Be like with grapefruit juice that a certain enzyme is inhibited thats needed to breakdown warfare and so if it isnt broken down the war for an is twice as potent and patients are in danger of haemorrhaging it. Every medicine pack includes a patient information leaflet that describes known risks but many patients dont read it they should that they can always ask their doctor or pharmacist about the sometimes surprising interactions between medicines and what they eat and drink. And heres something from the world of medicine. Every square centimeter of your fingertips contains up to two hundred sensory cells just for a touch. They react to the slightest stimulation in just a fraction of a second. The skin has receptor is for detecting pressure pain cold and. They receive information and send it as electrical impulses along sensory nerves to the brain. They are the stimulation is identified and processed. Certain body parts were touch plays an Important Role like the hands face and feet have vast numbers of touch sensitive cells. There preceptors are must densely distributed on the fingertips lips and tongue. On the back they are spaced much more widely apart. Do your fingers sometimes hurt turned white and pale especially when its cold outside i then you might suffer from something called reno syndrome which is exist where those vessels in your fingers constrict lets watch a report about this and afterwards lets meet again in the o. R. Clearing snow off his car without gloves or pager to shawn its a bad idea his fingers change color and start to swell the problem began a year and a half ago. On splits this would lay the skin on my hands would go blue in the cold or when i came into contact with water. My hands would hurt a lot swell up and turn blue i couldnt even do simple things anymore like grip will hold on to something on the news i couldnt touch anything hot or anything cold good on fast. Sudden attacks of poor circulation in fingers and toes is called. The attacks tend to follow a typical pattern. You know weve no symptoms progress and stages we call the tricolor phenomenon in the first stage the skin is pale and white which happens because the blood vessels spasm that disrupts circulation. In the second stage the bliss stage blood slowly flows back into the skin. In the third stage an excess amount of blood returns to the dilated blood vessels to the skin causing redness and pain. Pitchers started having other symptoms too he found it increasingly difficult to handle his work as a mechanic or cope with the demands of daily life. For the kind of i felt like i was out of breath the larger joints in my body were very painful and i couldnt walk very far climbing stairs was almost impossible i found myself getting weaker and weaker i couldnt manage ordinary activities i needed help to do just about anything. Together with the rhino syndrome these symptoms raised a red flag pagers doctor sent him to a rheumatologist in some cases can be a sign of a more serious disorder. How did. We distinguish between primary renos and secondary renaud syndrome in primary renos the blood vessels exhibit impaired functioning but dont suffer any lasting damage in secondary renos the condition is usually part of some more serious rheumatologist all disease. In peters case the weakness and shortness of breath suggested a more serious problem such as a more generalized vascular disorder or a connective tissue disease but there are also other red flags that mean a doctor should take a closer look. Wed like to check if theres an underlying room until logical disorder when skin discoloration takes longer and longer to fade. Or when these discolorations arise even at ordinary Room Temperature thickening of the skin or a feeling that your skin has become too tight is another sign and any sores on the fingertips or fingernails mean we definitely should take a closer look. Pager turned out to have and i sent the tape syndrome a rare auto immune disease that affects the joints muscles and lungs by the time of diagnosis he already had some lung damage to an established become close my first impulse was to ignore it but then i realized its a very dangerous disease that often leads to death my doctor and her team figured out exactly what i needed to be healthy again. Because once with my home. Page or now takes medication that suppresses his immune system the therapy is working his lungs joints and muscles have largely recovered but rhino syndrome cant always be treated. So. When we know syndrome is caused by an underlying the magic condition that were able to treat the symptoms can disappear but in the case a secondary renos we sometimes have to prescribe laser dilating medications phase of vitamin d. Come and most. Still suffers from sudden circulatory problems its often called in the garage where he works and if he notices an attack coming on he has to warm his hands quickly. His fine motor skills have deteriorated but in general says the forty seven year old therapy has helped. Now after a year of treatment im doing better the conquered but the disease wont go away but i can make the best of it i might not be able to do everything i could before but a positive attitude does help a lot in the fifty. Page it says sean used to play table tennis competitively his hands arent up to that anymore but he still enjoys playing just for fun. Were back in the o. R. And nows the big moment hes taking the gold later on. So the ball better has been removed it was actually full of stones what happens to the patients now the patient will go back to the ward stays in hospital for two more days and after discharge she will be fine and no more treatment is necessary and we have to do any follow ups there is no follow up necessary during her stay in the hospital we will do another outre sound to check the cost of operation postoperative situation and after discharge from the hospital she will be fine thats you have to change your lifestyle for instance or diet there is no need for changing our lifestyle no. Need for a diet in her case after removing all this goal that she would be fine and she can eat everything she likes thanks so much for inviting me today. And again next time for them lets all try to stay in good shape. Health. And here in. Solidarity. The fall by the wayside when the gap between rich and for. Life in an equal society. In fifteen minutes. Im a mother like two billion other mothers around the world i have one wish the best for my child. But in a society in which breastfeeding is often frowned upon and its will for me to abound with profits is more important than my babys well being how do i know how to make the right decision. Starting december ninth on d w. Theyre black and living in germany. Shes reminded what that means on a daily basis presenter john up like this nothing good to blend in and i was. Taking a Holiday Group and being you know different than the rest. She travelled across germany to meet other black people and to hear their stories. It seems that. I grew up in a white family in a white neighborhood it was definitely a challenge. She decided to put me up for adoption. The main thing was to keep your head down and your mouth shut of course of the face like this i could never completely disappear if you see all these stereotypes about africa its good to see you. Do something for your country but youre still the black guy with an. Afro germany starting december tenth d. W. I p t twenty cricket if i dont. Tell isnt and i make a speech i feel im telling the famous potato. This is due to the news live from berlin tension inside and outside a conference of the far right is a tea party here in Germany Police fired watertown and have left wing demonstrators trying to disrupt the event inside the Party Leaders engaged in a power struggle over ideology also coming up. On tour of the forces a curfew after own rests in the streets over a disrupted president ial election at least one protester has died. I am welcome to the program well several people have been injured in the northern germans as you have hand over where police used a water cannon to disburse a protest against the far right a. F. D. Party the injured in todays policeman and at least one protester class has occurred as the a. F. P. Reelected martin as one of the cochairs of the party and he won with seventy two percent of the votes. Our correspondent there is at the f t Party Congress in hanover and joins us live from there you can what is the latest from there at the moment. Well you can hear behind me some chatter and some genuine confusion after that first reelection of york moisten as the party heads he says that the camp of around you on hecker the right wing extremist is one part of the if he is willing to go so far and it was widely expected that the second party veto would come from the more moderate group peer. Of the butlins a Party Leader Well that proved to be very complicated indeed because there was a surprise candidate dormice wins and which couldnt stein who is against trying to get the right wing extremists company trying to get out of the party well both the polls that we saw just recently proved inconclusive so were waiting whats going to happen whether there will be yet another third round but the pretty surprising thing here in the room of my me just a few minutes ago was that it was a total possible to have such for in one round at least a surprise majority for the support of your hit shows the potential of right wing extremist support amongst these delegates and its pretty much so down that some in the party had feared and some observers had expected. Now the congress is being toasty watched as well by other Political Parties in germany why is that. Well because the alternative for germany came into Parliament Just over two months ago here in germany for the very first time its already been in fourteen regional the sixteen Regional Parliament and its changed the tone wherever it when its more aggressive and also its giving. A bit of a shake up to the Political Landscape here being one element in why it is so difficult for german chancellor Angela Merkel to forge another governing coalition the math simply costs more complicated with the presence of the f. T. And what else that mean then for germanys mainstream parties and whats your sense are going to form a government. Want to means that they face a party here that time in the past driven the agenda particularly on introducing more regulations on which shutting down avenues of migration of asylum into germany it certainly has been the driving force that driving also under the mackerels gender to a certain degree it can claim that political victory and were watching it at this very moment potentially shifting even further to the right. You can a cover for us there in hanover thank you very much for that update. Frances president a man who has called on iraq to dismantle all militias including the government sanctioned Popular Mobilization of forces or pm after his call followed a meeting with the Iraqi Kurdish leaders in paris they accuse the p. L. F. Of widespread abuses against kurds and i thank me makes areas across also called for dialogue between the Iraqi Government and the semi autonomous Kurdistan Regional government. The u. S. Senate has narrowly approved a sweeping tax overhaul and fast payments for businesses and the rich lawmakers voted by fifty one to forty nine to back the package takes president on the republicans a step closer to their biggest legislative win of the year its been suggested the bill will add nearly one and a half trillion dollars to the u. S. National debt to say its a giveaway funded by the taxpayer well for more on this now were going to cross over to. Get first whos going to join us. In washington and were going to ask now bias a president. Who says that this will cost him a fortune this particular move is that the case or who stands to benefit from these cuts well according to independent research actually the rich and the super rich will benefit mostly from this tax deal and according to one study by n. B. C. President dropping his family will benefit one billion dollars in tax savings based on a two thousand five. So trying to claim that that he will be hurt by this tax bill than this not supported by any evidence it is rather that actually he and his family and the super rich are standing mostly to gain from this from this tax bill could this bill help him shore up support from voters. Well it actually might because after all the republicans have failed to get any significant legislative achievement so far through congress in his first year this is the first big major success that they can claim that they have actually pushed something that they promised through congress and so this this could help them you know explain to voters that theyre actually doing what they were told especially since theyre repeated efforts to get health care. Repeal obamas Health Care Repeal package through the congress has failed but in the long term it is it is not clear whether this will actually help trump and the g. O. P. Because as as i said before this tax plan will not really help trumps core base supporters which certainly are not the super rich and the rich in the u. S. Now democrats complain that the bear was rushed to a vote of that time to read the final draft was the process in congress here unusual well i think its certainly fair to say that this process was a rush to i mean this bill had almost five hundred pages and it was released in full only hours before the vote there were also significant changes made some in hand in hand writing just before the bill was discussed and passed so it is fair to say that this bill was rushed through congress and there wasnt really significant time for anyone to read the full five hundred pages before they were supposed to vote on it is that going to get thank you very much for the house. Staying in the u. S. President has reacted to the revelation that his former National Security advisor Michael Flynn pleaded guilty to lying to the f. B. I. Tom tweeted that flynns actions were illegal as he worked on the president s transition into the white house on friday flynn pleaded guilty to lying to the f. B. I. About his contacts with russia his confession is also brought the president s son in law jared coercion or under renewed scrutiny unconfirmed reports suggest it was cushion or who ordered splined to make contact with russias ambassador. There just some of the other stories making news around the world. Officials in prague say four people were injured when a foot bridge that crosses the river of a lot collapsed the concrete bridge is used by cyclists and pedestrians on the way to prague through police are investigating the cause of the collapse. Authorities in southern albania have evacuated hundreds of residents amid heavy rainfall that has caused flooding in the region the waters have inundated thousands of homes and that to at least one death of many as ports are paralyzed and flights from with only International Airports has been suspended. Nuclear attack warning sirens have been blaring across hawaii for the First Time Since the end of the cold War Emergency Services have been testing Warning Systems in the event of a possible missile attack from north korea hawaii is one of the closest u. S. States to north korea. Pope francis has visited a church in dhaka in bangladesh on the last day of his asia trip that tour has been overshadowed by the will hinge a crisis the pope did not name the Muslim Minority group in myanmar but he did use the term in neighboring bangladesh where more than half a million or hengist have taken refuge. The government in honduras is in forcing a ten day curfew imposed after own rests over a dispute his president ial election at least one person has died in the street protests opposition leaders have criticized the curfew which also gives extra powers to the army and the police. The wait for the final results of last months president ial election is proving a tense standoff protesters have blockaded the streets amid reports of looting and injuries in clashes with riot police both candidates in the disputed election claiming victory and the people are indignant about what is happening we are peaceful people we want peace Foreign Tourists peace can only be achieved when all the corruption is standout there is no other way. With ninety five percent of the vote counted Election Officials say the incumbent president won Orlando Hernandez has a narrow lead. To violence and arson are completely unreasonable of ministers has declared a curfew to ensure the security of the country. Being. The unrest broke out after the opposition candidate salvador nasrallah claimed Election Fraud demanded a recount and called his supporters out onto the streets a ten day curfew is now in place while the counting continues. He may have heard of the nobel prize but what about the alternative nobel prize its official name is the rice livelihood award and last wise at a ceremony in sweden it was given to four people for their efforts to fight injustice. They arent famous but the winners of the right livelihood award known as the alternative nobel prize have dedicated their lives to social justice human rights and Government Transparency four people were awarded it this year and environmental lawyer from the us a human rights lawyer from india a disability rights activist from ethiopia and investigative journalist from azerbaijan. And the immensely pleased that at present the twenty seventeen right life in a war my friend went over for courage and tenacity in exposing corruption at the highest levels of government to outstanding Investigative Journalism in the name of transparency and accountability that is my lova couldnt leave azerbaijan to accept it despite international protest her countrys government has kept a travel ban against her in place she could only appear the video since the prices founding in stockholm in one nine hundred eighty the right livelihood award has been given to one hundred seventy people or organizations from sixty nine countries. Some football news now and dormans when the street in the bonus they get has been extended to seven games bosch remains under pressure after a wood all draw against host laver coups and despite dortmund playing the majority of the game against ten men and how often i made a big statement after apache run of form they blew away second place leipsic four nil side was the stand with two goals. Thats a good look at all the ones they give us all so far this weekend well theres that hoffenheim went over leipsic and the dortmund draw there on saturday by him in a piece had over graeme and to be. Downed mines on friday then vibrate shared these spoils with hamburg and inside it is a kick off shock a face cologne on sunday has a berlin face fanfares volves very bottle mentioned that back in rugby league then australia have edged to retain the world cup title in front of their home fans in brisbane boyd cordner broke through to score the only try of the game as the tournament hosts won the low scoring but absorbing finals six nailed if the eleventh time australia have lifted the world cup trophy. And there for another australian success Stephanie Gilmore has won the final event of the twenty seven world surf make championship tour in hawaii a six time john b. And from down under is her two thousand and six well to a victory with the win over iranian manuel in the final showdown despite some impressive moves it wasnt enough to say the championship title which was secured by American Time at rice earlier this week on a finished twelfth in the overall rankings. Thats it is up for an a join us again at the top of the hour in the meantime you can check our detail for us live at the dot com or of course follow us on twitter or watching did a very nice. Story there are people who go over information. Opinions and they want to express d. W. On facebook and twitter up to date and in touch follow us. A little a child. Had a great childhood i have two mason parents gave me everything i needed. A flat went out yeah. I mean we were coop but it was so much love there we didnt really notice. We grew up i dont have vitamin without you never really knew what was going to harm in that case ill go over and say im to. Come had previous tenant