ultrasounds.

That being said, all is not so grim in the world of PCOS. There are real, actionable things a woman can do, in regard to their health. As a physician who strongly believes in a holistic approach, I first encourage all PCOS patients to take their diet and lifestyle into account. Insulin resistance being central to this syndrome, it is important to work at this level.

We know that weight loss can be highly impactful. Shedding as little as 5% of the initial body weight can regulate menstrual cycles and ovulation and potentially even improve SHBG levels. Diet is critical to a holistic approach to PCOS, particularly eating a whole food, non-processed diet. Many foods can contribute to inflammation in the body, and inflammation certainly contributes to insulin resistance. It is important to eat a diet similar to a low-glycemic, Mediterranean diet that is high in fibrous vegetables, high-quality fats, legumes and whole grains. I also work with certain supplements, such as those from the inositol family or bitter melon, when extra help is needed. Lastly, we cannot talk about healthy living without talking about stress. Excess stress leads to increased cortisol levels, which also causes insulin resistance. I work with patients to find their anchor that they can do regularly as their daily exercise to stave off stress.

When all of these fail, we luckily have other options, such as hormonal methods and antiandrogen medications.

The bottom line is that there ARE solutions that work. Speak to your physician about your concerns, and together, find a plan that works best for you.

Vrinda Devani is a board-certified Obstetrician and Gynecologist practicing at Grace Clinic®. Learn more about Dr. Devani or call 806-744-7223 to book an appointment.

Learn more about Dr. Vrinda Devani