Heart Attacks, Strokes and Apples

We all heard our parents encouraging us to eat fresh fruit and vegetable, specially apples, and all of them used the old Victorian saying " An Apple a Day Keeps the Doctor Away" to further motivate us. Well, more then a century later it still holds true, especially for the above 50 population.
According to an article published in the christmas edition of the British Medical Journal, a research study led by Dr Adam Briggs of the BHF Health Promotion Research Group at Oxford University came to the conclusion that about 8500 deaths from heart attacks and strokes could be averted if all adults of 50 years and above were prescribed an a apple a day. The significance of this outcome is more apparent when compared to another recent study that showed that if adults 50 and above not already on it, were prescribed statins, it could prevent about 9400 deaths from heart diseases. 
Dr. Adam Briggs says 'It just shows how effective small changes in diet can be, and that both drugs and healthier living can make a real difference in preventing heart disease and stroke.' But the researchers stress that this does not encourage individuals already on statins to stop taking them, just try adding apples to your daily diet.
Although apples appear to be exceptionally good for maintaining a healthy heart, it is clearly essential to eat a variety of fresh fruits and vegetable on a daily basis to stay healthy.





P.S:
An Apple A Day Keeps The Heart Doctor Away (University of Oxford)
Apple Nutrition and Composition Facts(USDA Database)

What are the real benefits of antibacterial soaps, if any?

Probably because of my medical background I have always worried about the indiscriminate use of antibiotics, which can consequently create antibiotic-resistant bacteria called 'Super Bacteria'. Treating the infections caused by these super bacteria can be a nightmare, often leading to disastrous outcomes, even death.

It is in the same vein, I have always been a bit skeptical of the antibacterial soaps sold to consumers. Since antibacterial soaps are supposed to be killing everyday bacteria we end up collecting on our hands, they are also indirectly creating super bacteria. And besides that these antibacterial soaps are also killing off the normal bacterial flora on our hands. 

What is normal bacterial flora on our hands?

According to the 'WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care.' and Medical Microbiology. 4th edition :
The bacteria found on our hands can be divided into two types; namely resident and transient. The resident bacteria being the ones normally residing on our hands, these predominantly include Gram-positive organisms (e.g., staphylococci, micrococci, diphtheroids). The resident flora primarily plays a protective role by providing microbial antagonism and the competition for nutrients in the ecosystem. Hence the resident flora rarely causes infections.
The transient bacteria are the one we acquire through contact with infected individuals or surfaces. These can lead to infections and spread from person to person. This transfer of bacteria through direct contact is highest in health care workers. In fact their hands may constantly become colonized by some pathogenic flora such as Staphylococcus Aureus and Gram-negative bacilli.

The main bacteria killing ingredient in majority antibacterial soaps is Triclosan. Although Triclosan is meant to rid our hands of the transient kind of bacteria, over time it indiscriminately also kills the resident kind. 

What is Triclosan?

According to the FDA Consumer Update on Triclosan:

'Triclosan is an ingredient added to many consumer products to reduce or prevent bacterial contamination. It may be found in products such as clothing, kitchenware, furniture, and toys. It also may be added to antibacterial soaps and body washes, toothpastes, and some cosmetics—products regulated by the U.S. Food and Drug Administration (FDA).'

'Triclosan is not currently known to be hazardous to humans. But several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review.

Concerns about Triclosan:

According to the FDA Consumer Update on Triclosan:

'Animal studies have shown that triclosan alters hormone regulation. However, data showing effects in animals don’t always predict effects in humans. Other studies in bacteria have raised the possibility that triclosan contributes to making bacteria resistant to antibiotics.

In light of these studies, FDA is engaged in an ongoing scientific and regulatory review of this ingredient. FDA does not have sufficient safety evidence to recommend changing consumer use of products that contain triclosan at this time.

For some consumer products, there is clear evidence that triclosan provides a benefit. In 1997, FDA reviewed extensive effectiveness data on triclosan in Colgate Total toothpaste. The evidence showed that triclosan in this product was effective in preventing gingivitis. 

For other consumer products, FDA has not received evidence that the triclosan provides an extra benefit to health. At this time, the agency does not have evidence that triclosan in antibacterial soaps and body washes provides any benefit over washing with regular soap and water.

We are engaged in a comprehensive scientific and regulatory review of all the available safety and effectiveness data. This includes data relevant to the emerging safety issues of bacterial resistance and endocrine disruption due to triclosan in FDA-regulated products.'

On December 16  2013, FDA finally came out with the verdict FDA Taking Closer Look at 'Antibacterial' Soap.  Colleen Rogers, Ph.D., a lead microbiologist at FDA stated that "there currently is no evidence that over-the-counter (OTC) antibacterial soap products are any more effective at preventing illness than washing with plain soap and water." She goes on to say "New data suggest that the risks associated with long-term, daily use of antibacterial soaps may outweigh the benefits."

The update states "In light of these data, the agency issued a proposed rule on Dec. 16, 2013 that would require manufacturers to provide more substantial data to demonstrate the safety and effectiveness of antibacterial soaps. The proposed rule covers only those consumer antibacterial soaps and body washes that are used with water. It does not apply to hand sanitizers, hand wipes or antibacterial soaps that are used in health care settings such as hospitals.

According to Rogers, the laboratory tests that have historically been used to evaluate the effectiveness of antibacterial soaps do not directly test the effect of a product on infection rates. That would change with FDA's current proposal, which would require studies that directly test the ability of an antibacterial soap to provide a clinical benefit over washing with non-antibacterial soap, Rogers says."

In the end, it seems to be wise to continue washing our hands with just plain ol' soap and water, and postpone the use of these fancy antibacterial soaps till further notice. 



References:
Dangers of Antibiotic Resistance
WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care.
Medical Microbiology. 4th edition 
FDA Consumer Update on Triclosan
FDA Taking Closer Look at 'Antibacterial' Soap. 

Frankenstein may not be just fiction anymore....

Some recent headlines in the world of medicine have been unusual and a little unsettling, they sound like sci-fi more then actual reality.

One of them was in September ' Doctors grow nose on man's forehead' on ABC News Medicine Unit. Yes it is exactly what it says. A young man Xiaolian 22, in China, injured his nose in a traffic accident in 2012, subsequent infections lead to the corrosion of the damaged cartilage in the nose. Doctors could no longer fix it, hence they decided to grow him a new one at the Fuzhou hospital in China. Now that the nose is grown, doctors can transplant it to his face successfully.

Then yesterday read this headline ' Severed hand kept alive on man's ankle ' on BBC World News. Xiao Wei in China severed his right hand in an accident at work, his arm extremity was in such a bad shape that surgeons could not re-attach the hand immediately. To keep the hand healthy and alive, the surgeons then grafted the hand to his  left ankle and supplied it with a steady blood supply. After about a month the surgeons successfully reattached the hand to his right arm. According to latest reports from his doctors Xiao Wei will need several surgeries before he can regain full function of his hand, which is highly likely.

But the most disturbing one was in July 2013 'Human Head Transplants Could Become Reality' on ABC News Medicine Unit. Here is part of the report;
' In the journal Surgical Neurology International, Canavero outlined a procedure for taking the head of one person and transplanting it onto the body of another. It involves inducing hypothermia and cutting the spinal cord with an “ultra-sharp blade” so it can be fused with the donor’s spinal cord.
“This is, of course, totally different from what happens in clinical spinal cord injury, where gross damage and scarring hinder regeneration,” Canavero wrote.
He outlined a hypothetical scenario in which the body donor is a brain dead patient. He said the recipient could be anyone dying of cancer or anything else  that leaves the brain intact.
For the head transplant to work, two surgeries would have to take place in the same operating room in which both spinal cords would be severed simultaneously but only after all other cuts had been made. Then, the donor body’s spinal cord would be “chemofused” to the recipient head’s spinal cord using a substance called polyethylene glycol, or PEG. Canavero called his surgery the Heaven surgery, for “head anastomosis venture.” '
Heaven! Really? I would think more like Hell! This is not an issue of it being scientifically possible or not, to me it is a matter of whether it is ethical or not. Who gets a transplant? Whose body and whose head? Do we honestly want Frankensteins to be a reality? 
Mankind loves to challenge nature and overcome it's limitations, but trying to make this happen would not be wise, there is just so much meddling nature can take. Let's keep this one limited to our scifi books and movies... 

Legalization of recreational marijuana, is that a good idea?

After seeing Colorado join Washington state in making the recreational use of marijuana legal, as a mother of three, I am wondering 'Is that really a good idea?' If under age youngsters easily get their hands on alcohol and cigarettes, won't legalizing pot make it highly likely to be used by more youngsters now?

Last time I checked the National Institute on Drug Abuse website, Marijuana is still an addictive drug, it still poses some very serious physical and mental side effects and can lead to significant damage to personal and social life. So why is it suddenly ok to sell and buy it for fun?

Here are some basics information as given on the NIDA website;

Marijuana:

Marijuana is the most common illicit drug used in the United States. After a period of decline in the last decade, its use has generally increased among young people since 2007, corresponding to a diminishing perception of the drug’s risks. More teenagers are now current (past-month) smokers of marijuana than of cigarettes, according to annual survey data.

How it works:
When marijuana is smoked, THC rapidly passes from the lungs into the bloodstream, which carries the chemical to the brain and other organs throughout the body. It is absorbed more slowly when ingested in food or drink.
The highest density of cannabinoid receptors is found in parts of the brain that influence pleasure, memory, thinking, concentration, sensory and time perception, and coordinated movement. Marijuana overactivates the endocannabinoid system, causing the high and other effects that users experience. These include distorted perceptions, impaired coordination, difficulty with thinking and problem solving, and disrupted learning and memory.
How it affects health:
Research has shown that, in chronic users, marijuana's adverse impact on learning and memory persists after the acute effects of the drug wear off; when marijuana use begins in adolescence, the effects may persist for many years. Research from different areas is converging on the fact that regular marijuana use by young people can have long-lasting negative impact on the structure and function of their brains.
A recent study of marijuana users who began using in adolescence revealed a profound deficit in connections between brain areas responsible for learning and memory. And a large prospective study (following individuals across time) showed that people who began smoking marijuana heavily in their teens lost as much as 8 points in IQ between age 13 and age 38; importantly, the lost cognitive abilities were not restored in those who quit smoking marijuana as adults. (Individuals who started smoking marijuana in adulthood did not show significant IQ declines.)
Marijuana use can have a variety of adverse, short- and long-term effects, especially on cardiopulmonary and mental health.
Addiction:
Contrary to common belief, marijuana is addictive. Estimates from research suggest that about 9 percent of users become addicted to marijuana; this number increases among those who start young (to about 17 percent, or 1 in 6) and among daily users (to 25-50 percent). Thus, many of the nearly 7 percent of high-school seniors who (according to annual survey data) report smoking marijuana daily or almost daily are well on their way to addiction, if not already addicted (besides functioning at a sub-optimal level all of the time).
The amount of THC in marijuana samples confiscated by police has been increasing steadily over the past few decades. In 2012, THC concentrations in marijuana averaged nearly 15 percent, compared to around 4 percent in the 1980s. For a new user, this may mean exposure to higher concentrations of THC, with a greater chance of an adverse or unpredictable reaction. Increases in potency may account for the rise in emergency department visits involving marijuana use." 

After reading the above, can you really argue that it is safe and acceptable to make marijuana more  accessible to our children?



P.S:
National Institute on Drug Abuse: Marijuana page 
In 2 states, corner cannabis store nears reality (CNBC December 14  2013)

When should I discard these condiments?

It can be tricky to decide when to discard those condiments in our fridge. All items have expiry dates for when to throw them unused and unopened. The confusion is when they are opened, being used and being refrigerated, how long can we keep them and use them then?
Click on the following link to find a very simple list on the WebMD site of how long common condiments and other items in our refrigerators can be safely used;
http://www.webmd.com/food-recipes/healthtool-condiments-table

School children need more physical activity!

Every child needs plenty of physically activity both for healthy growth and maintenance of good physical and mental health. Unfortunately it is being seen that our children are getting less and less physically active. In addition to the overuse of TVs, computers, Nintendos, Playstations and X boxes as a major cause of reduced outdoor activities in children, there is also a significant dearth of physical education in school all over the country. Less then half even have a PE more then once of twice a week. But now concerned schools are coming up with new ways to keep children active.

Maanvi Singh writes on the subject on NPR Public Health page;

    To Get Kids Exercising, Schools Are Becoming Creative

Avery Stackhouse, age 7, of Lafayette, Calif., says he wishes he had more time for phys ed.

"We just have it one day a week — on Monday." There's always lunch and recess, he says. "We play a couple of games, like football and soccer," he tells Shots.

But at Happy Valley Elementary, where he goes to school, recess last only 15 minutes and lunch is 45. Between eating and mingling, he says, "there's only a few minutes left where we play games and all that."

Fifty-six percent of parents say their elementary school kids are getting just one or two days of physical education a week, according to a poll NPR conducted in partnership with the Robert Wood Johnson Foundation and the Harvard School of Public Health.

Fewer than 1 in 5 parents with children in kindergarten through fifth grade said their kids were getting physical education daily.

Yet the Centers for Disease Control and Prevention recommends that K-5 students get at least 150 minutes a week. Physical activity has a lot of benefits, from reducing obesity to helping kids do better academically.

Louisiana State University's Russ Carson, an exercise researcher, tells Shots the poll results don't surprise him. "This has been going on for years, unfortunately," he says. School administrators can only fit so many things into a day, and often, he says, "testing and other aspects of education take precedence over physical education."

(Continue Reading)

Exercise is good.....at any age!

Many who never exercise when young think it futile to try starting in senior years of life. But a recent study has proven that multiple benefits of regular exercise can be gained even if after being inactive for decades a person took up exercising.

Here is a Reuters Health report on the study:

Exercise later in life tied to healthy aging

NEW YORK (Reuters Health) - It's never too late to start exercising, according to a new study that found formerly inactive seniors who took up exercise still experienced health benefits.

The study sheds light on the question of whether the slower mental and physical decline seen among active seniors extends to former couch potatoes who begin exercising later in life.

"Regular physical activity in older age is important to remain healthy. However, taking up physical activity at old age is also beneficial," Mark Hamer told Reuters Health in an email. He led the study at University College London.

These findings "underscore the importance of prevention as well as rehabilitation," said Ursula M. Staudinger, who directs the Robert N. Butler Columbia Aging Center in New York City.

"When you start later in life you can still get gains," Staudinger, who was not part of the research team, said.

For their study, Hamer and his coauthors analyzed information on 3,454 healthy seniors involved in the ongoing English Longitudinal Study of Ageing.

Participants reported how much they exercised at the start of the study, in 2002 to 2003. Researchers then followed them through regular health surveys for the next eight years.

At follow-up, 19 percent of the seniors were considered to be aging healthily. That is, they had not developed any major chronic diseases or depression and had not experienced any deterioration in their physical or mental status during the study period.

Seniors who were active at least once a week at the start of the study and remained active were the most likely to experience healthy aging. But those who started exercising during the study period benefited as well, Hamer and his colleagues reported in the British Journal of Sports Medicine.

People who remained active during all eight years were over seven times more likely to experience healthy aging than inactive seniors. Those who became active after the study started were three times more likely than inactive adults to age well.

(Complete Report)