A recent trial by researchers at University of Edinburgh specifically focusing on individuals of South Asian descent, has shown that even small changes in lifestyle can lead to weight loss and significantly reduce the risk of type 2 Diabetes. It has been seen that men of Pakistani and Indian descent are three times more likely to develop diabetes as compared to men from the general population with similar body mass indexes.
This trial titled "Culturally adapting the prevention of diabetes and obesity in South Asians (PODOSA) trial", included 171 individuals of Pakistani and Indian descent living in Scotland with impaired glycemia thus at high risk of developing Type 2 diabetes.
As most South Asian cultural activities and traditions revolve around family and food. Participants were given detailed dietary advice by dieticians and provided culturally relevant lifestyle change plans and resources. The trials made use of professional translators and multilingual professionals for communicating instructions to participants. Also many of the manual and pamphlets were translated into participants' preferred languages, such as Urdu, Hindi, and Punjabi. In contrast, the control group was given basic instructions on weight control and management, it was not culturally specific.
According to Professor Raj Bhopal of Edinburgh University's Population Health Sciences Center 'These differing approaches show us that a more family-centred strategy,
with culturally tailored lifestyle advice, can produce significant
benefits to people's health through weight loss.'
Although trials in Europe and North America have not so far reported on the
impact on South Asian populations separately or provided the details of
their cross-cultural adaptation processes. But there might be a more positive outcome of such efforts when instructions and advice are culture specific.
P.S: Small Lifestyle changes 'lower type 2 diabetes risk' (BBC World: Health)
Tuesday, December 31, 2013
Tuesday, December 24, 2013
Welcome to MINDbank a new resource for mental health information.
On December 10th 2013, the WHO released its gigantic online database by the name of MINDbank. This database contains information on mental health, substance abuse, disability, human rights and the different policies, strategies, laws and service standards being implemented in different countries. One can also find key international documents and treaties in the MINDbank.
Because mental health is still a topic shunned and avoided in many countries all over the world, it can often be difficult to find out information on resources pertaining to mental health. The MINDbank is the only single point globally to access all comprehensive information related to to mental health, substance abuse, disability, general health, human rights and development.
WHO announcement for the media says;
Because mental health is still a topic shunned and avoided in many countries all over the world, it can often be difficult to find out information on resources pertaining to mental health. The MINDbank is the only single point globally to access all comprehensive information related to to mental health, substance abuse, disability, general health, human rights and development.
WHO announcement for the media says;
Launched on Human Rights Day, the platform is part of WHO’s QualityRights initiative, aiming to end human rights violations against people with mental health conditions.
“People with mental disabilities still face discrimination, violence and abuse in all countries,” says Dr Michelle Funk, from WHO’s Department of Mental Health and Substance Abuse. “The easy-to-use platform was established as a tool to facilitate debate, dialogue, advocacy and research on mental health, to improve care and to promote human rights across the globe.”
The care available in mental health facilities may often not only be of poor quality but can also hinder recovery. It can still be common in some countries for people to be locked away in small, prison-like cells with no human contact or to be chained to their beds, unable to move. The MiNDbank will help decision makers to address these issues, support reform efforts and ultimately improve the lives of people with mental health conditions in line with the Comprehensive Mental Health Action Plan 2013-2020, adopted by the World Health Assembly in May 2013.
“If a government, for example, wishes to develop a new mental health policy in line with international human rights standards it can - on the new platform - quickly get an overview about the policies of other countries and benefit from their experiences and an array of international guidance tools and resources,“ explains Nathalie Drew, WHO Technical Officer working on mental health and human rights. So far, already more than 160 countries are sharing key mental health information through the MiNDbank and updates will be provided on a regular basis.
The MINDbank is meant to be the go-to site for everyone, from clinicians, health policy makers, legislators, academics research professionals to educationists and anyone anywhere in the world interested in finding reliable information on mental health and related topics.
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)
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)
Friday, December 20, 2013
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).'
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.
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.
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.
Tuesday, December 17, 2013
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...
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...
Monday, December 16, 2013
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;
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)
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
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