Monday, December 13, 2010

Anni WIKI-Leaked!

As was only to be expected, the WikiLeaks whistle-blower's accounts of US diplomatic exchanges within has something to say of little Maldives too, and it has also the potential to embarrass, if not harass, the incumbent Government of President Mohammed Nasheed.

Considering that the President and his ruling Maldivian Democratic Party (MDP) are already caught in a corner on a host of domestic issues, starting with the Opposition-controlled Parliament's refusal to clear his 13-member Cabinet for re-election after their "stagged drama" resignation, as required under the Constitution, which has become a subject of contradicting interpretations.

The WikiLeaks on Maldives comprises two specific developments, at least one of them becoming controversial nearer home when the idea was first mooted. Both relate to the US, naturally -- not only because WikiLeaks is all about leaked American diplomatic exchanges among its various missions and the Washington HQ but also because they show up a strand in the Nasheed Government's thinking in moving closer to the West and secularism, particularly the US.

The already agitating issue relates to the Maldivian acceptance of at least one prisoner from the American facility on Guantanamo Bay in Cuba. The Maldivian Opposition had dubbed it 'sell-out' and the fundamentalist Adhalath Party, ironically continuing as an ally of the ruling MDP with no parliamentary support to offer, too had come down heavily on the Government's move. While domestic issues and politics upstaged the controversy, when it first came to light, the Maldivian willingness to accept someone whom the US had detained as a 'terrorist' brought in conflicting criticism.

Accordingly, the peripheral fundamentalist groups within Maldives felt that the Government was joining hands with a few other nations to provide an 'escape/exit route' for the US, when the latter should have been brought to book for video-taped ill-treatment of 'terror suspects' in the Bay facility, and also in Iraq and Afghanistan.

Here, one could feel their identification with 'religious fundamentalism', which the Nasheed Government in particular has been keen on eliminating from the Maldivian shores, one way or the other. But the true fact even a blind cow can see is that, whats happening in Bay facility, Iraq and Afghanistan are wrong in the eyes of humankind, not just Islamic Fundamentalists.

The other side, more moderate and secular groups, including responsible politicians and the mainline Opposition parties, felt that the presence of an ex-detainee from Guantanamo Bay could well become a focal-point for the emergence of a non-existent fundamentalist group, leading up to possible presence of a terror outfit, not very long after. Whether such extremist groups would be home-grown or 'imported' for whom the locals could provide safe-houses and contact-points were also being debated in private. The presence of peripheral fundamentalist groups and religious political parties have already become an increasing cause for concern, it was being pointed out.

The WikiLeaks on the subject now indicates that the Maldivian Government may have urged the US for help in procuring the much-needed IMF loan early on, in possible exchange for agreeing to house a Guantanamo Bay detainee. It is a well agreed and argued point that there are no free lunches in international politics and diplomacy, and that there may have been no harm in Maldives linking the two for benefiting the nation and its people in relative terms of few thousand dollars?. Yet, it may not be viewed the same way in the nation's backyard, where existing 'secular education' of the Gayoom era has given enough exposure to the 'IT generation' for them to draw their own conclusions beyond those narrow-minded self-centered politicians.

Ironically then, second WikiLeaks-related development pertains to the reported request of the Nasheed Administration for US help to modernise the educational system in Maldives. The idea, according to the leaks, was for the US to help Maldives discourage the migration of Maldivian students to countries such as Pakistan and Egypt, where they often schooled in madrassa education of a "fundamentalist" character.

On the issue, most locals believe this was among mounting attacks by Nasheed's secular administration to undermine Islam and promote their agenda by limiting ways to Islamic education. Other examples of such kinda are, their efforts to close down the only Arabic medium school in capital Male' Arabiyya and Mauhad.

Wednesday, August 11, 2010

Pea Sprout can mimic lung cancer nowadays!

Last June, Ron Sveden, was at Cape Cod Hospital waiting for doctors to tell him what he seemed to be the inevitable: he had lung cancer.

But Sveden got the surprise of his life when doctors removed a one-and-a-half inch long pea plant growing in one of his lungs.

A month earlier the 75-year old lifelong smoker began feeling fatigue, loss of appetite and was coughing more. He had been hospitalized for 10 days before a lung biopsy discovered what was causing his symptoms.

Sveden and his doctors believe that while eating peas, one went into his windpipe, lodged to his lungs and began sprouting. Sveden does not remember when the incident happened.

“It was probably there for quite a while because of its growth status,” Sveden told ABC News.

When his doctor gave him the diagnosis Sveden was amused.

“It took two minutes for it to sink in and I thought it was quite funny,” said Sveden. “I giggled. It was shortly after that I realized it wasn’t cancer and for me, my wife and family, it was quite a relief.”

Within days, Sveden’s appetite was back and his other symptoms began to subside. The hospital staff showed their sense of humor by including peas in one of his first meals.

“I laughed,” joked Sveden. “An then I ate them!”

Sveden continues to keep his positive outlook after his unbelievable ordeal.

“Right now, I feel great,” he said. “I feel like raising Hell again!”

Taken from ABC news August 11, 2010.

What are you thinking?

1) dont plants need sunlight to grow?? how does a pea sprout inside someones body without sunlight? Ans: They don't need sunlight to SPROUT, just some warmth and moisture. Each seed contains enough "food" to get the plant started.

2) Was he eating raw peas? Ans: He would have been eating raw peas. A cooked pea would not germiante.

New 'superbug' found in UK hospitals

A new superbug that is resistant to even the most powerful antibiotics has entered UK hospitals, experts warn.

They say bacteria that make an enzyme called NDM-1 have travelled back with NHS patients who went abroad to countries like India and Pakistan for treatments such as cosmetic surgery.

According to a Lancet paper, at least 17 of the 37 patients they studied had a history of travelling to India or Pakistan within the past year, and 14 of them had been admitted to a hospital in these countries - many for cosmetic surgery.

Although there have only been about 50 cases identified in the UK so far, scientists fear it will go global. Tight surveillance and new drugs are needed says Lancet Infectious Diseases.

NDM-1 can exist inside different bacteria, like E.coli, and it makes them resistant to one of the most powerful groups of antibiotics - carbapenems.

The fear would be that it gets into a strain of bacteria that is very good at being transmitted between patients” Dr David Livermore Researcher from the HPA (UK's Health Protection Agency)

And experts fear NDM-1 could now jump to other strains of bacteria that are already resistant to many other antibiotics.Ultimately, this could produce dangerous infections that would spread rapidly from person to person and be almost impossible to treat.

Infections have already been passed from patient to patient in UK hospitals.

At least one of the NDM-1 infections the researchers analysed was resistant to all known antibiotics.

Similar infections have been seen in the US, Canada, Australia and the Netherlands and international researchers say that NDM-1 could become a major global health problem.

The way to stop NDM-1, is to rapidly identify and isolate any hospital patients who are infected. Normal infection control measures, such as disinfecting hospital equipment and doctors and nurses washing their hands with antibacterial soap, can stop the spread.

GOOD NEWS! currently, most of the bacteria carrying NDM-1 have been treatable using a combination of different antibiotics.

BAD NEWS! The potential of NDM-1 to become endemic worldwide is "clear and frightening", say the researchers in their Lancet paper.

The Department of Health has already put out an alert on the issue since the threat is a serious global public health problem as there are few suitable new antibiotics in development and none that are effective against NDM-1.

By Michelle Roberts Health reporter, BBC News

Sunday, August 8, 2010

Serial heartbreaker nabbed!!

KUANTAN: First, she stole their hearts. Then she stole their money.

The long arm of the law, however, finally caught up with the female Casanova who promised to marry six men she befriended through Facebook but then left them poorer and without a bride.

The 25-year-old serial heart-breaker has been detained by police following a report lodged by the family of her latest victim.

According to the victim’s sister, the woman collected RM300,000 from her family members, purportedly for an investment, after going through a Chinese wedding ceremony in May at their hometown in Sabah.

The woman had refused to legally register the marriage, claiming she would only do so on Aug 8 as it was an auspicious day.

“My brother met the woman via Facebook in March and she moved in with him.
“A month later, she told my brother she was pregnant but refused to go for check up,” she said yesterday.

“During the ceremony, none of the woman’s relatives was present. “She gave the excuse that an uncle had passed away from cancer and her family members could not attend,” she said, adding that the “bride” also declined to have the wedding dinner in her hometown in Kuala Lumpur, Sin Chew Daily reported.

“We became suspicious when her tummy remained the same even after several months. There were also no returns from our investment,” she added.

The family subsequently discovered – through a friend and media reports – that the woman had cheated several other men using the same tactics.

“When I confronted her, she told me she had used all the money and pleaded with us to give her time to work so that she can save up enough money to pay us back.
“I had no choice but to bring her to the police station in Pudu two days later.”
A police report was subsequently lodged at a police station in Kuala Lumpur.

Friday, July 16, 2010

Malaria-proof mosquito engineered

The researchers, from the University of Arizona, introduced a gene that affected the insect's gut, meaning the malaria parasite could not develop.

They report the advance, which also reduced the insects' lifespan, in the journal PLoS Pathogens.

The ultimate goal is to introduce malaria-resistant mosquitoes into the environment.

"Before we do this, we have to somehow give the mosquitoes a competitive advantage over the disease-carrying insects," explained Professor Michael Riehle from the University of Arizona a principle investigator on the project.

In the study the researchers altered a gene that codes for a "signalling molecule".

This molecule, a protein, enables the mosquito's cells to communicate with each other, and is crucial for parasite development inside the mosquito.

The genetic tweak artificially increased its production, disrupting the whole process, and also shortened the insect's lifespan.

The team was able to add a fluorescent tag to the gene, to ensure that it had been successfully "expressed" by the mosquito larvae.

Professor Riehle said: "This is the first time that we've been able to completely block the parasite from developing in the mosquito."

Gareth Lycett, a malaria researcher from Liverpool School of Tropical Medicine in the UK, said it was an important advance.

"They have tested it on the most harmful of the malaria parasites, Plasmodium falciparum," he told BBC News. "It is another step on the journey towards potentially assisting malaria control through GM mosquito release."

But Dr Lycett pointed out that the this work had not been carried out specifically on the Anopheles gambiae mosquito. "That is the major vector of malaria in Africa where the disease is most prevalent," he explained.

This study was a collaborative project with the University of California Davis and the University of Georgia funded by the National Institutes of Health.

What happens next?

This is a key step in a long genetic battle against a global killer. The ultimate aim is to tackle the root cause of malaria's spread by releasing the parasite-proof mosquitoes into the environment.

For that to be successful, the genetically modified insects would have to "take over" from the naturally occurring, disease-spreading mosquitoes.

This means giving the GM insects a competitive advantage - something that has not yet been achieved. Researchers are investigating a number of genetic "tricks" in pursuit of this.

One of these is to ensure that the gene that blocks the parasite's development is guaranteed to be passed down to the modified mosquitoes' offspring - thereby making sure that the gene eventually spreads throughout the population.

The other is to give the malaria-resistant mosquitoes an additional genetic boost, such as a gene that makes them resistance to toxins that could be used against unmodified mosquitoes.

But there are serious ethical concerns about releasing a genetically modified insect into the environment. Once the science is pinned down, the risks and benefits to the environment, and to human health, will have to be properly assessed.

By Victoria Gill (Science reporter, BBC News)

Thursday, July 15, 2010

Finally, It's Settled: The Chicken Came First

"It had long been suspected that the egg came first, but now we have the scientific proof that shows that in fact the chicken came first," Sheffield University's Dr Colin Freeman, according to a report in the Metro.

Researchers from Scotland and England used a supercomputer called HECToR to look in such detail at a chicken eggshell that they were able to determine the vital role of a protein used to kick-start the egg's formation.

That protein is only found, wait for it... inside a chicken.

Freeman, who worked on HECToR with counterparts at Edinburgh's Warwick University, said the protein had been identified earlier by scientists and was known to be linked to egg formation, "but by examining it closely we have been able to see how it controls the process," he added, describing it as a catalyst.

Monday, July 12, 2010

Paul the Oracle Octopus goes eight for eight, is amazing

Eight picks, eight correct, eight tentacles. Paul the Oracle Octopus is clearly the biggest winner of the World Cup after recording a perfect prognostication record whether he knows it or not (he probably doesn't).

The big question was whether Paul's predictive superpowers would translate to the final - the first match he was asked to predict that did not involve his native Germany. But such piddly concerns did not bother Paul. Mostly because he's an octopus. Just as he predicted, the European champions Spain became world champions for the first time with an Andres Iniesta goal in extra time. And as the Spanish celebrated, Paul floated in his tank, sure of his genius and probably craving a fresh clam.

Since Paul is an international celebrity of the highest order now, everyone wants a piece of him - both literally and figuratively. Italy is trying to claim that he was caught in Italian waters, Spanish businessmen are trying to buy him for €30,000 ($38,000), and Dutch priests tried to dismiss him.

But in Spain, Paul is an icon. The Spanish prime minister has already spoken of his desire to protect "Pulpo Paul" and the mock up of a new version of Spain's flag could be dangerously close to becoming real.

So what becomes of Paul now? Well, he'll probably continue to live out the remainder of his days at the Sea Life aquarium in Oberhausen, Germany, no longer forced to pick his food out of flag-covered boxes while surrounded by an obscene number of media types. He will swim at his leisure and continue to be oblivious to the existence of sports. He will retire a winner and a global sensation - what every other octopus (and even a few pundits) wishes they could be.

All hail Paul.

Sunday, July 11, 2010

woman gives birth on plane - then 'tries to flush her baby down the toilet'

An unmarried Indian woman gave birth while on board an international flight - then allegedly tried to flush her baby down the airplane toilet.

Horrified cabin crew on board the Turkmenistan Airlines flight discovered the baby in the toilet as they were going through the cabin after passengers had disembarked in Amritsar, India.

They prised the toilet from the plane with the baby still inside and rushed it to hospital.

There surgeons had to cut the toilet away with a saw to get the newborn out, Dr HP Singh said, according to reports.

The baby remains in critical condition at Amritsar's Fortis Escorts hospital, Dr Singh said.

The mother, believed to be aged 25, was arrested in the airport.

She was admitted to the same hospital. He said she was in stable condition.

'She was unmarried. It looks like she wanted to get rid of the baby,' Dr Singh told CNN. Newspapers reported the mother was an unmarried medical student returning home after completing a degree abroad.

Police confirmed she was single and plan to question her once she was declared medically fit.

The mother's flight originated in Ashgabat in Turkmenistan, police said. She originally comes from Punjab's Hoshiarpur district.

Saturday, July 10, 2010

Good news for premature problems-well, for some of it, if not for all.

According to Medscape Medical News, Dapoxetine Hydrochloride (Dapoxetine) has been shown to be effective in all doses for treatment of premature ejaculation (PE). Experts are hopeful that this promising treatment will do for PE what other hugely popular drugs have done for erectile dysfunction.

There are many products that claim to help with PE, but this is the first that is simple, quick and has been proven in scientific studies. Dapoxetine is an easy, on-demand solution for the 30-70% of men who experience premature ejaculation and are looking for a way to last longer in bed.

Dapoxetine was developed specifically for enabling men to lengthen the time before ejaculation. An imbalance in the brain chemical Serotonin has long been believed to be a factor in rapid ejaculation. Because of this, SSRIs are often used "off label" to treat men who experience severe premature ejaculation.

Dapoxetine is considered a "novel SSRI", however, because unlike many similar medications that take over 2 weeks to become effective, it starts working within an hour. The drug is also quickly metabolized by the body. This eliminates the risk of long term side-effects often associated with other SSRIs.

Dapoxetine HCL is the first orally administered drug developed specifically for the treatment of men with premature ejaculation. The safety and effectiveness of Dapoxetine for the treatment of men with PE were studied in five, double-blind, placebo-controlled, Phase III clinical trials. These trials involved over 6,000 men from 30 countries worldwide, including countries in North America, South America, Europe and Asia, and in Israel and South Africa.

Monday, July 5, 2010

Maldivian style of politics- A no win game

Heard it was a Islamic republic,
Heard it was a dictator who was elected by the people,
Heard the votes were rigged,
Heard the people actually sold the vote for couple of bucks
Says the actor turned politician.

Heard there was a new guy,
Who was full of democracy and sanadhu (certificates of all sorts)
Heard him say that he is the most capable
Heard he claims that he is the “fader” of new Maldivian democracy.
Heard him suggesting it’s okey to build places of worship to non-Muslims.
Heard Maldivians were pissed off.

Heard him say he will bring so much to the country,
Saw him go abroad and beg for money,
Saw him sell all the public investments for couple of bucks
That meant nothing in the long run- says the economist.
He tells lies and he is full of crap- says a common man.
He brought shame to the blue sees,
He bought hatred and cacophony to us- says a poor.

Now that the nation is in trouble,
Now he is making drama with his drama queen,
Now he wants to fool every one with his play script,
But we aren’t gonna get fooled just like that-says old folks.

Friday, July 2, 2010

Short inspirational Parable Of The Pencil

The Pencil Maker took the pencil aside, just before putting him into the box.

"There are 5 things you need to know," he told the pencil, "Before I send you out into the world. Always remember them and never forget, and you will become the best pencil you can be."

"One: You will be able to do many great things, but only if you allow yourself to be held in Someone's hand."

"Two: You will experience a painful sharpening from time to time, but you'll need it to become a better pencil."

"Three: You will be able to correct any mistakes you might make."

"Four: The most important part of you will always be what's inside."

"And Five: On every surface you are used on, you must leave your mark. No matter what the condition, you must continue to write."

The pencil understood and promised to remember, and went into the box with purpose in its heart.

Now replacing the place of the pencil with you. Always remember them and never forget, and you will become the best person you can be.

One: You will be able to do many great things, but only if you allow yourself to be held in God's hand. And allow other human beings to access you for the many gifts you possess.

Two: You will experience a painful sharpening from time to time, by going through various problems in life, but you'll need it to become a stronger person.

Three: You will be able to correct any mistakes you might make.

Four: The most important part of you will always be what's on the inside.

And Five: On every surface you walk through, you must leave your mark. No matter what the situation, you must continue to do your duties.

Allow this parable on the pencil to encourage you to know that you are a special person and only you can fulfill the purpose to which you were born to accomplish.

Never allow yourself to get discouraged and think that your life is insignificant and cannot make a change.

by the Unknown Author

Wednesday, June 30, 2010

Flying car one step closer to reality

The Terrafugia, a small airplane that can drive on roads and has been billed as the first "flying car," is now one step closer to becoming street- and sky-legal.

The vehicle has cleared a Federal Aviation Administration (FAA) regulatory hurdle for craft classification by weight. A full-fledged production prototype might be just around the corner, according to multiple reports.

At issue was Mass.-based company Terrafugia wanting its Transition vehicle to be classified as a "Light Sport Aircraft" by the FAA so people eager to fly it would need only 20 hours of flying time.

Yet the two-seater vehicle came in 110 pounds (50 kilograms) overweight in accommodating roadworthy-assuring safety items such as crumple zones. The FAA said that so long as customers are advised about this extra weight, the car-plane hybrid can be sold.

The Terrafugia completed its maiden voyage last March in upstate New York. According to its maker, the Terrafugia can transform from a roadable vehicle that can hit a highway speed of 65 mph to a winged aircraft in 30 seconds.

The plane version can cruise at about 115 mph (185 kph) and cover about 400 miles (644 kilometers) worth of turf before needing a refill of regular unleaded gas.

The price of a Terrafugia is expected to be around $200,000 and deliveries could start next year, assuming the vehicle passes crash tests. The company has envisioned its vehicle as finding a home with amateur pilots who live near air fields, but as any Jetsons' fan knows, flying cars might well be the wave of the future.

by Adam Hadhazy (TechNewsDaily)

Sunday, June 20, 2010

Genetic counseling leads to father’s death and son's life long guilt

As soon as genetics solves one problem, others appear. You might think that the application of science to medicine is an undisputed boon. Petty has provided a compelling counter-example.

A man with Adult Polycystic Kidney disease due to an APKD1 mutation is in end-stage renal failure. A transplant from a matched, living, related, unaffected donor is highly desired. There is a 50:50 chance of passing on the APCD gene to his children. There are problems in his family, but he somehow persuades his adult children to have genetic testing to see if there are eligible donors. Each is apparently happy to donate a kidney to his/her father.

A can of worms is opened when 1 son realizes that he is the only child who can offer a good match. His brother is carrying the same mutation as his estranged father. The eligible son would rather save his kidney to help his brother than his father. Old animosities resurface and the family is in turmoil.

How will you feel if the father dies of a complication of dialysis, and both his sons feel guilty forever? We should not be too surprised at all this. Often in medicine bad comes out of our good intentions.

How can you good outcome out of bad?

By remembering this example and not doing tests lightly and by making genetic counseling as professional as possible. So that the complications can be foreseen and disasters can be pre-empted. Furthermore, don’t have unreasonable expectations about what genetic counseling can do. The number of diseases being found to have a significant genetic component is increasing faster than geneticists can formulate rational guidelines for screening.

Source: Oxford handbook of clinical medicine

Saturday, June 19, 2010

Can the success be a failure?

It’s amazing how you chase after dreams. Every day wake up and say, I want this, I want that. I want more of this and more of that. There is no end for it. It’s okey to want more. The more you have it the happier you are, they say.

Until one day, you realized you have what you worked for. After 5 long years of hardship you get to enjoy the success. Wait a minute, are you really enjoying the success or you are weeping over it? Why so? Did u suddenly realize that you have been neglecting everything else around you for the hunger of this? Now you realize you no longer have what you already had 5yrs ago? Love and respect of people around you-must savor it my friend.

Now, let me ask you how do u measure success my friend? Gold medal? Certificates? Two fantastic thumbs up? I used to measure it similar way. But then I realized sometimes success is not so obvious to differ from failure. Let’s say, North Korea played in the world cup for the first time in such a long time. They are 105th in world soccer ranking. They played against Brazil which is the top. Now, Brazil won the game by 2-1. Or should I say, North Korea lost by 1-2? Either way, same thing right? North Korea still lost right? Some argue otherwise.

That is why, my friend, I say success is a subjective thing. For instance, a lot of people view the game I just mentioned as a success to North Korea and a shameful loss to Brazil. Ironic isn’t it. Similarly, if your family, friends and loved ones are not with you when you achieve a Gold it doesn’t really feels like Gold, bronze or even silver. Sometimes it just feels empty and useless. Needless to go on bragging about this, I believe I made my point here.

Friday, June 18, 2010

The Knysna seahorse - a curious, legendary African fish

Seahorses are thought to have evolved at least 40 million years ago and have survived from ancient times with only very small changes in body structure or organ function.

They are unusual fish that have captured the imagination of artists, writers and poets, being found in the mythology, legends, folklore and superstitions. In fact some people still believe that these endearing creatures exist only in fables and children's stories- This time, they are wrong.

Given their unusual appearance and extraordinary biology, it is not surprising that Asians have credited seahorses with magical powers- like they always do. Seahorses are therefore exploited as traditional medicines. This use has led to concerns that the natural seahorse stocks are being depleted at a rapid and unsustainable rate.

The pregnant male!

Seahorses are the only fish species where the male experiences a true pregnancy. The pregnancy is considered true, as fertilization is internal and the eggs are held in a pouch consisting of tissues, which contain a capillary network which provides oxygen and placental fluid to the embryos.

The pregnancy of the Knysna seahorse lasts up to two or three weeks. The male will then give birth to between 5 and 200 young from one pregnancy and during the male's pregnancy the female will be busy producing more eggs. This means that just a few hours after the male giving birth, the female will once again pass her now ripe eggs into the male's pouch. The male will therefore be pregnant throughout the entire breeding season.

Flirting seahorses?

The seahorses mate monogamously for the entire breeding season. Every day the pair will come together in a ritualistic flirtatious dance to reinforce their connection. This ritual helps keep the pair synchronized reproductively. While the male is pregnant he will move very little, which for a seahorse means not more than a few centimeters.

If a mate is removed or dies, it will take weeks to find a new mate, that is, if it is able to at all! This is because seahorses live in isolated groups and move very little. It is thus extremely difficult to find another seahorse in the same part of the reproductive cycle.

So female look for a mate?

Since it is the male that becomes pregnant it was previously believed that it would be the females that competed for the male partners. This however is simply not the case. Like in most species, it is the male that competes with other males to attract and defend his female seahorse. So, it would appear that the male actually wants to be pregnant. The seahorse male is sounding more and more like every woman's perfect mate! Muwahaha.

Source: Science Africa

Tuesday, June 15, 2010

A solo mission to Kill Osama- By an apparently insane American.

An American man has been detained in the mountains of Pakistan after authorities found him carrying a sword, pistol and night-vision goggles on a solo mission to hunt down and kill Osama bin Laden.

Friends and family say construction worker Gary Brooks Faulkner is a devout, good-humored Christian who was "on a mission" to kill or capture Osama.

Dying man?

Faulkner's sister, Deanna, said her brother suffers from kidney disease that has left him with only 9 percent kidney function. But she told The Associated Press that she did not think his illness was his motivation to go to Pakistan.

"I don't believe this was, 'I'm dying, and I'm going to do a hurrah thing,"' she said.

Scott Faulkner, the man’s brother, said Faulkner was very religious and carried a Bible with him at all times but wasn't planning to proselytize. "He talked about why he was so passionate" to find bin Laden, Scott Faulkner recalled, adding that his brother retained vivid memories of the Sept. 11, 2001 terror attacks. "He has not forgotten". Scott Faulkner dropped his brother off at Denver's airport May 30, and the two discussed the possibility Faulkner would not return alive from his search for bin Laden. But Scott Faulkner insisted his brother was on a rational mission.

"He's as normal as you I," Scott Faulkner said. "He's just very passionate, and, as a Christian, he felt, when Osama mocked this country after 9/11, and it didn't feel like the military was doing enough, it became his passion, his mission, to track down Osama, and kill him, or bring him back alive."

Scott Faulkner said his brother sold all his tools to finance his trip and was prepared to die in Pakistan. He also said his brother took no weapons and had a valid visa for Pakistan. Scott Faulkner hoped his brother wouldn't be charged with a crime.

The 50-year-old Faulkner was in and out of Colorado state prisons between 1981 and 1993, serving a total of about seven years in five separate stints for burglary, larceny and parole violations, state officials said.Nobel & devoted Christian indeed?

He arrived June 3 in the town of Bumburate and stayed in a hotel there. He was assigned a police guard, as is common for foreigners visiting remote parts of Pakistan.When he checked out without informing police, officers began looking for him, according to the top police officer in the Chitral region, Mumtaz Ahmad Khan. Faulkner was found late Sunday in a forest.

"We initially laughed when he told us that he wanted to kill Osama bin Laden," Khan said. But when officers seized the weapons and night-vision equipment, "our suspicion grew." He said the American was trying to cross into the nearby Afghan region of Nuristan.

Khan said Faulkner told investigators he was angry after the Sept. 11 attacks. "I think Osama is responsible for bloodshed in the world, and I want to kill him," Khan quoted him as saying.

Asked why he thought he had a chance of tracing bin Laden, Faulkner replied, "God is with me, and I am confident I will be successful in killing him," Khan said.He said police confiscated a small amount of hashish, enough for a single joint, from Faulkner.

Schizophrenia or Bipolar disorder??

Hugo Corral, who owns a barber shop in Greeley, recalled cutting Faulkner's hair a few months ago. He said Faulkner was quiet and wouldn't answer his questions. After the haircut, Corral said, he saw Faulkner acting strangely outside his shop.

"He would walk, then stop, then do something like he was saluting something. It was kind of weird," Corral said. Through the glass of his shop, he said he could hear Faulkner cursing at no one in particular.

Published: The Star, Wednesday June 16, 2010.

The guardian of the The Gap- A suicide point.

In those bleak moments when the lost souls stood atop the cliff, wondering whether to jump, the sound of the wind and the waves was broken by a soft voice. "Why don't you come and have a cup of tea?" the stranger would ask. And when they turned to him, his smile was often their salvation.

For almost 50 years, Don Ritchie has lived across the street from Australia's most notorious suicide spot, a rocky cliff at the entrance to Sydney Harbour called The Gap. And in that time, the man widely regarded as a guardian angel has shepherded countless people away from the edge.

What some consider grim, Ritchie considers a gift. How wonderful, the former life insurance salesman says, to save so many. How wonderful to sell them life.

"You can't just sit there and watch them," says Ritchie, now 84, perched on his beloved green leather chair, from which he keeps a watchful eye on the cliff outside. "You gotta try and save them. It's pretty simple."

Since the 1800s, Australians have flocked to The Gap to end their lives, with little more than a 3-foot (1 meter) fence separating them from the edge. Local officials say about one person a week commits suicide there, and in January, the Woollahra Council applied for 2.1 million Australian dollars ($1.7 million) in federal funding to build a higher fence and overhaul security.

In the meantime, Ritchie keeps up his voluntary watch. The council recently named Ritchie and Moya, his wife of 58 years, 2010's Citizens of the Year.
He's saved 160 people, according to the official tally, but that's only an estimate. Ritchie doesn't keep count. He just knows he's watched far more walk away from the edge than go over it.

Each morning, he climbs out of bed, pads over to the bedroom window of his modest, two-story home, and scans the cliff. If he spots anyone standing alone too close to the precipice, he hurries to their side.

Some he speaks with are fighting medical problems, others suffering mental illness. Sometimes, the ones who jump leave behind reminders of themselves on the edge — notes, wallets, shoes. Ritchie once rushed over to help a man on crutches. By the time he arrived, the crutches were all that remained.

In his younger years, he would occasionally climb the fence to hold people back while Moya called the police. He would help rescue crews haul up the bodies of those who couldn't be saved. And he would invite the rescuers back to his house afterward for a comforting drink.
It all nearly cost him his life once. A chilling picture captured decades ago by a local news photographer shows Ritchie struggling with a woman, inches from the edge. The woman is seen trying to launch herself over the side — with Ritchie the only thing between her and the abyss. Had she been successful, he would have gone over, too.

These days, he keeps a safer distance. The council installed security cameras this year and the invention of mobile phones means someone often calls for help before he crosses the street.

But he remains available to lend an ear, though he never tries to counsel, advise or pry. He just gives them a warm smile, asks if they'd like to talk and invites them back to his house for tea. Sometimes, they join him.

"I'm offering them an alternative, really," Ritchie says. "I always act in a friendly manner. I smile."

A smile cannot, of course, save everyone; the motivations behind suicide are too varied. But simple kindness can be surprisingly effective. Mental health professionals tell the story of a note left behind by a man who jumped off San Francisco's Golden Gate Bridge. If one person smiles at me on the way to the bridge, the man wrote, I will not jump.

"A smile can go a long way — caring can go even further. And the fact that he offers them tea and he just listens, he's really all they wanted," Hines says. "He's all a lot of suicidal people want."

In 2006, the government recognized Ritchie's efforts with a Medal of the Order of Australia, among the nation's highest civilian honors. It hangs on his living room wall above a painting of a sunshine someone left in his mailbox. On it is a message calling Ritchie "an angel that walks amongst us."

He smiles bashfully. "It makes you — oh, I don't know," he says, looking away. "I feel happy about it."

Despite all he has seen, he says he is not haunted by the ones who were lost. He cannot remember the first suicide he witnessed, and none have plagued his nightmares. He says he does his best with each person, and if he loses one, he accepts that there was nothing more he could have done.

Nor have he and Moya ever felt burdened by the location of their home.

"I think, 'Isn't it wonderful that we live here and we can help people?'" Moya says, her husband nodding in agreement.

Associated Press Writer (updated 12:07 p.m. ET June 13, 2010)

Saturday, June 12, 2010

Epilogue: The man in a red canoe who saved a million lives

Mostly we commute to work each day driven by motives we would rather not look at too deeply. But one renal physician used a red canoe to commute each day from his house boat to the hospital. He could have been a very rich man, but instead Belding Scribner gave his invention away, and continued his modest existence.

He invented the Scribner shunt- a U of Teflon connecting an artery to a vein, and allowing haemodialysis to be something which could be repeated as often as needed. Before Scribner, a glass tube had to be painfully inserted into the blood vessels, which would be damaged by the procedure and haemodialysis could only be done for a few cycles.

Clyde Shields was his first patient with chronic renal failure to receive the shunt on 9 March 1960, and said that his first treatment “took so much of the waste I’d stored up out of me that it was just like turning on the light from darkness”.

Scribner took that was something 100% fatal and overnight turned it into a condition with a 90% survival. In doing so, he founded a branch of bioethics because not everyone could have the treatment immediately. This is the branch of ethics that is to do with who gets what- ie distributive justice. In Scribner’s day, this was decided by the famous ‘life and death committee’ which had the unenviable job of choosing who would survive by placing people in order precedence.

Scribner said that his inventions sprang from his empathy for patients, including himself. ‘I was a sickly child’ he said, and at times he needed a heart-lung machine, a new hip, and donated corneas. He was the sort of man whose patients would inspire him to worry away at their problems during the day- and then to awake at night with a brilliant solution.

On 19 June 2003, his canoe was found afloat but empty- and like those ancient Indian burial canoes found at Wiskam which have been polished to an unimaginable lustre by the action of the shifting sand around the island of the dead, so we polish and cherish the image of this man who gave everything away.

source: Oxford Handbook of Clinical Medicine.

Sunday, June 6, 2010

~Honey bee~ By Zee Avi.

I am a honey bee
Shunned off from the colony
And they won’t let me in
So I left the hive
They took away all my stripes
And broke off both my wings
So I’ll find another tree
And make the wind my friend
I’ll just sing with the birds
They’ll tell me secrets off the world

But my other honey bee
Stuck where he doesn’t wanna be
Oh my darling honey bee
I’ll come save you
Even if it means I’ll have to face the queen

So I’ll come prepared
My new friends say they would help me
Get my loved one back
They say it isn’t right
The bees have control of your mind
But I choose not to believe that
So we’ll meet in the darkness of the night
And I’ll promise I will be there on time
We’ll be guided by my new friends the butterflies
Bring us back to our own little hive

Oh my other honey bee
No longer stuck where he doesn’t wanna be
Oh my darling honey bee
I have saved you
And now that you’re with me
We can make our own honey

Wednesday, June 2, 2010

Parting speech: meaningful words.

It’s the season finale~mbbs. Graduates are overwhelmed with joy with the result of their 7 yrs of hardship. A worthwhile celebration, I would say. A long waited and indeed a sweet fruit of asperity. I can’t say I’m quite as excited as the rest of 103. But still, I’m excited too-perhaps very excited, compared to my usual dysthymic mood.

Today we had the most important event of our life. “Today you got the key to unlock your future” said one of our shīfus.

I was kinda touched to undertake this Oath~Muslim physician’s oath. It made me feel like now I have a real deal of responsibility on my head- though what already stuffed on my head isn’t anything less. I have read this many more times. I have written it many times. But still, saying it aloud with the rest of us in front of handful of lecturers felt special- really awesome feeling it was.

Not long time ago, our ex-shīfu (actually still our shīfu), talked to us about the purpose of IIUM. He mentioned that there are many medical schools in Malaysia. “Yet we wanted one, because we wanted an Islamic medical school”. “But that doesn’t mean we are going to be any less than other medical schools in our medical teachings. You have to master medicine 1st, and then you will add on Islamic knowledge to perfect it”.

During today’s ceremony, we had the benefit of valuable parting speeches by our current shīfu and deputy shīfu as well. Initially, I thought it would be just another lecture on medical ethics, perfecting our clinical skills etc. I was quite a bit wrong. I was moved to know what their priorities were. To my surprise, they didn’t talk much about doing so great in terms of clinical skills. “I honestly believe we have given enough knowledge to become good doctors” said the deputy dean.

They rather focused on another issue which we thought is not that significant, but the fact that they brought it up today, the last day they see us before we depart from this institution, made it pretty clear that this is the real important stuffs.

Prof Fauzi, our Dean, emphasized on 3 simple, but crucial points as his last word of advice to us. First and foremost, he stressed on importance of taking care of our surrounding. Ofcz, he was talking about family, to be a good son/daughter, good father/mother and a good husband/wife. Next thing he stressed was about giving our full commitment to whatever we do. Do it wholeheartedly. And do your best in everything you do.

Thirdly, he spoke of doing things for others. It is clear that ultimate satisfaction for man comes from giving to the society. But often man is only able to see this, and do this when he is old; when he has seen all the shades of life- then it becomes natural for man to work hard to win societal approval. But the dean in this particular day, suggested to his newly graduated students to do it now. To serve the community, to serve for the people from now on- no need to wait till your old and become a politician to serve the community.

Today they didn’t talk about the medical stuffs, which they had been doing for past 5yrs. Now they stressed on more important aspect of life which actually makes us a valuable share of society. “Obviously, doctors are the worst of fathers-no! not bad fathers, but worst of husbands, worst of friends, and worst of neighbors’. That is why I want you all to be better in these aspects and becomes a better person a whole” one of them said. Which I believe is the most valuable words of advice one could give us the day we leave this place for good.

Saturday, May 29, 2010

This is just the beginning

Target are easy to set, hard to achieve, and even more difficult to maintain. Think of a football team. Their target is so clear, to win the cup. Sometimes they win, sometimes they lose. But if they win, they just have to keep trying harder and harder to maintain. If they lost, they have to work as much. No win situation? I thought so.

As kids grow up, all sorts of ambitions surface up. The reason why they wanna be a particular "thing"? Pretty much hilarious. “what do u wanna become when u grow up” teacher asked, “I wanna be an elephant” replied the boy. He now is a big tall army officer. How close one can get to achieve his dream?

I always wanted to fly. Fly something, a plan, a kite or even a butterfly. Do u know doing a 12months pilot trainee in US coasts as much as that of a 5yrs MBBS course in Malaysia? So after much of back breaking process of weighing the pros and cons, I decided to come here. Alhamdhlillah. I think I made the right choice.

….and the journey started long time ago. Slowly getting the tone of it, hard to adjust to new life as I kept complaining all the time. But then, before I knew it, 5yrs passed by. Here I am now. Kinda happy that it’s over, but not totally over lah.

We all made sacrifices. At times we scarified our sleep. Sometimes stayed hungry waiting in labour room. There were times we stayed back without going home for Raya Holidays. (it’s a big thing for some of us). So we finally achieved our goals. Alhamdhlillah.

But what does this mean? Like a foot ball team, we can’t stop now. Once we achieved the title, we got to work even harder, over the clock, throughout the day and night, to maintain our title and to adhere to our oath.

“To be instrument of thy will and mercy, and, in all humbleness, to exercise justice, love and compassion for all thy creations: To extend my hand of service to one and all, to the rich and to the poor, to friend and foe alike, regardless of race, religion and culture: To hold human life as precious and scared, and, to protect and honor it at all times and under all circumstances in accordance to thy law: To do my utmost to alleviate pain and misery, and to comfort and counsel human beings in sickness and in anxiety”

Bottom line is… this is just the beginning. I would like to extend my warm felicitations to all my colleagues and wish you all the best in all your future endeavours.

Friday, April 30, 2010

Mysterious nothing box

Besides very obvious physical differences, one of the amazing differences between man and women is their brain. Not the morphology ofcz, but how the brain works. Don’t duh me, I can prove it.

Let’s think of a man’s brain as a warehouse filled with many boxes. Each and every box is dedicated for a particular subject. There is one box for car, one box for job, one box for children, one box for you and one box for your mother- its somewhere in the basement. The boxes are bound by one rule: boxes never touch each other. When the man wants to discuss a topic, he just take one box, open it, and discuss what’s in that box and then close it, put it back very carefully not to touch any other boxes. That’s men.

In contrast, a woman’s brain is like a ball of wires. Zillions of microscopic centers and each and every one is connected like a complicated mesh. Job is connected to house, house connected to car, car connected to kids, kids connected to mother in law, and mother in law connected to father in-law and so on. It’s like the internet super highway. It’s driven by the energy called “emotion”. That is why women tend to remember everything..bcz they care about everything. Which men don’t!

Now, men, have a box in their brain that women are not aware of. This particular box has nothing in it. In fact we call it “the nothing box”. Of all the boxes in our brain, the nothing box is our favorite box. That is why a man can do something completely brain-dead for hours. Like fishing or sitting in front of TV and flipping channels. Until you hear a scream from the kitchen “stop thaaaat! You can’t possibly be watching anything”. Im not! Go away!

Recent researches done on human brain have actually proved that man has the unique ability to think about nothing…. “teeeeeet”. It’s just a straight line. But women’s brain is always active.. “tzzzzzzzz”. Something is always going on, be it early morning or middle of the night. That’s why women don’t understand this nothing box- and it drives them crazy!

There are women who asks, can I go to this nothing box with him? “no u can’t, then there is something”. Besides, you’d go in there and say “u know this place could really use some wall pictures, a nice coffee table there and some flowers here”… Noooo! Nothing. We don’t want nothing in our "nothing box". Get out!

Friday, April 2, 2010

“Mangkuk” is a bowl, but also an artful Malay word

“Korang ni semua mangkuk mangkuk lah” Said a surgeon while addressing a bunch of medical students. Literally it would translate to something like “you all are bowls”. He wasn’t taking about types of ceramics or plastic polymorphs from which bowls are made. It was more of a metaphorical expression.

What did he mean?

“Do you know what a mangkuk is?” asked the big guy. One scared little girl at the back mumbled “it’s less severe than bodoh”.

“Bodoh” is another widely used Malay term to describe some ones incapacity to handle a situation well, or rather when someone fails to please another person, and then he is a “bodoh”. Yeah! again, much different from its literal meaning in English, ie “idiot”.

That wasn’t his definition!

“That is not my definition; to me mangkuk is you all” he said with a grin on his face.Did he mean mangkuk is best defined by medical students?

“You all are from International Islamic University, you all are not idiots. You are intelligent, how many “A”s are we talking about? 10A, 12As, some can’t even count the number of “A”s they have” He explained further.

“You know it. We expect you to know it, you have been taught it all, but u can’t use it, you can’t apply it; that makes you all mangkuk- mangkuk besar!” – Of cause mangkuk besar would then mean we are bigger bowls than other small bowls.

Oo! Wait, I think I’ve got it! Mangkuk is just a person who holds loads of knowledge. But cant make use of the knowledge. Like manguk sayur, it just stores the sayur. Doesn’t eat it. Ha!!

Different people with different definitions!

Don’t just over generalize it. For another person, mangkuk might be a different entity. So, it’s little difficult to say what they actually mean by it unless you get a first hand explanation from the person himself. Nevertheless, we hear it pretty often.

At the beginning when you hear it, you may think it’s all the same, but believe me, it’s actually different. For orthopaedic surgeons "mangkuk" is a medical student, while “mangkuk besar” is a House Office (HO) and at this rate, Medical Officer (MO) would become “mangkuk besar sangat”.- a very big bowl indeed!

Since “mangkuk” is such a widely twisted terminology, I believe here it somehow signifies the closeness of the MS, HO and MO to the specialist. Or rather it might just be an expression of the degree of the knowledge the three group of people have- or rather supposed to have. That may explain the ascending scale of besar-ness of the mangkuk.

Take home message; Even though mankuk sayur and mangkuk ayam is understood well in general population, other professions has its own definition of mangkuk. Therefore, practice caution while using and digesting it.

Tuesday, March 30, 2010

When doctors are too busy to care...

I'm not much of a worked up person when it comes to others feelings. I used to say, I just don’t care about what my friends say or think about me as long as they don’t say it right on my face. But even I happen to get emotional sometimes when I see how neglectful we can be.

I met this retired gentleman in the ward who came with right leg swelling about two months ago. Had been treated for filariasis in another hospital even when the blood film was negative and it turned to be a vain attempt. Fair enough. Let’s say the clinician made a "clinical" diagnosis and trial of treatment is just another way of "diagnosing" things, even though you wouldn’t like this kinda treatment on yourself.

He sought further medical attention in our centre (I mean the place where we go to study: P). His drs did the right thing considering other diagnoses and decided to investigate further. With extensive investigations it was found that he had cellulitis of right leg due to lyphatic obstruction, a right psoas abcess, and finally mycosis fungoides. Further investigations proves that he had "some kinda" malignancy going on with multiple lymphatic obstruction, satellite lesions in liver, kidney and pulmonary effusion as well. So let’s consider "it’s an advanced disease"- That is just excellent they managed to solve at least half of the mystery. Investigations are still going on to find the exact location of the disease.

I saw him again a month later; rarely do I get to talk to patients without a second tongue, so I was happy to see him again. Asked him how he is feeling, “want to climb a chair and jump off the building” he replied. I was taken aback by caustic remark. What happened? Is he terminal? Going through severe depression? He used to be such a nice gentleman, somebody must have broken him- I thought to myself.

Another friend of mine and I sat there at his bedside for an hour, not taking history, but just listening to him. He had lots of complaints about staffs at the hospital. Doctors, nurses, students,-anyone who walk in and out, basically.

“Yeah, he is a retired civil servant, what else do expect from old people like that” – you may think.

But let’s listen to what he had to say. “It’s been two months. They had been doing this and that, poking here and there. They don’t know where it is, what it is..made me eat medicine for Filaria, then say it’s not filarial, then say cancer, then say something else” I could see frustration on his face as he spoke with explosive tone and sometimes he paused for a deep breath- a sigh of frustration. We tried to explain to him the rationale of the persistent poking. How difficult it is sometimes to reach a definitive diagnosis when patients present with atypical presentations.

“I could accept that, but then why not say so, why do you have to be so ignorant of our feelings. We are not dead yet”.

Yep, he is right, this not a car which has a punctured tire that you take to a mechanic and point a finger to the tire-the mechanic would just fix it without saying a word. What if you took your car to the mechanic and you said it got a problem and the mechanic just started hammering the engine from sideways and didn’t tell you what he is doing? Would you be mad? Old man is not a car! He is a living being with feelings like howmuch we do.

The old man had more complaints.

“the nurses: they are not here to care for patients. They are too busy writing..Patient is sleeping..Patient is awake..Patient is not well today like other day” he elaborated on his statement.

“Sometimes I feel like doctors are just here to get salary. Only few are really concerned about me. They come in a gang..Like a group of flies..expose me and look at..and talk to themselves..write so many things. And then just go away. They tell me nothing.”

“ I asked them what is my problem, when can I go home, they said; have to talk to dr x (an old consultant), he is not around..look at my leg its getting worse, I cant even walk now, its so painful.. Sometimes I wonder what will happen to me if dr x is not here, he is the only one who actually care” – old man had a dry throat. But so much he had to say.

Finally he asked me “ what do you think? Am I just whining or do I really have a point- you are from IIUM, is that how they teach you to treat your patients” – Glad he expected something better from IIUM. I bragged about our “bio-psycho-socio-spiritual” model of management. But he knows that’s just theoretical crap and in reality nobody works that way.

“Sometimes I do wonder if we, people in health "care" profession are missing a heart. You may have the skill, knowledge and attitude but what if you don’t have an empathetic heart. what’s the use?”-I asked myself.

It’s understood that a busy HO or MO don’t get time to sit by the patient and talk about patients feelings-unless you are in psychiatry ward, of cause. But are we that busy for us not to even greet the dying old man when we see him and ask him how he is doing? Are we that preoccupied with commitments that we can’t even explain to him what we are doing and why we are doing it? I believe this has to change.

“ I want to help sick and those in pain, I want to make the old and dying person feel better” -You will surely hear this fancy answer when you ask anybody in medical school why do they want to be a doctor. But are we really doing it? Being busy is just not an excuse. Simply because you don’t want to be taken care by such a busy doctor when you are on the sick bed counting your last days.

Thursday, February 25, 2010

"Crabbit Old Woman"

What do you see, what do you see?
Are you thinking, when you look at me-
A crabbit old woman, not very wise,
Uncertain of habit, with far-away eyes,
Who dribbles her food and makes no reply
When you say in a loud voice,
I do wish you'd try.
Who seems not to notice the things that you do
And forever is loosing a stocking or shoe.
Who, unresisting or not; lets you do as you will
With bathing and feeding the long day is fill.

Is that what you're thinking,
Is that what you see?
Then open your eyes,
nurse, you're looking at me.
I'll tell you who I am as I sit here so still!
As I rise at your bidding, as I eat at your will.

I'm a small child of 10 with a father and mother,
Brothers and sisters, who loved one another-
A young girl of 16 with wings on her feet,
Dreaming that soon now a lover she'll meet,
A bride soon at 20- my heart gives a leap,
Remembering the vows that I promised to keep.
At 25 now I have young of my own
Who need me to build a secure happy home;
A woman of 30, my young now grow fast,
Bound to each other with ties that should last;
At 40, my young sons have grown and are gone,
But my man's beside me to see I don't mourn;
At 50 once more babies play around my knee,
Again we know children, my loved one and me.

Dark days are upon me, my husband is dead,
I look at the future, I shudder with dread,
For my young are all rearing young of their own.
And I think of the years and the love that I've known;
I'm an old woman now and nature is cruel-
Tis her jest to make old age look like a fool.
The body is crumbled, grace and vigor depart,
There is now a stone where I once had a heart,

But inside this old carcass, a young girl still dwells,
And now and again my battered heart swells,
I remember the joy, I remember the pain,
And I'm loving and living life over again.
I think of the years all too few- gone too fast.
And accept the stark fact that nothing can last-
So open your eyes, nurse, open and see,
Not a crabbit old woman, look closer-
See Me.

(The following poem was among the possessions of an aged lady who died in the geriatric ward of a hospital.)

A Nurse's reply "To the Crabbit Old Woman"

What do we see, you ask, what do we see?
Yes, we are thinking when looking at thee!
We may seem to be hard when we hurry and fuss,
But there's many of you, and too few of us.

We would like far more time to sit by you and talk,
To bath you and feed you and help you to walk.
To hear of your lives and the things you have done;
Your childhood, your husband, your daughter, your son.

But time is against us, there's too much to do -Patients too many, and nurses too few.

We grieve when we see you so sad and alone,
With nobody near you, no friends of your own.
We feel all your pain, and know of your fear
That nobody cares now your end is so near.
But nurses are people with feelings as well,
And when we're together you'll often hear tell
Of the dearest old Gran in the very end bed,
And the lovely old Dad, and the things that he said,
We speak with compassion and love, and feel sad
When we think of your lives and the joy that you've had,
When the time has arrived for you to depart,
You leave us behind with an ache in our heart.
When you sleep the long sleep, no more worry or care,

There are other old people, and we must be there.
So please understand if we hurry and fuss -
There are many of you, And so few of us.

The origin of HIV and AIDS

For over twenty years it has been a cause of countless arguments, with everything from a promiscuous flight attendant to a suspect vaccine program being blamed. What is the truth?

The first recognized cases of AIDS occurred in the USA in the early 1980s. A number of gay men in New York and California suddenly began to develop rare opportunistic infections and cancers that seemed stubbornly resistant to any treatment. At this time, AIDS did not yet have a name, but it quickly became obvious that all the men were suffering from a common syndrome.

What type of virus is HIV?

HIV is a lentivirus which attacks the immune system. The name 'lentivirus' literally means 'slow virus' because they takes heck of a long time to manifest as a disease. They have been found in a number of different animals, including cats, sheep, horses and cattle. But the most interesting lentivirus in terms of its relation to HIV is the Simian Immunodeficiency Virus (SIV).

So did HIV come from Chimps?

It is now generally accepted that HIV is a descendant of a SIV because certain strains of SIVs bear a very close resemblance to HIV-1 and HIV-2.

HIV-2 for example corresponds to SIVsm, a strain of the SIV found in the sooty mangabey (White-collared monkey)-indigenous to western Africa. Other closest counterpart of HIV that had been identified was SIVcpz-found in chimpanzees.

Scientists now believe that chimpanzees were the source of HIV-1, and that the virus had at some point crossed species from chimps to humans. It was then concluded that all three 'groups' of HIV-1 - namely Group M, N and O came from the SIV found in this particular Chimp (P. t. troglodytes), and that each group represented a separate crossover 'event' from chimps to humans.

How could HIV have crossed species?

It has been known for a long time that certain viruses can pass between species. As animals ourselves, we are just as susceptible. There are various theories about how this 'zoonosis' took place, and how SIV became HIV in humans:

The 'Hunter' Theory

In this scenario, SIVcpz was transferred to humans as a result of chimps being killed and eaten or their blood getting into cuts or wounds on the hunter. Initially the body would have fought off SIV, with time it adapted itself within human host and became HIV-1. The fact that there were several different early strains of HIV, each with a slightly different genetic make-up, would support this theory as every time it passed from a chimpanzee to a man, it would have developed in a slightly different way within his body, and thus produced a slightly different strain.

The Oral Polio Vaccine (OPV) theory

Some other rather controversial theories have contended that HIV was transferred iatrogenically. One particularly well-publicized idea is that polio vaccines played a role in the transfer.

An oral polio vaccine called “Chat” was tested on about a million people in the Belgian Congo, Ruanda and Urundi in the late 1950s. This theory suggests that “chat” was grown in kidney cells taken from infected chimps. This would have resulted in the contamination of the vaccine with chimp's SIV, and a large number of people subsequently becoming infected with HIV-1.

People have contested saying that local chimps were not infected with a strain of SIVcpz that is closely linked to HIV. Furthermore, the oral administration of the vaccine would seem insufficient to cause infection in most people as virus needs to get directly into the bloodstream to cause infection.

Later, Wistar Institute in Philadelphia (one of the original manufacturers of the Chat vaccine) announced the vaccine was analyzed and no trace had been found of either HIV or chimpanzee SIV.

The Contaminated Needle Theory

Even though the use of disposable plastic syringes became common around the world in 1950s, some parts of Africa might not have done so. It is therefore likely that one single syringe would have been used to inject multiple patients without any sterilization in between. This would rapidly have transferred any viral particles from one person to another, allowing virus to mutate and replicate.

The Colonialism Theory

During the colonial rule Africans were forced into labour camps with poor sanitation, scare food supply and physical demands were extreme. Prostitution was widespread and workers would have been treated with poor health ethics including non sterile needles. These factors alone would have been sufficient to create poor health in anyone, so SIV could easily have infiltrated the labour force and taken advantage of their weakened immune systems to become HIV.

The Conspiracy Theory

A a significant number of African Americans believe HIV was manufactured as part of a biological warfare program, designed to wipe out large numbers of black and homosexual people. Many say this was done under the auspices of the US federal 'Special Cancer Virus Program' (SCVP), possibly with the help of the CIA. Spread through smallpox inoculation programme, or to gay men through Hepatitis B vaccine trials.


Saturday, February 20, 2010

Neurocutaneous syndromes- always a big worry.

Neurofibromatosis (mostly familial)

T1: requires 2 of following for the dx
1)6 or more Café-au-lait spots (>5mm in pre, >15mm in post puberty
2)Axillary/inguinal freckling
3)2 or more Lish nodules (may need Slit lamp)
4)2 or more Neurofibroma ( 1 plexiform neurofibroma)
5)A distinctive osseous lesion (phenoid dysplasia, or cortical thinning of long bones)
6)Optic gliomas
7)A first-degree relative with NF-1
Assoc: Scoliosis, kyphosis, pseudoarthrosis, Gliomas, Mental retardation, seizures, neurofibrosarcoma, hypertension

T2: 10% of all NF,diagnosis needs 1 of…

1)Bilateral acoustic neuromas
2)First deg relative with NF-2 and either unilateral acoustic neuroma or any two of the following: neurofibroma, meningioma, glioma, schwannoma, or juvenile posterior subcapsular lenticular opacities.
Assoc: CNS tumours

Tuberous Sclerosis (Autosomal Dominant)

1)infantile spasms (hypsarrhythmic EEG pattern)
2)Ash leaf spots/ Amelanotic Navi (Wood ultraviolet lamp)
3)Adenoma sebacium (rare b4 2yr)
4)Shagreen paches
5)Subungual or gingival fibroma
6)Café-au-lait spots
7)retinal pharcoma
Assoc: Mental Retradation, developmental delay, palpable kidney (PCKD), epilepsy, cardiac rhabdomyomata, calcified tubers in the periventricular area (CT)

Mc_Cune Albright Syndrome (non familial)

Aka Polyostotic fibrous dysplasia. Features are…
1)Precauceous puberty (3-4yr, f>m)
2)Café-au-lait spots
3)Fractures/skeletal asymmetry
4)Assoc: Multiple endocrinopathy ( adrenal hyperplasia, thyroid, parathyroid and Growth Hormone abnormalities)

Sturge-Weber Syndrome (sporadic)

Features are…
1)Port wine stain at maxillary/ophthalmic division of trigeminal nerve
2)Ipsilateral: Oxophthamos, colobomata, glaucoma, buphthalmos.
3)Contralateral hemiparesis
4)Homonymous hemianopia
5)Taleniectasia of conjunctiva
6)Dark red fundus (retinal detachment)
Assoc: Epilepsy, mental retardation, cranial calcification (CT)

Von Hippel-Lindau Disease (Autosomal Dominant)

Features include:
1)Cerebellar hemangioblastomas (increase ICP)
2)Retinal angiomata (vision is unaffected until retinal detachment occurs)
3)Hemangioblastoma of the spinal cord (abnormalities of proprioception and disturbances of gait and bladder dysfunction)
4)CT scan typically shows a cystic cerebellar lesion.
5)Cystic lesions of the kidneys, pancreas, liver, and epididymis as well as pheochromocytoma, ranal carcinoma.

Child with Fever and Rash- a confusing condition?

Fever plus rash is a common combination seen in children. Often comes in out breaks. Most of the time diagnosis is made on clinical grounds and treated accordingly. Therefore it is important to know the differentials for a child with this problem.


I=7-10d, fever, coryza, cough, conjunctivitis, catarrh, Koplik’s spot.
Rash: 4th day, behind the ear to face and trunk (red, maculopapular)
Cplx: pneumonia, Otitis media, Encephalitis
Ix: raise in measles antibody titre, Immunoflourescence of Nasopharyngeal aspirate
Tx: symptomatic fluid and PCM, no antibiotics unless complicated


I= 10-21d, URTI, catarrh, cervical/suboccipital lymphadenopathy
Rash: erythematous, mainly on trunk
Cplx: Arthralgia, encephalitis (rare in childhood)
Ix: virus culture from stool/nose, rubella antibody titre

Mumps (no rash)

I=4-28d, parotitis (other glands rarely involved)
Cplx: meningitis, pancreatitis, orchitis
Ix: virus isolation from saliva, lymphocytosis, rise of Mumps antibody titre

Varicella (chicken pox)

I=10-21d, fever, rash (itchy): evolves from papules to vesicles, pulstures and scabes
Cplx: conjunctival lesion, encephalitis
Ix: electron microscopy of fluid from vesicles and virus culture, monoclonal antibody

Scarlet fever

I= 1-7d, (URTI) tonsillitis, rash (diffuse, erythematous, mainly on trunk 24-48hr after onset, papular, erythematous on trunk and limbs-looks red, face spared, blances, 3-4 d later rash fade with desquamation on hands, feet.)
Cplx: otitis media, Rh fever, Acute Nephritis
Ix: Throat swab for grp A haemolytic streptococcus, raised ASOT
Tx: penicillin V (250 mg/dose bid–tid PO) for 10 days, or benzathine penicillin G (600,000 IU for ≤60 lb, 1.2 million IU for >60 lb, IM) for compliance. Erythromycin (erythromycin estolate 20–40 mg/kg/24 hr divided bid–qid PO, or erythromycin ethylsuccinate 40 mg/kg/ 24 hr divided bid–qid PO) for 10 days

Other Differential Diagnoses to be considered:

Kawasaki disease (fever, rash, red swollen moth/hand/foot)

Meningococcemia (N. Meningitidis)

Roseola infentum (herpes 6&7)

Erythema infectiosum (parvo virus)

Dengue fever (fever, rash, bleeding, joint pain)

Hand foot mouth disease (coxsacie A)

Ricketsial diseases: Rocky Mountain spotted fever, Mediterranean spotted fever (eschar), scrub typhus (eschar) Dx by immunohistologic demonstration of rickettsiae on skin biopsy. Dec plt and wbc

I(incubation peiod), Ix (investigations), Tx (treatment), Dx (diagnosis) Cplx (complications)

Saturday, January 9, 2010

Lassa fever - African version of Leptospirosis?

An acute viral illness that is endemic in parts of West Africa (Guinea, Liberia, Sierra Leone and Nigeria). Caused by, Lassa Virus (family Arenaviridae), a single-stranded RNA virus and is zoonotic. The reservoir of Lassa virus is a rodent known as the "multimammate rat" of the genus Mastomys. Rodents shed the virus in urine and droppings.

Therefore, the virus can be transmitted through direct contact with these materials, through touching objects or eating food contaminated with these materials, or through cuts or sores. Also spread through person-to-person by contact with virus in the blood, tissue, secretions, or excretions of an individual infected with the Lassa virus.

In some areas of Sierra Leone and Liberia, it is known that 10%-16% of people admitted to hospitals have Lassa fever.

Signs and symptoms of Lassa fever typically occur 1-3 weeks after the patient comes into contact with the virus. These include fever, retrosternal pain, sore throat, back pain, cough, abdominal pain, vomiting, diarrhea, conjunctivitis, facial swelling, proteinuria, and mucosal bleeding. Neurological problems have also been described, including hearing loss, tremors, and encephalitis.

Diagnosis is by detecting IgM and IgG antibodies as well as Lassa antigen by ELISA. The virus itself may be cultured in 7 to 10 days. Immunohistochemistry performed on tissue specimens can be used to make a postmortem diagnosis. The virus can also be detected by RT-PCR

Ribavirin has been used with success in Lassa fever patients. (most effective in the early course of the illness). The most common complication of Lassa fever is deafness- and in many cases hearing loss is permanent.

Approximately 15%-20% of patients die, can be as high as 50% in sever cases. However, overall only about 1% of infections with Lassa virus result in death. The death rates are particularly high for women in the third trimester of pregnancy, and for fetuses, about 95% of which die in the uterus of infected pregnant mothers.