Monthly Archives: February, 2009

New On the Horizon – Medical Spas

It had to come soon enough – what with the emphasis on cosmetic surgery and medical tourism in recent times. Medical spas have sprouted in the last 5 years. In the US alone, the numbers have grown from  500 in 2004 to 2,500 today.


Medical spas have sprouted in recent years, not only in the USA...


...but also in Thailand and other countries

According to the International Medical Spa Association, a medical spa is a facility that operates under the full-time, on-site supervision of a licensed health care professional. The facility operates within the scope of practice of its staff, and offers traditional, complementary, and alternative health practices and treatments in a spa-like setting. Practitioners working within a medical spa will be governed by their appropriate licensing board, if licensure is required. In short, a medical spa is a hybrid between a medical clinic and a day spa that operates under the supervision of medical doctor.

Medical spas can treat facial conditions like brown spots, redness, broken capillaries that cannot be treated at all or as effectively by a traditional beautician. Most specialize in laser hair removal,  Botox treatment and fillers and are usually run by cosmetic surgeons as an extension of their business. This is in addition to massage services for de-stressing, although the clinical atmosphere of most medical spas may make one somewhat tense!


Removal of facial furrows..


..with Botox therapy

Specialised services include laser treatments ( laser  medical devices used to remove unwanted hair, uneven pigmentation, and broken capillaries), microdermabrasion (removing the uppermost layer of dead skin cells from the face, chest and hands, usually with high-tech anti-aging skin products) and Botox.

The popularity of these spas and their subsequent proliferation has brought its share of problems too. Thousands of consumers may be put at risk by unlicensed and untrained providers. These account for a large proportion of treatment failures and blotches that one reads in the media.

The take-home message here is:  make sure the doctor is trained to do the procedure and that he is on-site!

Movies, Medicine and Medical Men

This being the week of the 81st Annual Academy Awards, my thoughts shifted to movies which featured medical persona. Here’s some which crossed my mind:

movies_dr_no Dr No (1962) – Sean Connery’s first film as James Bond.

Dr. No:        That’s a Dom Perignon ’55, it would be a pity to break it !
James Bond: I prefer the ’53 myself…


The Hospital(1971) – featuring the late George C Scott as Dr Herbert Bock, a hospital doctor with suicidal thoughts.

Bock: We’ve established the most enormous medical entity ever conceived… and people are sicker than ever. We    cure nothing! We heal nothing!

movies_dr_zhivago Dr Zhivago (1965) – Omar Sharif plays opposite Julie Christie as Dr Yuri Zhivago, a Russian doctor/poet who, although married, falls for a political activist’s wife and experiences hardships during the Bolshevik Revolution. The film was a winner of 5 Academy Awards.

Zhivago: You lay life on a table and cut out all the tumors of injustice. Marvelous.

movies_young_frankenstein Young Frankenstein (1974) – A comedy directed by Mel Brooks featuring Gene Wilder as Dr Frankenstein, grandson of the original Dr F, who inherits granddad’s castle and repeats the experiments that made it the scariest comedy of all time.

Medical Student: Doesn’t the bringing back to life what was once dead hold any intrigue to you?
Frankenstein: You are talking about the nonsensical ravings of a lunatic mind! Dead is dead!
Medical Student: But look at what has been done with hearts and kidneys…
Frankenstein: Hearts and kidneys are tinker toys! I am talking about the central nervous system!

movies_patch-adams Patch Adams (1998) – Robin Williams has the title role, that of  a doctor who doesn’t look, act or think like other doctors. For Patch, humor is the best medicine, and he’s willing to do just about anything to make his patients laugh– even if it means risking his own career. Based on a true story.

Patch: “If you actually are a doctor and admitted it, you’d say, ‘I don’t cure a huge percentage, I don’t have a 50 percent cure rate … (but) I can have a 100 percent compassion rate..”

movies_critical_care Critical Care (1997) – Not much of a box-office hit but built its reputation on the realities of modern healthcare.

Tag-line: At Memorial Hospital no one ever dies… Until their insurance runs out. Dr Werner Ernst is a young hospital resident who becomes embroiled in a legal battle between two half-sisters..

Dr Butz:If he’s going to die, why should we proceed?

Dr Ernst:–Where have you been all your life? It’s called revenue.

Mending A Stroke In Time

Most people do not know the five warning signs of a stroke and what to do if they suspect one. This was the research finding from a presentation at an International Stroke Conference in San Diego,California today. This aside, from my personal interactions with members of the public, quite a few did not also know that a stroke has nothing to do with the heart.

Briefly, a stroke is either due to bursting or blockage of one of the blood vessels in the brain, causing possible permanent injury to the part of the brain that is affected.


2 Kinds Of Stroke: Here, due to a burst blood vessel..


..and here, due to a blood-clot causing a blockage.

What are the warning signs?

The research study confirmed what many doctors know : most people do not know the 5 warning signs that herald an impending stroke. If only they did; because if treatment is given early in hospital, quite a bit of the permanent complications could be minimised, if not avoided.


Advice from the American Stroke Association: when these signs occur, get to hospital quick

Why the Urgency To Get To Hospital?

Because stroke is a medical emergency. If given through the veins within three hours of the start of symptoms, a clot-busting drug called tissue plasminogen activator (tPA) can reduce long-term disability for the most common type of stroke, by dissolving the clot that caused the blockage.  In some cases, the stroke may be completely cured. Read more here.

In areas where ambulance service is poor, it makes sense to get to the hospital as soon as you can…because time lost is brain lost.

See also my latest article “Striking Away Stroke”

Going Bananas..over Bananas

Sports fans would have noticed that almost every world-class athlete would resort to that wonderful tropical fruit in between games or during rest periods. This is most apparent in tennis,when the cameras detect every move the players make during the rest periods.

Federer at rest - spot the banana?

Federer at rest - spot the banana?

Sharapova's at it too

Sharapova's at it too

Nadal - Its Good For You

Nadal - Its Good For You

So what’s this big thing about bananas? For athletes…a lot. It is a rich source for potassium which is abundantly lost by the body during sweating; lack of which causes cramps and weakness.

It also contains 3 readily digestible sugars (sucrose,fructose and glucose) which can easily be digested to generate energy almost immediately. Even for non-athletes, bananas provide several other advantages:

  1. Reducing Depression: bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier.
  2. Anemia: High in iron, bananas can stimulate the production of hemoglobin in the blood to improve anemia.
  3. Blood Pressure: extremely high in potassium yet low in salt. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit’s ability to reduce the risk of blood pressure and stroke.
  4. Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives.
  5. Nerves: Bananas are high in B vitamins (esp B6,B12) that help calm the nervous system.

For the technically-minded, take a look at what’s in it:


For Those Studying Medicine…(7)

With the plethora of diagnostic devices and computer-generated devices, its not surprising that some doctors can arrive at a diagnosis examining-a-patientwithout  coming into physical contact with a patient, other than by entering the room with a cursory greeting and a customary “how are you?”.

Physical contact  includes  simple things like hand-to-hand contact and actual physical examination of the patient. True, there are limitations as to what can be achieved by using your five senses, what with high-fangled scans and sophisticated devices being able to get to the root of the problem with hardly any sweat being raised.

My contention is that the physical examination is an important ritual in establishing a good patient-doctor relationship. This ritual sets the stage by which the person being examined transforms his role to that of a patient and also, places his trust in the hands of the doctor examining him.

And just in case you think rituals are not important, we might as well have not had the Presidential swearing-in ceremony for heads of state!

Milk, It Eats..oops, Drinks Both Ways,Too

The last posting highlighted that the US has its hands full with the peanut scandal (see here), just as China was mired in the melamine milk melamine-milk-bottle1mishap  last year.  Now it looks like its payback time as China appears to be on the offensive to state that it wasn’t the only culprit in the melamine issue.

The Shanghai Municipal Bureau of Quality and Technical Supervision said today it was investigating whether Dumex, the powdered-milk unit of France’s Danone Group, had produced milk powder contaminated with melamine. A lot is at stake as Dumex ( Chinese Web site: ) sells the most baby milk powder on China’s market in 2005 and 2006 in terms of sales volume and revenue.

Added to the mystery is that the Shanghai health authorities, as reported by China View here, specified that it was only interested in Dumex milk powder produced before Sep 14 2008.

Dumex did not waste any time in denying these allegations. Its Malaysian website today stated that “the current situation in China has been incorrectly reported and our colleagues there have confirmed that Dumex products manufactured in China have been tested thoroughly by certified official laboratories and were found to contain no melamine.”

It certainly will be interesting to see the outcome of the Shanghai investigations..this will dispel any lingering doubt that the melamine milk scandal is a problem not of China alone.

Update (14/02/09) : Chinese authorities have cleared Danone-Dumex of any industrial chemical contamination of their milk products. See here.

Nuts, It Eats Both Ways

While the melamine milk scandal hit China’s credibility as a safe food producer in recent months, now the US has its own equivalent to contend with. An outbreak of food poisoning caused by contaminated peanuts has affected 43 states with at least 8 deaths reported. The fact that food safety issues can still be an issue in one of the world’s most developed countries highlights the fact that food safety is really a global issue.


The Source of the Salmonella outbreak in Georgia, which has since closed down and caused the nationwide recall of more than 1,000 food products

While this outbreak first had its origins in 1997, traced to the same company in Georgia, Peanut Corporation of America, the present outbreak has produced a lethal outcome. FDA has discovered that the company had continued to distribute its products despite having failed positive tests for contamination by Salmonella typhimurium.


Salmonella typhimurium - from the same family that causes typhoid

What is Salmonella? This fishy-sounding bacteria is a well-known cause of food-poisoning and is spread by the fecal-oral route, which is a polite way of saying that infection-laden stool from one person finds its way into the mouth of another person.Antibiotics are available to effect cure, but people can die despite this if treatment is late or there is drug resistance or when there is decreased resistance in the patient, such as in the elderly.

And what’s the result of the outbreak? Wary consumers are shunning all brands of peanut butter, even those not caught up in the massive recall, driving sales down by nearly 25 percent, The New York Times reported Saturday. Even more significant, it shows that where food safety standards are concerned, even the most developed country can fall prey to breaches in safety if there is no proper enforcement. The repercussions are global in today’s world, and countries as far away as Malaysia can be affected. See here.

For a complete list of products recalled by the FDA, go here.

For a video on Do’s and Don’ts During the Outbreak, go here.

Dubai’s Depressive Disease

When I wrote recently, ” London is Unwell – What’s the Prognosis?”, little did I realise how far the disease called RECESSION had begun to affect other parts of the world. The fall of the Icelandic government to bankruptcy is an example.

Another patient just about to be afflicted with the recessionary disease is Dubai, that jewel in the United Arab Emirates, where there has been a dizzying economic boom in the last 7 years or so. A blogger colleague, Fidel, on a recent visit, had written how impressed she was with the massive skyscrapers, huge megamalls and innovative hotels, having not visited this city for the last 9 years.


Dubai's main highway, Sheikh Zayed Road, in 1991


The same view, 2005 (pics courtesy of BBC News)

Personally, we had visited and held discussions with officials of the Dubai Healthcare City project some 6 years ago and was impressed with their visionary ideas but, even then, we held reservations on its sustainability. There’s a limit to what money can buy; and to expect world-class surgeons to uproot themselves from the mainstream centres of medicine worldwide was asking a bit too much, we thought.

Today, Dubai is not spared the ill-effects of recession. Out of the 4.5 million people in Dubai, expats make up 3.6 million or 80% of the population. According to the Times of London,


Abandoned Cars at Dubai Airport - a sign of the times

8% population decline is predicted this year, as expatriates leave

1,500 visas is cancelled every day in Dubai

62% of homes are occupied by expatriates & 60% fall in property values is predicted

50% slump in the price of luxury apartments on Palm Jumeirah

25% reduction in luxury spending among UAE expatriates.

Now, faced with crippling debts as a result of their high living and Dubai’s fading fortunes, many expatriates are abandoning their cars at the airport and fleeing home rather than risk jail for defaulting on loans. Police have found more than 3,000 abandoned cars in recent months that include BMWs, Mercedes and Porsches.

Will the shifting sands of fortune cure Dubai? It remains to be seen..


1. Skyscrapers and the Curse of Recession: One useful indicator of when countries will slip into recession or economic downturn is the completion dates of major skyscrapers. The Empire State Building (1931-the Great Depression), London’s Canary Wharf Tower (1991-UK recession), Malaysia’s Petronas Twin Towers (1998- Asian Economic crisis) and now Dubai’s Burj Dubai in 2009.

2. The Queen of England Cancels state visit to Dubai: The Times reported on Feb 7 2009 that the proposed State visit next month to the Middle East has been cancelled, in a move which shocked observers as such trips are planned up to a year in advance. It is the first time in recent memory that a state visit has been cancelled for reasons other than war or terrorism.

Obama’s Fitness To Rule

No, I’m not going to debate on whether he should be in the White House. Its really about President Barack Obama’s  health routine, which is something most Americans would do well to emulate. Those who saw pics of Obama bathing on the Hawaiian beaches last summer will note his lean but muscular physique. Take a look:obama-fitness

So, at 47, how does he keep in shape? Well, by design certainly rather than by accident. Despite his busy schedule as President,  he wakes up 6.45 in the morning and does his workouts daily, both cardio and weights. After dressing up, he reads several newspapers and has breakfast with his family before sending off his two daughters to school. Then its a 30 sec walk downstairs to the Oval Office just before 9 am.

Buts its not all sedentary behind-the-desk work, as he has been known to roam the corridors. According to the International Herald Tribune, Obama tends to roam the halls; one day, he turned up in the office of his press secretary, Robert Gibbs, who had his feet up on the desk when the boss walked in. “Wow, Gibbs,” the press secretary recalls the president saying, “Just got here and you already have your feet up.”honesttea_pomegranetwhite2

For Obama, lunch generally means a cheeseburger, chicken or fish in his small dining room off the Oval Office. There is a new addition to White House cuisine: the refrigerators are stocked with the president’s favorite organic brew, Honest Tea, in Obama’s preferred flavors of Black Forest Berry and Green Dragon.

In the evening,he eats dinner with the family and often returns to work reading briefing papers for the next day, often up to 10pm (unhealthy?). An indication of what he likes to eat is seen by the appointment of his former chef in Chicago, Sam Kass, an advocate of healthy, environment-friendly foods, as a new chef in the White House.

Considering the problem of obesity and today’s preponderance of lifestyle diseases like diabetes,hypertension and heart disease, many would do well to emulate his leadership by example, as far as a healthy lifestyle is concerned. And that includes most of today’s leaders too.

London is Unwell – What’s the Prognosis?

Passing through London, the unhealthy effects of the recession is apparent. For those who have visited the English capital over the years, the metamorphosis it’s undergoing at the moment, no thanks to the economic crisis, is rather dramatic, considering its relative resistance to change.

Consider the following:

  • Britain is in its worse-ever recession in modern history.
  • There are close to 2 million unemployed today.
  • Bank interest-rates are at its lowest ever in 300 years, at 1.5%, and expected to hit near-zero soon.
  • House prices have dropped 15% over the last year.
  • The pound (the ‘sterling’ currency) has weakened to almost parity with the Euro.

Richard Branson sold Virgin Megastores in 2007 to new owners Zavvi who are now about to close down (picture taken in Oxford Street,30th Jan)

So if you walk through the streets of London (listen to the original Ralph McTell hit here), one can see how the economic situation has affected London. Gone are the trademark stores like Woolworth’s, Virgin Record Stores, Sharper Image, Barratt’s shoes and Whittard’s tea stores. Closing down sales are widespread and more stores are expected to fold up real soon. This does not mean the streets are empty..on the contrary, hordes of Europeans have descended into London, taking advantage of the weak pound.


Even London's newest shopping mall,Westfields at Shepherd's Bush is feeling the pinch, with most shops offering drastic discounts

The prognosis doesn’t look too good presently, with possible complications imminent. The indomitable British spirit looks unlikely to resuscitate the ill economy..or will it?

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