Monthly Archives: March, 2009

Don’t Let The Sun Catch You Crying..

Many baby-boomers will remember Gerry & the Pacemaker’s 1964 hit which many, including myself, consider to be one of the finest songs ever written by him ( Liverpool football fans will disagree, I’m sure, in favour of “You’ll Never Walk Alone”). Have a listen here:


Sunburn - the pain that can get you crying after

This tune came to mind when a reader wrote in to say that, now that summer’s round the corner(she’s from Denmark), would I mind elaborating on do’s and don’ts in exposing the body to the sun.

The first condition that comes to mind is of course, sunburn as a result of suntanning. Sunworshippers would know that their first defence would be the simple things like sun umbrellas, sunhats and sunglasses. The second defence would be using suntan lotions, where the higher the SPF (sun protection factor), the greater the protection. They do have the disadvantage however that they do tend to wash off after swimming or sweating. Alternatively, zinc oxide which comes in day-glo colours nowadays can be applied to  sensitive areas like the forehead,nose and cheeks. Don’t be misled by a cloudy sky as ultraviolet radiation is the real culprit in causing sunburn of the skin which appears painfully a few hours later as redness, tenderness and blistering.

A lesser-known but more troublesome condition is a skin disease that causes redness and rashes over those parts of the skin exposed to sunlight (or even indoor spotlights) called actinic dermatitis, otherwise known as photosensitive dermatitis. This does not lead to cancer of the skin, unlike a related condition called actinic keratosis, which may lead to skin cancer.

And does Bill Clinton have a permanent sunburn? Afraid not, he has been documented to have rosacea, but that’s another story..

Striking Away Stroke

Some readers of this blog asked what they can do to prevent  a stroke from hitting them. Plenty! A very recent research study just released  stroke_prevention2in the British Medical Journal by 4 authors, one of whom is a Malaysian classmate who now works in the UK, reveals 4 things that people can do to reduce the chances of getting a stroke by half.

The study, conducted in England involving 20,000 people over 11 years, showed that they could reduce the chances of getting stroke by 50% if they did all the following life-style measures:

  • not smoking
  • being physically active
  • limiting their alcohol intake to not more than 14 units a week
  • fruit and vegetable intake of at least five servings a day.

Apart from the above, it is well-known that the presence of the following risk-factors also predispose to stroke: high blood pressure, diabetes, high cholesterol, atrial fibrillation (irregular heart-beats), heart disease and certain blood diseases which cause clotting.

One does need to realise, however, that some risk-factors cannot be changed or eliminated. Try changing your age (the chance of having a stroke approximately doubles for each decade of life after age 55), sex (more common in men), your relatives( your stroke risk is greater if a parent, grandparent, sister or brother has had a stroke) or the fact that you have had a previous stroke or transient ischemic attack (TIA, or warning strokes)!

The whole idea of getting away from stroke is to eliminate as many of the above risk-factors as possible and to lead a healthy lifestyle.

See my related article “Mending A Stroke In Time”.

The Fat Duck’s Food Furore


The Fat Duck in Bray, Berkshire, England.

Foodie fanatics have made a bee-line to its unpretentious premises ever since it made headlines in 2005 as the best restaurant in the world by Restaurant magazine.To get a table at the 40-seat restaurant, you need to make reservations months in advance and you also need a fat wallet to take in the 17-course sampler menu which comes at around 130 pounds(USD 190).

The Fat Duck is a 3-star Michelin restaurant, about an hour’s train ride out of London,  run by chef Heston Blumenthal who specialises in molecular gastronomy (applying science to the art of cooking).


MANGO AND DOUGLAS FIR PUREE, Bavarois of lychee and mango, blackcurrent sorbet. Molecular cooking at its best.

In February, the award-winning restaurant made the wrong kind of headlines when it was forced to close on February 24 after a total of over 400 diners were struck by diarrhoea and vomiting. Customers cried foul and the health authorities called in to investigate what was thought to be food-poisoning. However, all tests for causes of food-poisoning yielded negative results.

The Health Protection Agency , according to the Telegraph 20 March 2009 has now narrowed down the culprit to norovirus infection, commonly called stomach flu or viral gastroenteritis. 6 members of the staff were found to have been infected and presumably passed on the infection to customers. Find out more about this infection here.

Which goes to show- such viruses are no respecter of status or style. But viruses being viruses,the infection is self-limiting and diners are flocking back since the restaurant re-opened March 13.

What Killed Natasha Richardson – Lessons To Be Learnt


Natasha Richardson - would have been alive today...see text

Actress Natasha Richardson had an innocuous fall while practising skiing on the beginner’s slope. She was reported to have not lost consciousness and was able to laugh off the whole incident soon after. An ambulance that was summoned to the scene was turned back when she appeared to have fully recovered.

But this soon changed an hour later when she developed headaches and appeared disorientated. Within 1 day, she was dead. What was the cause?

Doctors following this case were not surprised at the autopsy results – epidural hematoma, caused by a blunt injury. Epidural hematoma is a type of brain injury caused by trauma where damaged blood vessels within the skull lead to a blood build-up between the outer layer of the brain and the skull. If not identified and treated immediately, this injury can often lead to death because, as blood pools within the rigid skull, the brain is usually forced out through an opening at the base of the skull (coning) causing irreparable damage and brain death.


Types of Blood-Clots in the Brain - EPIDURAL HEMATOMA are clots just underneath the skull but outside the brain covering

A feature of this kind of damage is the phenomenon called ‘lucid interval’- where the injured party acts and appears fine for an hour or so while internally, at the same time, their brain swells or bleeds. This is why people with head injuries are supposed to be monitored for the first 24 hours after an accident. Richardson may have had a better chance had she had taken the ambulance when it arrived and received timely help. In her case, she was not hospitalised till the next day.

There are lessons to be learnt here:

1. Helmets can help prevent this kind of injury (she wasn’t wearing one). This is the same reason why helmets must be worn at construction sites or on the highways.

2.After any head injury, watch out for severe headaches, confusion, erratic behaviour,paralysis or fits that may only appear an hour after; even if initially everything had looked ok.

3.In suspected cases, an urgent CT scan of the brain needs to be done. If epidural hematoma is confirmed, immediate craniotomy by a brain surgeon is often life-saving.

4.Most important of all, in head injuries, there is no substitute for  immediate professional opinion and management. There are only limited things that can be picked up from the internet or first-aid books. Besides, this is a medical emergency and time lost is a life lost.

On Ballooning Healthcare Costs..


Wahyu steak - try getting the fat out of this one!

“It’s not like the fat sits out here easily identified and you just slice it off. It’s marbled throughout the meat.”

Jon M. Kingsdale, executive director of the agency that administers the universal healthcare service in Massachusetts, when asked to identify and reduce costs so that the healthcare budget will fall in line.

My comment: For those preaching universal healthcare (free healthcare for everybody), there’s no such thing as a free lunch. Someone’s got to pay for it, be it the individual or the state. You can try to reduce costs, but that’s easier said than done. Great quote!

Clinton’s Confusion on Conjugation

If you’re confused about the hoo-hah concerning President Obama’s decision last week to lift the ban on federal funding for stem cell research using human embryos, you’re not alone. Even Bill Clinton is confused too..when he mentioned several times in a CNN interview on March 11 that it was ok to research embryos if they’re not fertilized.

It does appear that he does require more lessons on sexual biology and reproduction    –  if you recall, he did try to convince the world several years ago that fellatio was not a form of sex!

By definition, embryos are the result of an egg from the ovary being fertilised by a sperm. Most kids can tell you that. But not many will be able to say what stem cells are. Simply put, stem cells are primitive cells capable of multiplying & morphing to eventually form any organ in the human body. Hence the growing interest in medical research, because  a damaged kidney could be replaced by growing a new one.

There are two sources for stem-cells: adult stem-cells (derived from adult cells like the bone-marrow) and embryonic stem-cells (derived from embryos). The latter is preferred as the yield of stem-cells is much higher but it means embryos need to be destroyed. In other words, the beginnings of a human life is terminated just to produce stem-cells. Which is the main reason why former President Bush did not allow any research funding to be given for this source of stem-cells, on moral and ethical grounds. More of the stem-cell controversy here.

Footnote: the interviewer in the CNN programme above is none other than Dr Sanjay Gupta, CNN’s chief medical correspondent who was also Obama’s first choice as Surgeon-General before he opted out. Just as well, because he did not correct Clinton’s mistake during the show, despite being a medical doctor himself..

Across Meeting Rooms Worldwide…

cartoonProbably the most-repeated statement in recent times 🙂

Obama’s Healthcare Lessons To The World

When you’re the newly-installed leader of the most powerful nation in the world and you inherit two of the biggest issues facing the country and the world, there are many ways to skin the cat. The woeful state of the economy aside, healthcare  is the next main concern for Americans.

Roughly 45·7 million Americans—15% of the country’s population—lack health insurance. Both wealthy and poorer states have almost a quarter of residents between the ages of 18 years and 64 years uninsured. The US Congressional Budget Office predicts that, nationwide, the number of uninsured people will rise by 10 million in the next decade. And this in a country where health-care expenditure alone is estimated to exceed US$2·5 trillion this year (17% of the GDP).

How did this situation arise? Well, largely because there has never been a national policy of healthcare; healthcare services were private-sector driven and subjected to market forces. Only the elderly (Medicare), the poor (Medicaid) and the military (Veterans Health Admin) were provided with some sort of cover, and this too was limited. Not that there were no attempts by previous Presidents to redress the issue. The Clinton (Hilary, not Bill) healthcare plan was mooted in 1993 to provide universal healthcare for all Americans but fell by the wayside – largely because it was formulated behind closed doors and eventually  attacked by its own party members.


The White House Forum on Health Reform, March 5, brought together 150 participants representing healthcare stakeholders

Enter President Obama.  Realising Clinton’s mistake of not getting public consensus first before planning, one of his first tasks was to call for a obamahealthplan1White House Forum on Health Reform summit in the East Room which was held on 5th March 2009 and attended by  150 representatives, including legislators from both parties and representatives of interest groups such as drug companies, health professionals and labour unions.

Lesson No 2 – engage the people across the country. Via the internet,  9000 community discussions were held throughout the country from December 2008  and 3,000 reports filed in to the forum.

Even at the Summit, it was clear that the President wasn’t going to get his way as exemplified by his campaign promises on healthcare reform (covered by my posting here “Obama vs McCain on Healthcare”). But there was room for compromise and consensus..lesson no 3.

Although the path is long and expensive and the solutions far from apparent, the President concluded that there was “a clear consensus” over the need for reform, promising a “transparent and inclusive” process.

Initiating a national healthcare  financing plan is an arduous challenge for any country in the world, but the lessons from Obama so far show a practicable and feasible way of tackling the problem, no matter how enormous it is.  Perhaps, other countries (like Malaysia, where they have been vacillating a national insurance plan for decades) can benefit from these lessons on the way to go forward.

Babies Made To Order – Take Your Pick


Boy or girl? Blue eyes or black? Blonde or brunette? In less than 2 years, would-be parents will be offered the chance  to select traits like the sex, eye and hair colour of their offspring.  A US Clinic, pioneer of IVF (in vitrio fertilisation) in the 70’s, is now offering this service based on a procedure called pre-implantation genetic diagnosis, or PGD.

PGD is a technique whereby a three-day-old embryo, consisting of about six cells, is tested in a lab to see if it carries a particular genetic disease. Embryos free of that disease are implanted in the mother’s womb. Introduced in the 1990s, it has allowed thousands of parents to avoid passing on deadly disorders to their children. However, this method has now been extended to select those genes which will result in a desired trait, like color of eyes.


Design your own baby (image courtesy of Getty Images)

Its not all glamour and bells & whistles. Coming soon after the birth of octuplets (eight,yes eight) in a single pregnancy by a Los Angeles mother in January this year after an unrelated fertility treatment (see here), this technology too has attracted its share of critics.  BBC News reports UK fertility experts are angered that the service will distract attention from how the same technology can protect against inherited disease. Moral, ethical and legal issues will arise when babies are turned into commodities that you can buy off the shelf. Also, in the UK, sex selection is banned under present laws.

As a reflection of changing times and rapid medical advances, the UK will soon introduce legislation that will allow IVF mothers to name anyone as “father” on the birth certificate – even another woman. Confusing? Welcome to the world of designer babies..

Also see “No Girls Please, We’re Indian”

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