Monthly Archives: August, 2011

The Bird Flu Flies In Again

Fears of a fresh outbreak of bird flu this year have been raised by the United Nations, after an increase in the number of deaths and, crucially, the emergence of a new, mutated strain of the disease.

The Avian Flu affects birds mainly but can affect humans occasionally

There has been 8 deaths this year in Cambodia alone

Although in six countries – Bangladesh, China, Egypt, India, Indonesia and Vietnam – it is known to be endemic (present all the time albeit in smaller numbers), at least eight people have died of bird flu in Cambodia this year alone.  Of note – the emergence of a new, mutated strain of the disease for which the existing vaccines do not work.

Just as a reminder, the H5N1 bird flu virus  spread across Asia in the last few years, killing millions of fowl and several hundred people but never gained genes to spread easily among humans. This is unlike the swine flu virus (H1N1) which readily affects humans and spread rapidly in 2008 from Mexico to the US and beyond, killing thousands.

While it is expected that the the new Avian mutant virus may not  be so  transmissible to humans, it is difficult how dangerous it potentially is. Nevertheless, it is of sufficient concern for the United Nations’ Food and Agriculture Organisation (FAO) to issue a warning urging stiffer surveillance measures to prevent the disease spreading to new areas, particularly when bird migration can take the virus to countries which have never got the illness.

The threat of catching the disease aside, the economic impact of another outbreak can be quite tremendous, considering that in 2008, some 400 million domestic poultry were slaughtered and the disease was said to have cost the world’s economies US $20bn.

Bisexual Men Do Exist

The New York Times yesterday highlighted a recent study which showed that men who claimed to be  bisexual do in fact get attracted to both men and women. The study, which is published in the Biological Psychology Journal, confirms that bisexual men can get sexually aroused by both men and women.

The Bisexual Pride Flag - a symbol of the bisexual community


Strangely enough, the same researchers had reported in an earlier study in 2005 that  “with respect to sexual arousal and attraction, it remains to be shown that male bisexuality exists.”  So why the about turn?  This time round, the study was better designed and with stricter criteria, with participants required to have had sexual experiences with at least two people of each sex and a romantic relationship of at least three months with at least one person of each sex.

The Academy Award-winning film "Black Swan" features bisexuality as one of the themes

Bisexuality, defined as physical and/or romantic attraction to both males and females, have been known to exist in society for ages, but scientific evidence of its existence has all this while been lacking. While this is the case, it is interesting to note that the American Psychological Association has long recognised that an individual’s sexual orientation is located anywhere between the homosexuality-heterosexuality spectrum. In other words, many people can fall anywhere between purely heterosexual (or homosexual) to being a bit of each. This sexual orientation  can develop across a person’s lifetime–different people realize at different points in their lives that they are heterosexual, bisexual or homosexual.

Certainly this view is not as drastic as Sigmund Freud – who suggested that  “all human beings are bisexual – – and that their libido is distributed between objects of both sexes, either in a manifest or a latent form.



Licence to Practise…And Be Sued

Here’s some sobering news for doctors and those who aspire to be one. If you are a neurosurgeon or a heart surgeon, you’re going to face a malpractice claim at least once by the time you reach 65. Coming from the New England Journal of Medicine study published recently, even if you’re a doctor in a low-risk speciality eg  GP or skin specialist, the chances of being taken to court by age 65 is still high, at 75%.

Brain and Heart Surgeons Top the List of Those Being Sued (courtesy NEJM)

I’m not surprised at all..what with more well-informed patients, an egalitarian society, litigation-conscious families and the ever-present doubt on the quality of medical can only expect malpractice claims to rise.

Medical students in particular should take note of this trend. Medical schools need to also address this issue in their curriculum. As it is well-known that, even after an untoward event, whether the patient decides to sue is largely dependent on effective doctor-patient communication – medical schools would do well to introduce communication skill as an integral part of a medical course.

Good patient-doctor communication can make the difference in whether a malpractice claim surfaces

A good doctor is more than just being adept at diagnosing and treating diseases – they have to be skilled at managing information and communicating with their patients.

Fasting, Fast Times and the Olympics

2012 Summer Olympics

Image via Wikipedia

The news that the 2012 London Olympics is going to be held entirely during the Muslim fasting month of Ramadhan in August next year poses  the question: does fasting affect sports performance?

In July 2012, it is estimated that more than 11,000 athletes will compete, of which about a quarter of whom will be Muslims who will be expected to undertake a dawn-to-dusk complete abstinence of all food and water. That means, at the height of summer, no food or drink from something like from 4.30am till 9.30pm daily.

In the 2012 Olympic long-distance races, contestants from East Africa,mainly Muslims, will compete during the fasting period.

Lets take a look at how fasting may affect sports performance. Broadly, it does so in the following ways:

1. Energy restriction – while it is generally held that the total calories will drop in a day, the food intake is very cultural and depends also on whether the diet is balanced. So it is possible to ingest more calories than one would normally do when not fasting with consequent weight gain. Experts are divided whether there is any curb on energy at all.

2.Hydration – dehydration of more than 2% of body weight will impair aerobic exercise performance, despite the attempt by the body to conserve water, as seen by one’s highly concentrated urine when fasting and the fact that one tends to sweat less when exercising.

3.Body temperature is governed by circadian rhythm of one’s body and explains why body temperature, muscular strength and reflexes become optimum in the late afternoon, at the peak of the circadian rhythm. When fasting, the alteration of sleep (sleep deprivation)and altered eating habits affect the circadian rhythm. This may cause a reduction in exercise performance.

4.Training load – while it is generally believed that fasting will affect training, largely by a perception of easy tiredness, professional coaches have established that, if diet, sleep, a balanced diet and hydration are maintained, athletes can undergo the same physical training load as those who are non-fasting.

Most authorities accept that athletes who maintain their energy intake and  prefasting hydration status and who get adequate sleep can maintain their training load during fasting without suffering any substantial impairment in performance. Of course, if the fasting is on religious grounds, this is a personal matter for the athlete to decide as to whether, in the first place, he should fast at all and defer the fasting period till after the race.

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The Lingering Death of Newspapers

A Foam Pie Lands on Rupert Murdoch Despite the Wife's Intervention in the July 20th Incident

The ongoing phone-hacking scandal, with elements of slapstick comedy in the courtroom, rang the death-knell to the News of the World. It is frequently commented that this event marked the beginning of the end of newspapers; but in reality, the demise of newspapers began even before this.

How do you reconcile the fact that newspapers were introducing online versions for free on the internet and yet expect the public to pay a premium for the hard-copy version?  The business model was wrong.. a fact that Rupert Murdoch knew and tried, albeit unsuccessfully, by charging for the online version of The Times. Readers were not falling for the bait as they could access the Internet for other free online news or watch 24-hour  TV news channels. The Internet could very well also be blamed for the loss of advertising revenues, as advertisers went online with their own webpages.

Other changing trends include the loss of one of the biggest sources of revenues of newspapers – classified ads – to online portals like Ebay and Jobstreet.

Did not the newspaper owners forsee the advent of the Internet? I’m sure they did, but they were complacent. A decade or two ago, the newspaper business was a licence to print money,  where branding and economies of scale permitted them to charge a premium for copies and adverts. Today, changing lifestyles (read smartphones) and the Internet have ensured declining readership, even if free copies were distributed. This has ensured that the number of people who read newspapers has gone into a steep, possibly terminal decline. And, like a stage 4 cancer, the prognosis looks bad..

Today’s Healthcare Quote

Fasting Healthily

The term fasting”  brings up different meanings to different people…to some it holds spiritual significance whether they are Jews, Christians, Hindus or Muslims. To others, it is done on a purely physical level, the main benefit being that of healing, where the body is allowed to rest and rehabilitate, thereby flushing out toxic wastes which have been allowed to accumulate. In fact, fasting has often been called  the single greatest natural healing therapy. To most, fasting is both spiritual and physical.

Whatever the reasons and objectives, there are proper ways to optimise the health benefits.  In response to some readers’ queries on eating healthily, below are some pointers for otherwise healthy folks. Bear in mind that, in the context of medical conditions like diabetes, kidney or heart failure, advice from your care-giver is important.


In view of the long hours of fasting, one should consume slow digesting foods including fibre containing-foods rather than fast-digesting foods. Slow digesting foods last up to 8 hours, while fast-digesting foods last for only 3 to 4 hours.

·Slow-digesting foods are foods that contain grains and seeds like barley, wheat, oats, millet, semolina, beans, lentils, wholemeal flour, unpolished rice, wholemeal bread,capati,naan,etc. (they are also called complex carbohydrates).

·Fast-burning foods are foods that contain sugar, white flour, etc. (called refined carbohydrates).

One should avoid:

  1. Excessive fried and fatty foods which will create indigestion and ‘wind’.
  2. Foods containing too much sugar when commencing the fast. This may cause ‘rebound hypoglycemia’ and cause a feeling of hunger and giddiness.
  3. Too much tea or coffee when commencing the fast. They makes you pass more urine, taking with it valuable mineral salts that your body would need during the day in addition to causing dehydration.
  4. Smoking cigarettes (but of course!).  If you cannot give up smoking, cut down gradually starting a few weeks before commencing the period of fasting.

Try to eat:

·Complex carbohydrates before commencing fasting so that the food lasts longer in your stomach thus making you less hungry.

·Dates when breaking the fast as they are an excellent source of sugar, fibre, carbohydrates, potassium and magnesium to replace that lost during fasting.

Try to drink:

·As much water or fruit juices as possible in the hours before commencing the fast so that your body may adjust fluid levels in time.This helps to prevent dizziness in the afternoon due to low blood pressure as a result of dehydration.

·One tall glass of water at the commencement of fast to minimise dehydration.

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