Monthly Archives: September, 2009

Vaccines: Damn If You Do, Damn If You Don’t

They say in the USA, 3000 people have a heart attack every day, so if it happened to you soon after receiving the swine flu vaccine, would you blame in on the vaccination  and not on the smoking, fried foods, lack of exercise, high blood pressure and the like?

A similar dilemma faced the NHS Trust in the UK a few days ago when a 14 year-old girl died soon after receiving a cervical cancer vaccine, as part of the ongoing national cervical cancer immunisation programme which has seen 1.4 million schoolgirls so far  already been given this vaccine. The NHS Trust denies that the death was due to the vaccine  and pins it down to a “serious underlying medical condition”, says the BBC. (Update 5th Oct 2009: It has since been confirmed that the cause of death was a large tumor in the chest involving the lungs and heart, according to the coroner. See here )

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Side-effects of Cervarix reported so far in UK

There’s no denying any vaccine, for that matter, any medication, will carry some form of side-effect. In fact, the cervical cancer vaccine (Cervarix) is widely recognised to carry quite a few, albeit minor.(see diagram).

While these side-effects are minor, it just needs a major catastrophe to cause parents to react in alarm. A possible cause of death in this young girl  could be anaphylaxis ( a form of severe allergic reaction which is sometimes fatal if no immediate treatment is given), which can happen to anybody given practically any drug, although the incidence is quite rare.

Back to swine flu. Many countries, including the US, are embarking on a mass flu vaccination programme in a few weeks. In the US, health authorities hope to vaccinate well over half the population in just a few months against swine flu, which doctors call the 2009 H1N1 strain. That’s 150 million shots. So can you imagine the probable number of untoward side-effects that’s going to surface?

FLU SHOTS

Half the population of the USA are going to receive H1N1 flu shots - who benefits and what are the risks?

In the case of the swine flu vaccine, the inherent risk is going to be higher; simply because this experimental vaccine did not undergo the necessary full safety trials in view of the haste in which its production had needed to go ahead (for the technically minded, many of these vaccines have been tested up to Phase 2 only).

In children and infants, the swine flu vaccine is going to be even more hazardous. Read this article from Bristol University “Top ten reasons why Children should avoid the H1N1 flu vaccine”.

The recurring question that the public is going to ask is “How do we know the vaccine’s safe?”. In truth , we don’t know..

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An Aspirin A Day Used To Keep The Doctor Away

aspirin2

ASPIRIN - used as a pain-killer for a century, it became renowned as a prevention for heart disease since the 70s

Times have indeed changed…3 decades ago, the medical fraternity were singing praises about the wonder pill that would be the panacea for preventing heart attacks and strokes. So much so, health authorities were seriously considering adding it to the community’s drinking water supply so that everyone could benefit. Doctors, otherwise hale and hearty, were taking them ‘ just in case’. What was it supposed to do? It thins the blood enough to prevent clots from forming within the blood vessels and thereby preventing blockage.

Now, aspirin, a humble drug which has been used as a pain-killer for over a century, has come under severe cross-examination. Why? Largely because researchers have recently discovered that taking aspirin pills does not prevent heart or blood-vessel disease in otherwise normal people.

In fact,  healthy people who take aspirin to prevent heart attacks could be doing more harm than good. Aspirin is notorious for causing bleeding in the stomach, sometimes several months after commencing it. And the bleeding can be silent, without much stomach pain with the symptoms being confined to ‘blackish’ stools.

A caveat though…for those already suffering from heart disease or stroke, the role of aspirin is still undisputed and its benefits far outweigh the disadvantages. For those who are otherwise healthy but have several risk factors (like smoking, parents with heart disease), the decision is not that clear-cut though. You need to discuss this with your own doctor.

One thing for certain, if someone has symptoms suggestive of an impending heart attack, chewing an aspirin pill immediately can be a life-saver even before one reaches the emergency room..

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Healthcare Nowadays..(5)

cartoon3An innovative way to cut healthcare costs.. 😉

More seriously, the US healthcare reforms should be about how to reduce costs, not who’s paying for it.- Doctor2008

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Health Alert (9): A New Malaria Kid on the Block

Looking at all the disease epidemics in the last decade, there is a striking similarity between them. SARS, Avian flu, Nipah virus, swine flu… they all originated from an animal source. And, probably because these animals had begun to develop immunity to them, these germs began looking for  another host – man.

And if one is empathetic, can you blame these viruses for invading man? After all, they are living things and they do need to fight for survival! Even viruses have their rights,  too. 🙂 Anyway, I digress. Looking at the spate of infectious diseases spread from animals to man in recent years (scientists call them zoonoses) , is this a trend that will herald a queue of other zoonoses which are going to affect mankind?

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Malaria parasites (in purple) within a red blood cell about to burst and infect nearby cells

There are indications that this might be the case. Take for example, malaria, a disease that kills one million worldwide. Its an established fact that the causative bug, a parasite called Plasmodium is transmitted from an infected person via the Anopheles mosquito to a potential victim. Its never been known that malaria could be transferred from anyone else other than man…until recently, that is.

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The Macaque - those with malaria can now pass them to man

Now, with potentially serious ramifications,it has been proven that a human can get infected with malaria coming from monkeys. This finding, by a group of researchers in Sarawak, Malaysia showed that the parasite that causes malaria only in monkeys (called Plasmodium knowlesi) has been found to have infected humans in Sarawak as well as Sabah, on the island of Borneo.(read more here).

What does this mean? Malaria would have to be classified as a zoonosis, thereby changing public health strategies. With increasing tourism now, it would be a matter of time before this type of malaria will spread far beyond Borneo, even to Western countries. This particular strain of malaria is also as deadly as the wellknown falciparum strain found commonly in Africa.

My doctor friends in Borneo have told me they have been aware of this for several years – fortunately in most cases, cure has been achieved using conventional medications. According to them, the problem often is in making the diagnosis, as some of the symptoms do mimic other diseases like dengue fever.

(This article is dedicated to Z Y)

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Anger Management & Sports

The foot-fault was not the major issue, but it was how Serena Williams handled the situation at the 2009 US Open tennis semi-finals that mattered. In any case, watch for yourself :

Roy_Keane

Pulsating Veins & Angst - Roy Keane confronts the referee yet again

The outburst is nothing new in competitive tennis (old-timers will remember John McEnroe in the early 80s) or for that matter in most other high-pressure sports, especially the English Premier League football competition. Largely due to intense rivalry and the necessity to perform consistently at one’s best, participating is always like being in a pressure-cooker, just waiting to explode.

Controlled aggression, like fist-clenching, shouting (to oneself!) and short outbursts of anger, are commonplace, indeed  beneficial, because it makes the sportsman hyper-sharp mentally and may raise their performance level. However, when it goes out of control, then it becomes destructive. Football and tennis coaches spend a great deal of training time in controlling emotion and anger management, as these are now regarded as part and parcel of being professional.

What is anger management? When the response to anger becomes excessively inappropriate, manifested as violence,recklessness and abusiveness – it becomes a harmful emotion. Anger management are strategies to help control anger which has become self-destructive. One effective strategy (by Dr. Tony Fiore and Dr. Ari Novick) outlines the following steps:

  1. Recognise stress – as stress causes anger, reduce stress before it turns to anger.
  2. Develop empathy – see things from the other person’s perspective.
  3. Respond, don’t react – choose how you respond to anger.
  4. Converse with yourself – recognize and modify your inner self-talk.
  5. Be assertive – communicate effectively how you feel without being emotional.
  6. Be realistic about expectations – minimising the gap between what you expect & what you get.
  7. Forgive & accept – the decision to “let go”prevents resentment (self-damaging).
  8. Retreat & Think Things Over – taking “time-out” and removing from the stress situation.

Back to Serena Williams -why did she fail to control her anger?

For one thing, tennis is an individual sport. There are no team-mates to pull her away or to help absorb the pressure, unlike football. Then there’s the element of human error by the umpire adding on to unnecessary stress; not to mention the close proximity of the sell-out crowd egging her on. All in all, the fact remains that she did not acquit herself well as a professional and will probably need more training in this area!


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Healthcare Nowadays..(4)

cartoon2(Courtesy: USA TODAY)

Too Tired? Take Coffee!

..That’s the advice by the Queensland State government to their doctors who have been working on 30-80 hour non-stop shifts. This advice is contained in a 102-page Queensland Health Fatigue Risk Management System in response to a complaint  that public hospital patients were dying because dangerously tired medics were being forced to work up to 80 hours without a break.(see the Reuter’s report)

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Coffee..postponing fatigue and sleep deprivation, but at what cost?

The document recommends 400 milligrams of coffee (6 cups of coffee) as a fatigue fighter, so that the exhausted doctors can continue their duties.  600 milligrams? That’s enough to cause heart palpitations, raised blood pressure, dizziness, anxiety and hand tremors! Not to mention caffeine dependence and addiction.

The background for this astonishing strategy appears to be mainly due to Australia’s ailing public hospital system which is managed by state governments like Queensland, with federal government support. Gross inefficiencies and the rising cost of healthcare have led to insufficient funding and staff shortages. In a scenario similar to the US, urgent healthcare reform is on the cards and Kevin Rudd is seriously considering a  federal government takeover.

Back to coffee..lets not forget its beneficial effects. Its a rich source of anti-oxidants like chlorogenic acid and melanoidins. It also helps to prevent diabetes,Alzheimer’s and Parkinson’s disease. The jury is still out on whether it causes heart disease although it is known to increase blood pressure. Read more about the health effects of coffee in my earlier posting  “Losing Sleep Over Coffee”.

Thanks to Fidel for drawing attention to this news report.

coffee_types

The Benefits of Plain Coffee is Neutralised by Adding Sugar & Milk such as Those Found in Coffee Outlets

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What’s In A Name? Plenty!

If you were a smoker and you had to make a choice between the following, which would you choose?

Marlboro_Redmarlboro_gold

Chances are you’ll go for the one on the right- because you would believe it to be healthier and easier to give up.These confirm the results of a survey which showed that subtle branding on cigarette packets are misleading smokers into believing some products are less harmful than others.

The truth is that all cigarettes are equally hazardous, regardless of what colour the pack is or what words appear on it. This is part of a marketing ploy by cigarette companies to give a false sense of reassurance to consumers that really do not exist.

And the authorities are coming in hard on this mis-information – since 2002 it has been illegal under EU legislation for manufacturers to use trademarks, text or any sign to suggest that one tobacco product is less harmful than another. This includes terms such as “low tar“, “light” and “mild“. In the US since 2006, after a historic 7-year court trial, the US Department of Justice stopped America’s big cigarette makers from using similar terms.

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Cigarette Displays Are Now Banned in the UK, with More Countries Following Suit

Just as well..cardiologists like myself have seen enough of the ravages due to smoking to call it the public murderer number 1.

And to my friend who said that low-tar cigarettes were ‘okay’, let me remind him not to forget about nicotine (the amount of which is unaltered in such cigarettes) and its terrible effects on the heart and blood vessels.

See my other postings on smoking:

Smoking – It’s Not Cool Anymore

Smoking… Where There’s A Threat, There’s Opportunity

Identifying Kids Who Will Smoke

Smokers Offered Money To Give Up

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Healthcare Nowadays..(3)

healthcare nowadays4

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Chilling Out With Chilies

There are several friends of mine who would not travel abroad or even eat without having chilies by their side, almost to the point of, well.. an addiction! Well, that might be the right word, as it is well-known that the active ingredient of chilies, capsaicin, has been shown to stimulate the production of endorphins, the feel-good chemical produced by your own body in response to strenuous exercise, excitement, pain and orgasm.

Chilli_SantaFe

Sign in an obviously Hispanic store in Santa Fe, New Mexico (courtesy of ZA Yusof)

This probably explains why people go bungee-jumping, jump off buildings in their parachutes and return for more. Endorphins mimic the ‘hard drugs’ like opiates in their ability to produce natural pain-relief and a sense of well-being, as well as being addictive – the difference being that endorphins are produced within our bodies. Well, this same effect is produced when consuming chilies, due to this production of endorphins.  So much so, while Mexico has gained the dubious reputation as a source of clandestine drugs, it has always been  known for  exporting the  legalised form-  chilies!

There are many healthy benefits in consuming chilies:

  • it prevents sinusistis and blocked noses
  • it has anti-inflammatory and pain-relieving properties, useful in arthritis and nerve diseases
  • capsaicin can fight cancer cells from the prostate
  • capsaicin, according to a Duke University study, can can also help to kill the ulcer-causing bacteria, H. pylori
  • chilies are high in antioxidant carotenes and flavonoids, and contain about twice the amount of vitamin C found in citrus fruits

Are there any unpleasant effects? Apart from watery eyes, a running-nose and stomach irritation, consuming chilies do cause an irritating cough, due to the capsaicin. See here for a possible cure to the cough.

For chili connoisseurs, many are aware of the Scoville Scale, measured as Scoville Heat Units (SHU) which determines how ‘hot’ different types of chilies are.Chilli Scale2For those friends of mine who claim to have conquered the bird-eye chili (phrik thai, chili padi), they would be amazed to know that it ranks under moderately hot only (see Thai peppers in above diagram). The real challenge is in trying the world’s hottest chili, Naga Jolokhia, which comes from India. Those who have tried it claim that it is too hot to be taken au naturel and recommend it be pickled in mustard oil and taking the oil, one drop at a time!

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The Naga Jolokhia -the World's Hottest Chili

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