Five research papers that revolutionised health

Kids

Some very interesting insights into how medical research was published and how pretty much every medical insight was thought to be stupid. I learnt this German  term yesterday while doing the learning to learn course. It say that our previous learning can actually stop us from learning new things. So true. I need to constantly keep my mind open to new ideas and thoughts. 

Saying no is too easy son. Stay away from people who reflexively say no. Listen to them but keep working away. It's not easy to fight. I'm struggling against some entrenched interests to get a pet subject launched. One year and I'm getting there. Fun times. 

Anyway. Much interesting aspects in the story here. 

Love

Baba

Five research papers that revolutionised health
http://www.bbc.co.uk/news/health-31869173
(via Instapaper)

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15 March 2015 Last updated at 10:16 By Deborah Cohen BBC Health Check

The world’s first scientific journal with its founders Viscount Brouncker, King Charles II and Francis Bacon

You are unlikely to find The Lancet, Thorax or the Journal of the American Medical Association in your doctor’s waiting room, but their contents have more impact on your health than the usual lifestyle magazines.
Such journals, where papers are reviewed by other scientists in the same field - are where researchers set out their findings about how diseases occur, which drugs save lives or what surgical procedure is best.
The first scientific journal - Philosophical Transactions - was published 350 years ago this month. It is still produced now - along with thousands of others.
Here are five of the many papers that have transformed medical practice - and people’s lives - over the centuries.
JAMES JURIN AND INOCULATION - PREVENTING SMALLPOX

Indian Doctors in Kenya, 1895–1940: The Forgotten History

I havent read the book, just read the review and it was interesting in its own rights. You normally associate Indian emigrants as labourers and agricultural workers during the British Empire because that's what they were in the majority, but you dont really hear about the other professions. Yes, Yes, I know Gandhi was a lawyer and there were many who went out there to setup businesses but professions? not that much. the abstract is quite interesting

The story of Indian doctors in Kenya has been “almost entirely written out of the history books” (1). Thus begins Anna Greenwood and Harshad Topiwala’s careful and exhaustively researched monograph, which aims to rectify this oversight by providing a collective biographical portrait of the two hundred or so Indian doctors who practiced Western medicine in Kenya between 1895 and 1940. Topiwala, the son of a Kenya Indian doctor, and Greenwood, a historian of East Africa’s colonial medical service, argue that Indians supplied a “cheap, and also appropriately educated, medical labour force” (33), yet faced harsh material conditions, unequal pay, and a largely hostile European medical establishment. The British colonial state, understaffed and undercapitalized, initially leaned heavily on India for a range of assets—the wealth of its traders, the labor of its indentured servants, and the expertise of its professionals. Yet, as white settlement and political power surged in Kenya by the early 1920s, the Indian presence came to be seen more as a threat than a resource. By 1924, the colonial medical service dismissed its forty-four Indian doctors under the cynical banners of …

More active duty personnel die by own hand than combat

I attended a lecture on Wounded Minds at the old alma mater. Fascinating stuff. the lecturer talked about the following:

The First World War not only shaped the lives of thousands of young men and their families but also sparked a significant transformation in the treatment and understanding of mental illness. For many the trauma of war didn’t end with the final gunshot; the phenomenon of shell shock saw soldiers return home still reeling from the horror of what they’d seen. Whilst many of their symptoms – dizziness, loss of appetite, and deafness – were typical of having sustained a head injury, many soldiers had no such wounds and some hadn’t even been on the front line.
Leading physicians and neurologists alike, baffled by what they were seeing, began to think differently about psychiatric disorders, producing new causal theories and treatment initiatives. By the end of the war over 240,000 cases of shell shock had passed through British Army medical facilities. With treatments researched and out-patient units emerging, psychological medicine had truly arrived.
Whilst the term ‘shell shock’ has since become redundant, with psychologists preferring ‘Post-Traumatic Stress Disorder’ (PTSD), there’s no doubt that what this phenomenon taught us about mental illness remains as invaluable as it ever was.
As we mark 100 years since the start of the Great War, we are delighted to invite you to join Professor Sir Lawrence Freedman, Professor of War studies, Professor Sir Simon Wessely, Director of the King's Centre for Military Health Research, and Professor Edgar Jones,Professor in the History of Medicine and Psychiatry, to examine the appearance of shell shock during the First World War, the struggles faced by affected soldiers and exactly how it impacted our understanding of mental health then and now.

anyway, there was one point which they mentioned which made me go look for more information. And this was the story of George McQuay.

Here’s the soldier before he left for the war.

then he left for the war. mental health treatment was pretty much rudimentary. Shell Shock was considered to be “cowardice”, he came back to Australia with complete loss of memory, depression. So they ran a campaign to find out who he was. After many many misses, his mother found him, from NZ!

Such a tragic story. But you know what fucks me off? Is how easy we think of sending our troops into battle. Here are some statistics about the PSTD incidents. I quote,

Summary of Veterans Statistics for PTSD, TBI, Depression and Suicide.

• there are over 2.3 million American veterans of the Iraq and Afghanistan wars (compared to 2.6 million Vietnam veterans who fought in Vietnam; there are 8.2 million "Vietnam Era Veterans" (personnel who served anywhere during any time of the Vietnam War)
• at least 20% of Iraq and Afghanistan veterans have PTSD and/or Depression. (Military counselors I have interviewed state that, in their opinion, the percentage of veterans with PTSD is much higher; the number climbs higher when combined with TBI.) Other accepted studies have found a PTSD prevalence of 14%; see a complete review of PTSD prevalence studies, which quotes studies with findings ranging from 4 -17% of Iraq War veterans with post-traumatic stress disorder)
• 50% of those with PTSD do not seek treatment
• out of the half that seek treatment, only half of them get "minimally adequate" treatment (RAND study)
• 19% of veterans may have traumatic brain injury (TBI)
• Over 260,000 veterans from OIF and OEF so far have been diagnosed with TBI. Traumatic brain injury is much more common in the general population than  previously thought: according to the CDC, over 1,700,000 Americans have a traumatic brain injury each year; in Canada 20% of teens had TBI resulting in hospital admission or that involved over 5 minutes of unconsciousness (VA surgeon reporting in BBC News)
• 7% of veterans have both post-traumatic stress disorder and traumatic brain injury
• rates of post-traumatic stress are greater for these wars than prior conflicts
• in times of peace, in any given year, about 4% (actually 3.6%) of the general population have PTSD (caused by natural disasters, car accidents, abuse, etc.)
• recent statistical studies show that rates of veteran suicide are much higher than previously thought (see suicide prevention page).
• PTSD distribution between services for OND, OIF, and OEF: Army 67% of cases, Air Force 9%, Navy 11%, and Marines 13%. (Congressional Research Service, Sept. 2010)
• recent sample of 600 veterans from Iraq and Afghanistan found: 14% post-traumatic stress disorder; 39% alcohol abuse; 3% drug abuse. Major depression also a problem. "Mental and Physical Health Status and Alcohol and Drug Use Following Return From Deployment to Iraq or Afghanistan." Susan V. Eisen, PhD
• Oddly, statistics for veteran tobacco use are never reported alongside PTSD statistics, even though increases in rates of smoking are strongly correlated with the stress of deployment and combat, and smoking statistics show that tobacco use is tremendously damaging and costly for soldiers.
• More active duty personnel die by own hand than combat in 2012 (New York Times)

I hate war, and I hate a foreign policy which requires needless deployment of soldiers. By all means, defend the country, but to send them to Kurdistan? why? So the Islamic State will win over, sod it.

Do you meditate differently when you are a Hindu Vs a Buddhist?

Apparently you do! See this fascinating paper.

The most diffuse forms of meditation derive from Hinduism and Buddhism spiritual traditions. Different cognitive processes are set in place to reach these meditation states. According to an historical-philological hypothesis (Wynne, 2009) the two forms of meditation could be disentangled. While mindfulness is the focus of Buddhist meditation reached by focusing sustained attention on the body, on breathing and on the content of the thoughts, reaching an ineffable state of nothingness accompanied by a loss of sense of self and duality (Samadhi) is the main focus of Hinduism-inspired meditation. It is possible that these different practices activate separate brain networks. We tested this hypothesis by conducting an activation likelihood estimation (ALE) meta-analysis of functional magnetic resonance imaging (fMRI) studies. The network related to Buddhism-inspired meditation (16 experiments, 263 subjects, and 96 activation foci) included activations in some frontal lobe structures associated with executive attention, possibly confirming the fundamental role of mindfulness shared by many Buddhist meditations. By contrast, the network related to Hinduism-inspired meditation (8 experiments, 54 activation foci and 66 subjects) triggered a left lateralized network of areas including the postcentral gyrus, the superior parietal lobe, the hippocampus and the right middle cingulate cortex. The dissociation between anterior and posterior networks support the notion that different meditation styles and traditions are characterized by different patterns of neural activation.

Whilst I do meditate, I am not really sure if I know the difference between these two modes, do tend to work to the Hindu mode while starting in the Buddhist mode. Does that make sense?

but absolutely fascinating, we are different…

Being religious helps with mental illness recovery

This was a fascinating study. I quote:

There is increasing recognition that a person's spiritual or religious experiences contribute to quality of life (QOL). However, research exploring the relation between spirituality and QOL has mainly been in the context of chronic and life-threatening illnesses and studies examining this important correlate of QOL in chronically mentally ill subjects are sparse. This study aimed to explore the relationship between spirituality and QOL and to investigate if spirituality contributes to other domains of QOL (both physical and psycho-social) in subjects with residual schizophrenia. By using a cross-sectional design 103 patients with residual schizophrenia were assessed on positive and negative syndrome scale and their quality of life, spirituality and religiousness were assessed by WHO Quality of Life-Spirituality, Religiousness and Personal Beliefs (WHOQOL-SRPB) scale. The SRPB domain and all its facets other than spiritual connection correlated significantly (ρ < 0.001) with all other domains of QOL and overall QOL. On regression analysis, inner peace domain of spirituality explained 21.6 to 37.6% of variance of all QOL domains except the domain of level of independence. Spirituality domain explained 33.8% of variance of ‘level of independence’ domain of QOL. Taken together, inner peace and spirituality facets explained 23 to 40% variance of social relationships domain, psychological domain and level of independence domain of QOL. This study suggests that spirituality and religiosity have an important influence on overall QOL of patients with schizophrenia. Hence, besides pharmacological and non-pharmacological management for schizophrenia, clinicians should focus on this aspect and encourage their patients to follow their religious practices and spiritual beliefs.

Now here’s the issue, for example in the UK. When doctors ask patients about their faith, they are slapped down. Here is an example. What was the problem? The doctor suggested some other faith than the chap’s. But because of issues like this, doctors are purely clinical or medical or both. But looking after the mental well being of the patient is left alone because it crosses too many boundaries. I think this is a wrong thing but I suppose that’s the price for living in a secular system.

Urine

Urine is a curious bodily fluid, which is frequently made a butt of ewwww and ick jokes and expressions, but I somehow think this has been overdone. While reading this: and I quote:

What are the pros and cons of using camel urine as a medicament? The question was recently tackled in the journal Dirasat – a peer-reviewed research journal published by the Deanship of Academic Research, University of Jordan. In Vol 37, No 1, 2010, authors Mohammad A. Al-Natshah, and Isma’eel M. Al-Braishi, examine the history and philosophical aspects of its use in their paper: A Look at the Tradition Narrated by Okal and Oraynah, Medical Treatment by Impurities Filthy Things where they explain:

“Treatment by camels urine in particular is permissible by sharia scholars. As for being pure, the Sharia scholars were in disagreement as some of they said its pure while others said they are impure. Those who supported using it for treatment rested at the fact that it can be administered if patient is very ill though medical products are so advanced. The research goes a head by narrating, discussing and giving evidence, that the camels urine is impure but despite that filthy things can be used in pharmaceuticals.” _{[sic, various]}

Building on the historical guidelines, practical progress in applied camel urine usage has also recently been made. Research by Dr. Faten Abdel-Rahman Khorshid, associate professor at the King Fahd Medical Research Center, Department of Medical Biology, Faculty of Medicine, Medical Center, King Abdulaziz University (KAAU), Jeddah, Saudi Arabia, has determined that camel urine contains nano-particles which might be effective against certain types of cancerous cells. The ‘active ingredient’ in the urine – identified by its codename PM701 – has already been tested in humans: See: Khorshid, F., H. Alshazly, A. Al Jefery and A.M.M. Osman, 2010. Dose escalation phase I study in healthy volunteers to evaluate the safety of a natural product PM701. Journal of Pharmacology and Toxicology, 5 ( 3 ): 91 – 97, 2010.
In order to further promote its medical potential in the fight against cancer worldwide, professor Khorshid has also applied for a swathe of international patents. Here is the US application – covering “an absolutely novel use of camel urine“ – it focuses on PM701 obtained from the adult single-humped Arabian camel (Camelus dromedarius) found roaming natural pastures near Jeddah.  ‘Separation and formulation of bioactive fraction and subfraction from camel urine work as anticancer agent‘ (US patent app. 2009/0297622 A1)

What people dont realise is that urine is a sterile by product, it does not have any toxic materials. People have drunk urine as a medicine like the famous Indian Prime Minister Morarji Desai. People drink processed urine on the space station after processing it. As a matter of fact, quite a lot of normal drinking water also contains processed urine. There’s a thought for the homeopaths who believe that molecules leave behind memories when diluted to hell and beyond.

Urine can also be used as an emergency medicine if you get hit by jellyfish. And I didnt know that urine shares many properties with amniotic fluid. Go figure. Its also considered to have therapeutic values in various Hindu sacred books. And cow urine been made into a cola!

Urine has also been used to make gunpowder, again because of the presence of nitrogen compounds in it and that makes saltpeter crystals which in turn is used to make gunpowder. So the next time somebody says to you when you have a lump, do you have a gun in your pocket, just say, yep, and i can make gunpowder as well.

Some even take a bath in it, here are dinka tribespeople…

Then again, its also been used as a protest vehicle. What happened to the good old days of using shoes, eh?

Get holidays and degrees for old religions

Heh, you couldn't make this up even if you wanted it. In the UK, you get holidays if you are a pagan. I quote:

POLICE who worship heathen gods will get eight days off a year to celebrate pagan festivals. They are also in line for thousands of pounds of taxpayers’ money in recognition of their status as a “community” of pagans.

Home Office chiefs this week gave their backing to the Pagan Police Association which will be entitled to public funding, along the lines of that given to other rank-and-file organisations like the National Black Police ­Association. Last year the Home Office introduced a pagan oath which can be used in the courts and yesterday officials said self-styled witches, Druids and heathens were welcome in the police. But last night there was growing anger that public money should be spent supporting the policemen’s “religion”.

Why stop at policemen? We now have traditional medicine.

THE desire of many of South Africa’s 180,000 traditional healers to be absorbed into the mainstream health system was given a boost yesterday when Wits University launched a degree for sangomas. A bachelors or masters degree in indigenous knowledge systems is on offer at the university’s school of medicine. Once qualified, traditional healers will be able to diagnose diseases such as HIV/Aids, tuberculosis and diabetes, and refer patients to state hospitals. They will also be taught how to sell their medicines and open their own surgeries. Yesterday, about 1400 traditional healers from across South Africa, Namibia, Zimbabwe, Swaziland and Lesotho met to urge the government to formalise their status.

We are in cloud cuckoo land moving into loony street soon. Very soon, we will get good remedies such as Rhino juice for AIDS.

One of them is a potion called Ubhejani, the Zulu word for rhino, and in the city of Durban 500 bottles of it are being sold every week as a treatment for AIDS. He said he was not taking the anti-retro viral drugs which his doctors had recommended - because he believed they would harm him. The recipe for Ubhejani is a secret closely guarded by its creator, Zeblon Gwala.He says the combination of 89 African herbs came to him in a dream. Mr Gwala is a former truck driver with no medical training. And yet he has no qualms about encouraging his patients to stop taking orthodox AIDS drugs and consume his potion instead. In his time in office Thabo Mbeki has questioned the existence of AIDS and accused the big drugs companies of preying on Africa. He has refused to dismiss his Health Minister, who has been nicknamed "Dr Beetroot" by the local media for trumpeting the benefits of African medicine and vitamin supplements for HIV-positive people.

What on earth is the world coming to?

Why should vaccines be free?

I agree with this company, why on earth should the vaccines be free? Say I am a shareholder of GSK and Novartis (which I am not, btw), and I have invested my money in its stock. Why are you expecting ME to fund the vaccines? What's the solidarity in that? If my returns are lower, do you think anybody will be willing to top up my pension? in solidarity? I dont think so. I quote:

Novartis, the Swiss pharmaceuticals group, defied the World Health Organisation and some of its corporate peers by ruling out a donation to the poor of vaccines to counter the latest flu pandemic, and saying developing nations or donor nations should cover the costs.

Daniel Vasella, Novartis chief executive, told the Financial Times that he would consider offering discounted pricing to low-income nations, but unlike other drug companies, including GlaxoSmithKline, would not offer vaccines for free. He said: “If you want to make production sustainable, you have to create financial incentives.”

It definitely makes sense, the firm is not running as a bloody charity, you know? it has to pay its suppliers, its staff and its other commitment holders. If you take the argument to its logical conclusion, every medicine it makes will be expensive to the poor because in effect even a 1 cent/paise/pence cost will be quite high for the poor. So does that mean that in solidarity, this firm should be run as a charity? No way. So Margaret Chan, the WHO Director General, please note that you are saying complete bollocks.

Also remember what happens if you make things like this free, then no private firm produces them. Many of these instances have happened in our history, for example with measles and polio vaccines in the past. When will these idiots learn? This is not to say that the governments cannot step in and purchase sufficient vaccines for their populace or some international body does it for them, but asking something like this is forced charity, that’s not solidarity, that’s stupidity.

This is impressive

At one point in time, I had a bit of an accident and the docs said that I cannot ever walk again properly, but thanks to a great doctor, I managed to overcome that disability. But that was nothing. People who rise above their physical disabilities to this extent are very impressive and this lady’s video story is very impressive and you can see her life a full and active life.

Technorati Tags: China,Disabilities

The 50th anniversary of Thalidomide

It is now 50 years that a pregnancy drug went spectacularly wrong. The word Thalidomide entered into the dictionary, a word meaning an unthinking and risky approach to medicines which blighted the lives of thousands of people. Babies were born with devastating injuries and liabilities, families were torn apart and many died. The babies are now growing up and still face a huge burden for the rest of their lives.

Even this horrible accident made many things better for the rest of us, drug testing was improved, legal history was made in terms of compensation, we understood pregnancy much better (I dont know much about this pregnancy malarky, but my wife does, check out her site).

The German company apologised and is considering fresh support for victims still alive.

Hear, Read and Weep