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The Caribbean island of the Dominican Republic is the perfect place for an enjoyable holiday. The island has been a centre for tourism since 1492 when Christopher Columbus and his crew became the first non-indigenous people to set foot on the island.

Hispaniola

When Columbus arrived, he named the island Hispaniola in honour of his Spanish patrons. The local people at the time, the Taínos, who had been living peacefully on the island since around 800 AD, were wiped out within fifty years by diseases brought by the Europeans, not to mention their brutal methods of colonisation. The capital city was called Santo Domingo and became the first European owned city outside of Europe itself.

The main sources of income for the island were gold and sugar. Before long though, the gold ran out and the settlers moved on. The island was then over-run by French pirates. In 1795, the Spanish ceded the island to France, then following a period of invasion by Haiti, the locals established the independent country of the Dominican Republic in 1844.

Getting there

Most visitors to the Dominican Republic require a visa which can be obtained from the consulate in London or at the airport upon arrival. It is valid for 30 days. Anyone wishing to stay longer must apply for an extension. There are regular flights from the major UK airports to the Dominican Republic.

What to see and do

Most people who go on Dominican Republic holidays are looking to enjoy the 300 kilometres of beautiful sandy beaches. The main tourist area is on the north side of the island between Puerto Plata and Cabarete, where most of the holiday resorts are sited. The capital, at the southern end of the island, is also a popular tourist spot with its cathedral and other historical sights. The culture of the indigenous people can still be seen with traditional arts and crafts available for purchase.

Flora, fauna and forests

The Dominican Republic has several national parks and areas of scientific interest. The mountains in the centre of the island are covered with forests which contain a wealth of floral gems including 67 types of orchid. Sadly, much of the original forest was destroyed at the time of colonisation but an extensive preservation programme has seen the island's natural glory restored. The island is home to several types of reptiles including crocodiles and various species of iguana. Tourists can also watch humpback whales and manatees.

Last word

Christopher Columbus may have been the first tourist, but there is still plenty for modern day tourists to enjoy. Visit the official tourism website for more information.

Radiology is a medical specialisation which deals with investigating diseases and disorders through the use of X-rays, MRI scans and ultra-sound scans. It also refers to the treatment of patients with radiotherapy for cancer. Radiology is an important tool for doctors and specialists in the diagnosis and treatment of patients.

Careers in radiology

People wishing to become radiologists or radiographers have to undergo radiology training after they have completed their medical degree. They have to pass an examination to become a specialist in radiology, usually specialising in a particular area such as studying mammogram results, x-rays or interpreting the results of MRI (magnetic resonance imaging) or CAT (computerised tomography) scans.

Certain specialists are trained to use radiotherapy for cancer patients. Radiology technicians or assistants are the people you are most likely to meet as they are the ones who operate the machinery that performs the test and then pass the results to the radiographer for analysis.

Radiology covers a number of different tests. This article looks at the different types of tests that a radiographer will perform.

X-Ray

This is the most common test and most people will have an x-ray at some point in their lives. X-rays show up the skeletal structure of the body, so will be used if a broken bone is suspected and may show any abnormalities in the organs and soft tissues, such as tumours.

CAT scan

This gives a much clearer picture of the body part scanned by using a computer x-raying from various angles and directions and will show more definition of the area. This is used for things like detecting strokes, tumours etc. Nowadays, with new software, a 3-D image can be produced.

MRI scan

An MRI scan is performed in a machine which appears to the patient like a tunnel and into which the patient is placed head first. The machine uses nuclear magnetic resonance technology to take pictures of very thin slices of the part of the body being scanned. This gives the doctors a very clear view of the problem as it shows bones, muscles, tendons, soft tissues etc. In this way, a surgeon, for example, can get a very clear view of the position and size of a tumour or the area of damage to a tendon or bone.

Radiotherapy

This is a type of treatment using radiation for people with non-malignant or small cancers. The specialist will adjust the treatment to the specific needs of the patient. It generally has less severe side effects than chemotherapy.

Last word

Radiology is a very important medical discipline which provides information for specialists through a variety of tests.

Malaria is an unpleasant and potentially lethal disease caused by a parasite carried by certain varieties of mosquito. With more people from Britain travelling to exotic hot spots, it is very important that you take precautions against malaria. Statistics show that around 1,500 people come back to the UK from their holidays with malaria every year.

Malaria causes

There are five parasites of the type called plasmodium each causing a different type of malaria, which are carried by the female anopheles mosquito. The most dangerous is 'plasmodium falciparum', which causes most of the malaria deaths in the world and is mainly found in Africa. Travellers should also be aware of 'plasmodium vivax' which is found in Latin American and many parts of Asia. Once a mosquito has bitten an infected person, it will then carry the malaria parasite which it will pass on to you if it bites you.The parasite heads for your liver, and from there, into your bloodstream where it multiplies constantly.

Symptoms of malaria

Depending on which parasite you have been infected with, symptoms will appear between eight and fifteen days after you have been bitten. With some varieties, symptoms may not appear for up to a year. The main symptoms are a very high fever (38º C or above), repeated episodes of chills and then sweats, muscle pain, bad headache and in certain cases diarrhoea. The falciparum malaria is the most dangerous one, developing rapidly and leading to shock, liver failure and possibly cerebral malaria. Urgent treatment is required or you may die.

Malaria diagnosis

If you are abroad and start to develop symptoms, which may be malaria, go immediately to the nearest doctor or hospital. If you begin to feel ill after you get home, go straight to your GP. Tell the doctor where you have been travelling and what anti-malarial precautions, if any, you have been taking. A blood test will be performed and if malaria is confirmed, treatment will be started immediately.

Prevention of malaria

If you plan to travel abroad, check if it is a malaria area. Take the correct anti-malarial medication. Some may have side-effects, but these are much better than catching malaria. Do everything you can to avoid getting bitten as the anti-malarials are not 100% effective. Stay somewhere that has proper air conditioning and screens on windows and doors or use mosquito nets. Wear long sleeved tops and trousers, especially in the early morning and at dusk and use DEET insect repellents.

Last word

Malaria is a potentially fatal disease, so make sure you are fully prepared before travelling. More information can be found on the NHS website.

Arthritis of the knee is a painful condition which causes considerable discomfort for the patient. The treatment depends on what type of arthritis the sufferer has and how badly the knee has deteriorated. Read on.

Types of arthritis

There are different kinds of arthritic and rheumatic conditions causing joint diseases. The ones that are most likely to affect the knee are rheumatoid arthritis, osteoarthritis, reactive arthritis or secondary arthritis.

Rheumatoid arthritis is an auto-immune disorder where the body's immune system turns on itself. It causes severe pain and swelling in joints and usually affects several joints. The sufferer also feels very tired, is very stiff (especially first thing in the morning) and may feel generally ill as if they have the flu. There is no cure.

Osteoarthritis is the most common type of arthritis, especially as you get older. It develops slowly and will only affect one or maybe two or three joints, usually the knees, hips, spine, hands and feet. Osteoarthritis is caused by wear and tear on the joint, breaking down the cartilage which causes the affected joint to develop extra bone to compensate. The joint is very stiff and painful to move and may be swollen. There is no cure.

Reactive arthritis may follow an infection such as flu, food poisoning or a sexually transmitted disease. It causes pain and swelling in the knee joints, ankles or toes and may be accompanied by other symptoms such as eye problems. It is treatable, although it may take up to a year for the disease to disappear .

Secondary arthritis is caused by an injury to a joint, such as those suffered by sportsmen, but will not appear until years later.

If you have aching knees and are suffering the pain of arthritis, the first thing you should know is what can be done. Your doctor will x-ray the affected joint, take blood tests and other tests to confirm diagnosis. It will depend on what type of arthritis you have as to what treatment is needed.

Rheumatoid arthritis sufferers are treated with a range of medications including non-steroidal anti-inflammatories and disease modifying drugs. In severe cases, joint replacement may be considered. Those with osteoarthritis in the knees will be given a variety of pain relieving drugs and an exercise programme. They are most likely to have the joint replaced - a common operation which gives the sufferer a new lease of life. Those with reactive or secondary arthritis will be given drugs as needed and an exercise programme to follow.

Final word

If you have arthritic knees, be assured that there are several treatments available. See the 'Arthritis Care' website.

Atrial fibrillation is a condition of the heart that causes an unusually fast heart rate. It's the most common heart rhythm problem and can affect anyone, although it's mostly common in people over 75 years old. Usually, the human heart beats at a rate of between 60 and 100 beats per minute when a person is resting. In atrial fibrillation, however, the beat rate shoots to over 140 beats per minute.

How the heart works

The heart is divided into four sections, two at the top called atria and two at the bottom called ventricles. The heart is basically a muscle and contracts and relaxes to push the blood through the four sections. In the right atrium, there's the sinoatrial node which sends impulses to the atrioventricular node and together, they regulate the heart's beat. This is called your pulse and you can feel it in your neck or in your wrist.

Abnormal heart beat

Sometimes, for reasons which scientists are still studying, these impulses go haywire and the atria contract randomly causing an irregular heartbeat. Since this erratic heartbeat doesn't allow the heart to relax properly between contractions, it may cause the patient to feel some symptoms, although many people are not aware of anything until the doctor takes their pulse. Those who do suffer from symptoms may feel breathless, dizzy or suffer chest pains. They may be aware of a flutter in their heart or of palpitations.

It's still unknown why some people are susceptible to heart fibrillation but likelihood increases if you have high blood pressure, atherosclerosis or a disease of the heart muscle or valves such as cardiomyopathy or pericarditis. Other medical conditions, especially those associated with the lungs such as pneumonia or a pulmonary embolism may also lead to atrial arrhythmia. Binge drinking, taking drugs such as cocaine and heavy smoking can cause heart rhythm problems.

Diagnosis

If you notice a sudden change in your heart rhythm, visit your doctor who will check your pulse. They may send you for an ECG to check for atrial fibrillation.This is a simple test where electrodes are placed on your chest, arms and legs and the machine then produces a piece of paper showing how your heart is working. From this, your doctor can make their diagnosis. Your doctor may also require further tests.

Treatment

The treatment will depend on the type of fibrillation and its cause. Your doctor will decide whether you need medication or a referral to a cardiologist (heart specialist) for more tests and treatment.

Last word

If you notice an irregularity in your pulse or palpitations, it's best to check with your doctor.