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This Slimming Pill Kills

The death of a medical student who took a banned slimming pill, dinitrophenol, commonly called DNP, raises the point that most, if not all, slimming pills that are currently available, are a major hazard to health. In fact, to date, the US FDA has only approved two new weight-loss pills (in 2012) after the previous approval of Xenical in 1999. Such are the difficulties faced by pharmas in securing approval for a safe and efficient medicine to lose weight.

DNP_Sarah

Sarah Houston – succumbed to the slimming pill DNP.

23 year old Sarah Houston, a medical student at Leeds University,England, died after taking DNP in an attempt to lose weight in September last year. DNP had already been linked to 62 deaths around the world in a study published last year in The Journal of Medical Toxicity.

DNP is illegal for human consumption but is still available commercially to make make dyes,other organic chemicals, wood preservatives and herbicides. It was originally used as a diet pill in the 1930s but the presence of severe side-effects such as an undue rise in body temperature (hyperthermia) which can be fatal has resulted in its ban since.

A shocking fact which emerged following this tragedy is that DNP is still being sold online as a diet pill. In Sarah’s case. she had bought them via the internet from a trader in Spain. My advice: scrutinise the ingredients of any nonprescription diet pill carefully and avoid disreputable sources.

 

 

Say No to HRT

At one time, hormone replacement therapy (HRT) was routinely prescribed to any woman reaching menopause and asking for it, in an effort to prevent fractures,osteoporosis, dementia and other chronic diseases.

menopause

Hot flushes are a common symptom on reaching menopause, not always needing treatment

osteoporosis-(1)

That was fine but recent developments have advocated the reverse – only women with severe symptoms of menopause like flushing,headaches and excessive sweating are given a short course to relieve the symptoms. Otherwise, HRTs are now not advised at all.

What is the evidence for the change in stance? The US funded Women’s Health Initiative, known as WHI, was halted in 2002 when initial results showed women taking a combination of estrogen and progestin had a higher risk of breast cancer, heart disease and stroke than women who received a placebo( or ‘dud’ pill). This marked a drastic shift in opinion, so that now, these combination pills are no longer advocated. Indeed, even oestrogen-only pills are now  taboo.

You can find more facts about HRT here:

http://www.nhlbi.nih.gov/health/women/index.htm

For alternatives to hormone therapy, see here:  http://www.nhlbi.nih.gov/health/women/pht_facts.pdf

So What Is the Mediterranean Diet?

The fact that the Mediterranean Diet has led to lower rates of heart disease, stroke and cancer has been known for decades; and the latest study highlighted over the media recently (see here) is on the back of several similar studies done over the years. I had written about one such study in an earlier blog posting in 2008 (see here).

Mediterranean food pyramid

So how many more studies do we need before the guidelines on healthy eating habits are changed by governments from the low-fat high carbohydrate that is so widely advocated? Even in those countries where a greater awareness of what constitutes healthy eating exists, the end-product may not be what the consumer paid for – olive oil is adulterated and/or filtered, garlic is taken as a pill than a freshly-crushed clove and even red wine is not aged and commercially processed so that it is lacking in polyphenols.

olive oil

There are many grades of olive oil – extra virgin being the best

The Mediterranean Diet – low in saturated fat and high in fiber and monounsaturated fat -  includes vegetables, whole grains, fish, legumes, fruit, and moderate red wine, if so inclined. The main cooking fat is olive oil – pure unfiltered virgin olive oil is preferable, although the quality varies quite a bit commercially.

It is interesting to note that this oil has been around since time immemorial and its benefits  mentioned by most of the world’s major religions, whether its the Muslim Hadith (“Consume olive oil and anoint it upon your bodies since it is of the blessed tree”), the Catholic church (“Oil of the Sick”) or the Jewish Talmud which states that frequent consumption of olive oil is good for one’s memory.

But behind the benefits of this diet, a more stark message is revealed: that the typical ‘Western Diet’ is  the antithesis, with processing, additives and chemical substitutes causing many of the lifestyle diseases it is supposed to prevent.

 

Flying On The Wings of Stress

As the Olympic athletes fly home by the tens of thousands, I could’nt help wondering what kind of stress they were subjected to.. Anyway, the official seven leading causes of stress, according to a University of Washington study are finances, work, family, personal concerns, personal health & safety, relationships and death. I’m going to take it they left out flying.. because they forgot to ask anyone who’s taken a trip by air. Many will agree that taking a flight is one of the major causes of stress in modern everyday living.

The amount of stress involved in flying starts way before the actual flight, right on the ground itself. First and foremost, the long trip to the airport itself is fraught with stresses, from lack of timely taxis to traffic jams to  making sure the kids are ready on time. Even if you decide to take to take to the road yourself, there’s the outrageous airport parking charges and the distance they are located from the terminal..

Having reached the terminal, there’s the queues, the far-from-easy electronic check-in terminals and the extra charges, ranging from that for overweight baggage to really unexpected surprises – Ryan Air insists you print your own boarding cards and if you misplace yours, they’ll print it for you..for a fee, 40 British pounds to be precise.

Then there’s the security screening..more stresses if you have shoes with bootlaces or laptops. By the way, the liquids ban mean you need clear plastic bags which are now sold at 1 pound each at some UK airports. Departure delays..these are a way of life nowadays with airlines cutting back on flights due to bad times.

Flight stress

Despite Attempts to Improve Economy Class, some Stressors Cannot be Eliminated

Once in the air, your problems are about to begin. If you turn left on entering the aircraft, well and good; but if you turn right, be prepared for cramped seating conditions (noticed the shrinking leg-room, especially on low-cost carriers?). If you can stomach the low-quality food, this may not stay down too long if the plane hits into turbulence – this has been cited as the top cause of stress while flying.

Once settled down, your mind may be jarred by a seemingly endless stream of in-flight announcements, in multiple languages, informing that you are 35,000 ft in flight stress2the air (who really cares?). Add to this, the snoring passengers and crying babies and the soon-to-be-allowed mobile phone-calls and one can see why there’s so much stress.

Don’t forget polluted cabin air..a recent report in the London Telegraph confirms that the smell of jet-fuel in some cabins is far from imaginary.

toxic-cabin-air_

TCP,from jet-fuel present in cabin air, causes drowsiness,nausea and headaches

Lost-luggage

33 million pieces of luggage were misplaced in 2008

Once landed at your destination and after surviving the long queues at Immigration, you might have to face the heart-sinking sensation of lost luggage (God forbid!) and the monumental paperwork that comes with it. And you thought London Oxford Airport would be at least near London.. be prepared for a 60-mile journey to the city!

And..long after reaching your final destination, there’s still the perennial fight with jet-lag! Numerous antidotes have been promulgated – but that’s another story..

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Football – When the Violence Is At Home

Balotelli reacts after an apparent foul in the Italy vs Spain match at Euro 2012

With the Euro 2012 soccer finals in progress, its quite understandable when episodes of violence, real or simulated, occur on the field, or even nearby( as the riots after the Russia-Poland game showed). But when this extends into the home, then its a cause of public concern.

Research by BBC News has found there was a surge in domestic violence reports to police during the 2010 World Cup.Police in England noted that reports of domestic violence increased by some 29% during games when England played in the recent 2010 World Cup.  The police expect a similar increase in domestic violence during the current Euro finals and have placed themselves on alert, apart from publicising awareness in the media and working together with related agencies like Domestic Violence UK.

Chris Hancox, from White Ribbon UK, which campaigns against violence to women, said: “If someone’s football team loses, that’s no reason to take it out on anyone, particularly the person they’re supposed to love.”  But the reality is quite the opposite:  arguments about the amount of television watched, alcohol intake, jealousy due to people spending more time with friends and an increase in money spent could lead to an increase in tensions.

Many would agree that alcohol by itself does not cause domestic violence, but could be the catalyst, especially when there is disinhibition after excessive alcohol and deeper emotions begin to surface.

So what does the Football Association (FA) has to say about it? It said it could not comment on what was not a footballing matter. Is that really a fair statement?

Gonorrhoea..And Then There Was One.

There was a time not too long ago when  doctors could cure a patient with gonorrhoea (aka the clap) with their eyes shut. But then this was the pre-HIV days when this disease stood centre-stage among sexually-transmitted diseases.

The Gonorrhoea bug has become drug-resistant and developed into a superbug nowadays

With the attention diverted to HIV and AIDS, the disease was practically unheard of in the media. What really happened was that Neisseria gonorrhoeae (aka gonococcus), the bacteria causing this disease,  continued to proliferate quietly without the bells and whistles, not making the headlines because it was so easily treated with the wide array of modern antibiotics that were readily available. Up to now, that is.

In the 60s this may be true, but not nowadays when the effective drugs are down to one

 

The World Health Organization(WHO)  warned yesterday of a spreading resistance to drugs used to treat the sexually transmitted disease gonorrhoea.

Millions of people with the condition may be at risk of running out of treatment options unless urgent action is taken, the United Nations agency said.

Up till now, the germ had developed resistance to many antibiotics which had been used over time; so much so, the current mainstay is the use of cephalosporin group of antibiotics, in particular ceftriaxone.  But , there now emerges reports that even this antibiotic has proven useless. Left untreated, gonorrhoea causes infertility in men and women and may add considerable healthcare costs if left untreated.

WHO has called for greater vigilance on the correct use of antibiotics and more research into alternative treatments for so-called gonococcal infections, which is quite understandable, as research for new antibiotics have taken a back-seat in recent years. Meanwhile, for individuals, the best way of not contracting the disease is of course having a regular partner or abstinence, failing which condom usage has proven effective.

 

The Best and Worst Doctors of 2011,part 2

Took me some time to compile this list, so here goes:

The Best Doctors

1.Drs Beutler, Hoffman and Steinman

These three were the winners of the 2011 Nobel Prize in Medicine and the impact of their research will be felt for many years to come.

In essence, they discovered receptor proteins in the body that can spot bacteria and other microorganisms and then activate the body’s innate immunity to defend itself. These dendritic cells activate the T cells which then produce antibodies which attack the invading germs.

Their studies determine  how clinicians prevent and treat infection, inflammatory diseases, and cancer in the future. Strangely enough, one of them, Dr Steinman (right,above pic) himself died of cancer of the pancreas before he won the award. This disease was one of the potential beneficiaries of his research.

2. Dr Valentin Fuster

This Spanish cardiologist, who is the Head of Mount Sinai Heart Centre in New York, is the only person to be awarded the top research awards from all the four main cardiovascular organisations.

He is best known for his profound contribution towards the understanding and prevention of atherothrombosis and was the first to have highlighted the role of platelets in acute coronary syndromes. In other words, how heart attacks happen-see below.

Dr Mark Kris

Lung cancer specialist at one of the top cancer centres in the world, Memorial Sloan-Kettering in Houston,Texas, he was recognised for his  dedication and compassion in his professional work and volunteer efforts by being awarded the inaugural ASCO Humanitarian Award .

He has built homes for families in Hyde Park, New York,  gone to Costa Rica to build a basketball court and a church and made several trips to assist with earthquake relief in Haiti; and helped with relief efforts in Biloxi, Mississippi  after it was hit byHurricane Katrina.

Of course, to the unsung heroes out there,those who have toiled without bells and whistles, well done for being a credit to your profession!

 

The Best and Worst Doctors of 2011,part 1

Couldn’t help recalling that last year, quite a number of physicians made the headlines..so here’s my list of the Dr Jekylls and Dr Hydes of 2011.

The Worst Doctors

1. Conrad Murray,MD

Physician to the King of Pop.. in November he was sentenced to 4 years in jail for his conviction on a charge of involuntary manslaughter in the pop star’s death. There wasn’t much substance in his defence once he admitted to using propafol injected intravenously into Michael Jackson’s veins so as to enable him to sleep at home. What was worse was that this drug is normally used in a hospital setting with the patient hooked on close monitors; using it otherwise (at home) constitutes negligence and inappropriate use.

2. Gerald J Klein, MD

Gerald who? Well, he was one of 14 Florida doctors indicted in August 2011 for illegally distributing opioid analgesics such as oxycodone and sedatives like Xanax. Drug addicts and dealers would queue in their clinics to sell or receive drugs illegally under the pretext of valid medical reasons. Opioid analgesics were dispensed and prescribed on an assembly line basis,  paid for with cash and credit cards. Clinic employees hauled their money to the bank in large garbage bags. This way, each doctor netted USD 1 million yearly. “Drug dealers in white coats”, said the FBI.Read more here.

Dr Gerald Klein..described as a drug dealer in a white coat

3. John R McLean,MD and others

The Maryland cardiologist was convicted on 6 charges of healthcare fraud relating to insurance claims that he had filed for doing unnecessary coronary angiograms and angioplasties (invasive test and treatment of blocked heart arteries), as well as for ordering unnecessary tests and making false entries in patient medical records. In November, Dr. McLean was sentenced to 8 years in jail.

The buck does not stop here in Maryland – already two other cases are being heard (see here and here) of similar cases where cardiologists have done unnecessary procedures on otherwise well patients, in return for unethical financial rewards.

In the next blog entry, I will name the best doctors of 2011.

Fat Finger Syndrome: How an Electronics Company Avoided giving Away Free Laptops

When Currys, the British high-street electricals chain advertised that it was selling a brand-new netbook at a giveaway price of 10% of its retail price, it was inundated with customers quite naturally at what was ‘the bargain of the century’.

This Samsung Galaxy Netbook, retailing at GBP229, was offered at GBP22.

However it turned out that an incorrect price was put on Currys’ website by a member of staff who mistakenly missed off the last digit.

The retailer said that it was unable to sell the laptop for the amount shown online and has emailed or telephoned all the customers who tried to buy it to explain and apologise. At this point, many customers felt that they were within consumers’ rights to insist that the retailer honour its promise and deliver nonetheless.

But they did not reckon with the fine print in its terms and conditions on its website which made clear that if an item was priced due to human error, then the price does not hold.

And what was the human error? Currys blamed it on fat finger syndrome.

This condition has made headlines several times recently. Of note was the tokyo trader who, in 2006, mistakenly keyed in a transaction order which inadvertently cost him USD 18 million.(see here). In essence, this syndrome refers to the invocation of a unwanted secondary action due to (a) one’s finger being bigger than the envisioned touch zone, or (b) accidental inaccuracy in the fine motor movements of one’s extremities. In simple terms, accidentally pressing an unwanted key on a keyboard. Quite common nowadays with mobile phones being as small as it is!

The Original Fat Finger Syndrome case? A typographical omission of the word "not" in the sentence "Thou shalt not commit adultery." This printing of the Bible has become known as the Wicked Bible( from Wikipedia)

 

Steve Jobs – What the Death Certificate Showed

Tributes lie on the pavement outside Steve Jobs home in Palo Alto, California

 

According to the Santa Clara County Public Health Department in San Jose, California which issued the death certificate, the immediate cause of death of the Apple CEO was listed as respiratory arrest with the underlying cause “metastatic pancreas neuroendocrine tumor”.

This puts to rest the speculations that arose when Apple Inc announced his demise without specifying any details. Other facts which emerged, according to Bloomberg:

-he passed away at home, 3pm on October 5.

-no autopsy was performed.

- he was buried at a non-denominational cemetery in Santa Clara County on Oct. 7.

The conclusions that can be drawn from the death certificate implies that the neuroendocrine cancer of the pancreas (the rarer form of cancer of the pancreas) presumably spread to the rest of the body (stage 4) despite the liver transplant in 2009 to remove cancer cells in the liver. This is much in keeping with the seriousness and malignant nature of this type of cancer, where the survival rates are less than 4% after 5 years (less than 4% of sufferers live beyond 5 years).

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