Monthly Archives: April, 2009

When Mexico Sneezes, the Whole World Catches the Flu…

Economists will give a wry smile on seeing the above title, as its a well-known mantra that the shape of the US economy determines that of the whole world! Yet, the swine flu outbreak in Mexico seems to affect the world’s business scene just as well..

One of the first things that accompany news of dangerous flu viruses is an economic evaluation of the effects of a pandemic. In a recent article, Reuters pointed out in 2008 that the IMF said a flu pandemic could cost $3 trillion and cause a 5% drop in global GDP. In other words, it would almost certainly turn the current deep recession into a worldwide depression, says Newsweek.


Most people may not suffer from Swine Flu, but they may be impacted financially (ABCNews pic)

In Hong Kong, where the government machinery is well-versed in handling potential epidemics (after the SARS outbreak in 2003), there are 1,400 empty beds ready to take in isolation cases as and when necessary. Despite this, the Hang Seng Index fell 2.7% yesterday – worse hit being airline shares (Cathay Pacific dropped 8%, China Airlines 13%).

However, behind every dark cloud, there is a silver lining – rubber glove-makers are rubbing their gloved hands in glee. The makers of the only two antiviral drugs approved for the treatment of influenza viruses in general –Tamiflu (Roche) and Relenza (GlaxoSmithKline)-have seen their stocks climb on share markets.

Swine Flu – A Misnomer

For those who think that they cannot get Swine Flu as long as they do not come into close contact with pigs, recent research has shown that this is not true for at least two reasons:  the virus responsible ( Influenza A H1N1) has been shown to adapt and change readily with the common flu viruses, so that transmission is possible from human to human. This was not the case with the Avian Flu outbreak in 2003 which started in China as the virus responsible (H5N1) was not able to change as readily, so the outbreak among humans fizzled out. See the Bloomberg report here.


The Swine Flu Virus - just like Human Flu and Avian Flu, there are no specific antidotes

With the rapidness of air-travel and the fact that passengers are cooped up in an enclosed space for hours, its not surprising that the World Health Organisation (WHO) called the outbreak a “public health emergency of international concern” , with 81 Mexicans succumbing so far. Eleven cases in California, Kansas and Texas, all of them mild, have been connected as well, and at least eight students in New York are being tested for whether they match the Mexico strain, health officials said.

Here are some FAQs about Swine Flu (more details from the CDC website):


As there is no specific treatment for this potential epidemic, many countries have resorted to screening passengers who have just been to Mexico; but if this illness rapidly spreads across borders, we may very well see health screening procedures at major airports around the world (remember the SARS epidemic in 2003?).

Diseases of the Internet

When it comes to the most-searched  topic for Web queries,  there’s no doubt that sex tops the list; but, bearing in mind that health-related matters take up 2% of all queries on the search engines, its not surprising that there are a variety of internet-related ailments that can result out of this!

Internet addiction has been around for years. How do you know if you’re already addicted or rapidly tumbling toward trouble? Take this Internet Addiction Test here.


Cyberchondria - aggravated by Self-diagnosis Web-sites which have 90% of the diagnoses where patients die within one week!

Cyberchondria (aka internet self-diagnosis) is another condition first coined in 2000 and refers to  the practice of leaping to dire conclusions while researching health matters online. If that severe headache haunting you in the morning led you to the Web search-engine and convinced you that it is caused by a brain tumour, then the likely diagnosis is probably cyberchondria. People tend to look at the first few results in the search-engine and that froms the basis for them to probe further. For instance, a search on ‘headaches’ could lead to ‘brain tumours’ or ‘meningitis’. The phenomenon has become so pervasive that Microsoft did its own study on the causes of cyberchondria (see here).

My advice? While its good for people to know what’s going on in their body, make sure you look at reputable sites only and even then, look at them after your doctor has told you what you have (this will give you a reasonable launching pad to look at other likely possibilities- what doctors call differential diagnoses).

G-20 Man’s Death: 2nd Postmortem Raises More Questions

The earlier revelation that 47 year-old Ian Tomlinson had died of a heart attack at the G-20 meeting in London following assault by a policeman caused quite a ripple when this evidence surfaced in the form of a video taken by a New York fund manager who happened to be at the scene. I had commented then (April 8th) that it would not be surprising that a second postmortem would be ordered.


A Police paramedic attends to Ian Tomlison within minutes of him collapsing (photo courtesy of Daily Mirror,UK)

Well, the second postmortem was indeed performed at the behest of the IPCC and the family of the deceased and the results released yesterday(April 17th). The second postmortem was conducted by Dr Nat Cary, who was able to scrutinise video evidence before conducting his examination. In a statement last night, City of London coroners court said Dr Cary had provisionally concluded that internal bleeding (intra-abdominal hemorrhage) was the cause of Tomlinson’s death, not a heart attack.

This finding has raised several questions:

1. How did the first pathologist(Dr Freddy Patel) who conducted the initial postmortem come to the conclusion that it was a heart attack that killed the victim? It was discovered that Dr Patel had previously been reprimanded by the General Medical Council, the watchdog body for doctors in the UK, over 2 other cases. See here.

2.The second postmortem did not state so far the cause of the internal bleeding. The assault, as seen on the video, appears to be mainly from a baton hit on the victim’s left thigh and not on the torso.


A CT scan of the abdomen, showing a swollen aorta(in white) - an aortic aneurysm - a common cause of bleeding as it tends to leak eventually

Abdominal bleeding is usually due to bursting of the blood vessels of any of the organs within the abdomen, such as the liver, spleen, intestines or even the aorta (the largest artery in the body). The commonest cause for these blood vessels to burst is any kind of trauma, such as road accident injuries, severe falls or assault. It would be fair to say that massive abdominal bleeding arising out of a simple fall is very unusual.

We await further developments in this case. Meanwhile,the Metropolitan police officer suspected of the assault has  been suspended from duty has now been interviewed under caution on suspicion of manslaughter.

See my earlier posting “G-20 Man’s Death Diagnosis Disputed”

Losing Weight – Its Not How Much You Eat, Its What You Eat

If the results of a new research study are to be taken seriously, it really doesn’t matter what kind of diet you’re on, the results are eventually going to be the same in terms of weight loss.


Whether its a Fillet-O'-Fish (400 cal)..


..or a Starbucks slice of cake(390 cal)..


..or Oriental Chicken-Rice (400 cal), Its the Calories That Count!

Whether you’re dreaming to be a Beyonce look-alike willing to die to diet and look like her, or you’re on a strict doctor’s demand to recover from a coronary, there’s never been so many diets out there than ever before.  Among the more popular ones are:

Atkins: High protein, low carbohydrate
WeightWatchers: A points system to count calories
Rosemary Conley: Low fat, low sugar
Slim Fast: Low-fat shakes replacing b’fast and lunch.
In an earlier posting “Popular Diets a Health Threat – or Not?”, I had pointed out that whichever one you choose, the above diets were effective and “carried no health threats”, according to the Nutrition Journal.
In this new study from the American College of Cardiology (see here), overweight adults were put for 2 years on 4 different diets: 1) low-fat, average-protein ; 2) low-fat, high-protein; 3) high-fat, average-protein ; and 4) high-fat, high-protein. Similar foods were used in all diets.
The result? Whichever diet they were put on, they all lost the same weight (an average of 3.6kg), mostly in the first 6 months. What’s more, the diets were well-tolerated and had similar satisfaction.
The take-home message – among overweight patients, a reduced calorie diet was principally important for long-term weight loss and not the proportion of fat, protein, and carbohydrates in the diet. So, keep counting the calories!
Check the calorie counts of some popular fast-foods here and here.
Into Malaysian foods? Click here.

G-20 Man’s Death Diagnosis Disputed

In a scenario rather duplicated in recent times, a man’s death was initially attributed by authorities to be due to ‘natural causes’ but the appearance of a video clip has raised an uproar as to the actual cause.

Ian Tomlinson, a 47 year-old newspaper vendor, collapsed on Wednesday evening as scores of protesters  gathered near the Bank of England in the City of London. Despite receiving treatment at the scene, medics were unable to save him and Mr Tomlinson was pronounced dead later that day in hospital.
The City of London Police said: “A post-mortem examination found he died of natural causes.(He) suffered a sudden heart attack while on his way home from work.” See here for details.

But the appearance of a video taken by a New York visitor who was at the scene and made available to the Guardian has revealed a different story. See the video here.


Video still shows the victim walking with hands in pocket(left) before being hit on the left thigh by a truncheon(middle) and subsequently being pushed forward(right)-photos from the 'Guardian'

According to eyewitnesses, the victim bounced heavily on the ground twice following the assault, remonstrated with the police while on the ground, staggered up and walked away in a stumbling manner and with glazed eyes. He subsequently collapsed 3 minutes later and resuscitation efforts commenced by a police medical team.

The matter is now being investigated by the IPCC, the Independent Police Complaints Commission( This is an independent body comprising of 12 commissioners (who have never served in the police force) which conducts  investigations when any allegation against the police is of such significance and probable public concern that the investigations need independent oversight. The Commission also handles appeals by the public about the way their complaint was dealt with by the local force.The whole idea of all this is to increase public confidence in the complaint systems and  to make investigations more open, timely, proportionate and fair.

Meanwhile, I will not be surprised if the IPCC request for a second post-mortem –  has the possibility of a epidural haemorrhage due to head trauma been excluded? (see my earlier post What Killed Natasha Richardson-Lessons To Be Learnt”)

Fitness Formula For Formula-1


Glamour may be omnipresent..but its hard work for the drivers (captured at Ferrari pitstop at the Malaysian Grand Prix)

Formula-1 racing drivers are arguably fitter than Premiership footballers – this is an opinion shared by fitness experts. While a life of adrenaline, jet-setting, sky-high monetary rewards and ardent admirers seem to be the order of the day, the health demands of the modern-day F1 driver is nothing short of miraculous.


At the Malaysian Grand Prix - a driver's fitness also depends on impeccable teamwork

Consider the following:

  1. Their ‘mobile offices’ can carry them from a standstill speed to more than 3oo km/hour in a matter of seconds, subjecting them to gravitational pressures of more than 5 G’s. This means a driver’s head, usually 6 kg, will weigh like 30 kg round a fast corner.
  2. Many F1 drivers experience heart-rates of 200/min during the race  (resting heart-rate is around 70-80 for most people and gym treadmill users usually reach 160).
  3. With temperatures hitting 50 degrees C inside their fireproofed suits, the drivers can sweat around two litres during a race. That’s the equivalent of 4 bottles of mineral water.So much so, the guidelines for drivers dictate a litre of fluid before the race, two litres while driving and two litres afterwards.

In order to meet these excessive demands, all F1 drivers undergo stringent exercise regimes which may take hours daily, every day. Louis Hamilton has his workouts at the Mclaren headquarters using special contraptions. See here. Most drivers now follow a weights programme of high repetitions with low weights to build, long, lean muscles, with emphasis on the back, shoulders, neck and arms.


Hamilton smiles as a reporter is put through his paces at the McLaren Mercedes HQ at Woking, Surrey(courtesy of the Telegraph)

Apart from muscle tone, visual fitness is necessary too – and there’s more to it than hand-eye coordination. You need to hone your visual reaction time, your ability to recognize objects, and your ability to judge distance as decisions have to be made fast at 300 km/hr!

Last but not least..Formula One drivers need to control their diets by carefully regulating the amount of carbohydrate and protein that they absorb. During the race weekends, they eat pasta or other carbohydrate-rich foods to provide energy and to give them enough stamina for the race, but that of course does not mean that fettucines and fusillis are the norm always.

The physical and mental demands of these drivers are on a plane much higher than most other athletes – they have too in order to fly high too!

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