Dates in Doncaster

While contemplating the honey roasted cashews at coles (Westfield Doncaster), i was also vagualy listening to that irritating lady with the mic in the vegi section, with hair and makeup overdone, formal black clothes, in uncomfortable heels.
" a punnet of strawberries for only 1.60, fresh and tasty for this low price of 1.60"
i was thinking that was a good price, will pick some up once i reach that side...
"and for those of you celebrating ramadan, we have dates ..."
did i hear that right? the lady at coles knows about ramadan? I craned my head to have a look at her, and saw that my mum had the strawberries and now was placing a few dates into a bag..
damn thats great marketing!

For the all DIY people with warts

Depending on which studies you prefer to believe, duct tape can be a cheaper alternative cure to warts as opposed to burning them off with liquid nitrogen...Cryotherapy works but for this is for those who cant be botherd with appointments!
If you do have the time to read thro all the research done, then yeah you probably would find studies that state they don't work, but why not try it since it has worked for some.

Procedure:
Apply small pieces of duct tape to each wart. Leave the tape in place for six days (re-apply tape if it falls off). At the end of the sixth day, remove the duct tape, soak the wart in water, and gently debride it with an emery board or pumice stone. Replace the tape overnight, then re-apply for another six days. Repeat this pattern for two months or until the wart is resolved.

Use this as motivation: "In patients treated with duct tape, 85 percent of the warts completely resolved, compared with 60 percent in the cryotherapy group."

Tiggie

Tagged by Mass

Favorite Colour; All shades of blue and a few shades of pink.
Favorite Perfume (guys); Safari by Ralph Lauren
Favorite Perfume (girls); Into The Blue by Givenchy
Favorite Clothing wear brand; Zara/ H&M/ Stradivarious
Favorite Person in the entire world!; Husband
Favorite Country; Home
Favorite car; Prado
Sport; Official Sport Of Slurping
Sports man; Nadal Raphael;)
Favorite spot in America; a safe park?
Animal; possums and wombats
Movie; The wind that shook the Barley was good
Singer; Kareem Salama, Daeud Warnsby, Natiev Deen
Day in the week; Saturday
Time in the day; Iftar time
Holiday season; summer cos i get to travel to winter countries:)
number: 8
food; feta cheese and olives
cartoon; family guy
ice cream flavor; vanilla with hot milk chocolate poured over it
favorite chocolate; Curly Wirly
favorite blogger; husband
favorite name; ninnevah
favorite hobby; Laptopping
fruit: pears, chakita bananas;)
room in the house: mine cos its quiet
Book: patricia cornwell.
momment: when i wake up and realize i dont have anything planned that day so i can declare it a lazy day

I tag Husband and Y.M

Manuka can Heal You!

So now whether you've got high LDL,

gingivitis

an unhealing venous ulcer,

just delivered your baby by c-section,

a diabetic foot ulcer

or fournier's gangrene...

Then Manuka Honey is for you!!

And remember..

The darker the better!!!

here is the evidence

Red Meat - The Rich Man's Dinner

"Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality," the study authors write. "In contrast, high white meat intake and a low-risk meat diet was associated with a small decrease in total and cancer mortality." from here

"High meat intake has been associated with higher levels of N-nitroso compounds, heme iron, and advanced glycation end products, which could result in oxidative damage and could be toxic to the retina," Dr. Elaine W.-T. Chong at the University of Melbourne and fellow researchers note in the American Journal of Epidemiology for April 1.

In a large Australian cohort study, greater consumption of red meat was positively associated with early AMD. Higher intakes of fresh and processed red meat were associated with similar trends toward an increasing prevalence of early AMD. In contrast, eating chicken was inversely associated with late AMD, and this inverse association seemed unlikely to reflect simply a lower intake of red meat.

Red meat included veal, roast beef or veal, beef steak, meatballs, meatloaf, mixed dishes with beef, roast lamb or lamb chops, mixed dishes with lamb, roast pork or pork chops, and rabbit. Processed meat included salami, sausages or hotdogs, bacon, ham, and manufactured luncheon meats. Chicken included roast or fried chicken, boiled or steamed chicken, and mixed dishes with chicken.

Conclusion: red meat is baaaaaaaad! eat panda's instead!

Diabetes Insipidus-what i need to remember

DI -Central: Vasopressin deficiency
DI - Nephrogenic: Vasopressin insensitivity at the level of the kidneys
VASOPRESSIN: * Is the regulator of tonicity
* Largely stimulated by increased plasma tonicity
* AntiDiuretc
* Synthesized in the hypothalamus (paraventricular + supra optic nuclei)
* Stored in the post pituitary
* Also stimulated by baroreceptors in the aortic arch and carotid sinus
DRUGS THAT INHIBIT VASOPRESSIN RELEASE
`ethanol
`phenytoin
`opiate antagonists
`halothan
`alpha adrenergic agents
ANP ~ Isolated form cardiac atrial muscle
Actions: *Decrease salt resorption
*Decrease vasopressin secretion
*Relaxes arterial sm m.
DI diagnosis by
*Serum osmolality > 300 mOsm/kg
*Urine osmolality < 300 mOsm /kg
Wolfram Synd ~DI central
~DM
~Optic atrophy
~Deafness
DI assoc tumors: * Germinomas (polturia)
* Pinealomas (Check hCG B subunit, MRI scans)
* Craniopharyngiomas
* Optic gliomas
* Acute myelcytic leukemia (pit stalk + sella infiltration)
Triphasic Response Following surgery:
1. Transient DI 12-48 hours
Could be due to local edema, interferes with vasopressin secretion
2. Inappropraite ADH 10 days unregulated vasopressin release from dying neurons
3. Permanent DI
90% of neurons destroyed

JNC Hypertension Part 1

RANDOM THINGS FROM THE REPORT THAT I FOUND INTERESTING OR MIGHT NEED TO BE REMINDED OF LATER ON
THE SEVENTH REPORT OF THE JOINT NATIONAL COMMITTEE ON PREVENTION, DETECTION, EVALUATION, AND TREATMENT OF HIGH BLOOD PRESSURE

Arighty so we've already mentioned the classification, so whats next, the treatment?
In my supershort summary all i need to remember is this;

Stage 1 hypertension (systolic = 140~159 Hmmg and/or diastolic = 80~89Hmmg)
Lifestyle Modifications
Thiazide type diuretics
Consider ACEI, ARBS, BB, CCB (or)
(If considerable indication present, like HF, post MI, CAD, DM, CKD, resort to another post-link coming soon)

Stage 2 hypertension (systolic 160 Hmmg and above and/or diastolic 100 Hmmg or above)
Lifestyle Modifications
TWO drug combination:
Thiazide type diuretics AND an ACEI or ARBS or BB or CCB

BTW- extra caution is required for those at risk of orthostatic hypotension (DM, autonomic dysfunction, some old ppl)
If after a trial of that and the goal Blood pressure hasnt been attained,
1.Optimize dosages
2.Add additional drugs
3.Consult a htnsive specialist

N.B. Commonly used = clorthiazide, lisonopril-enalapril, perindopril ACEI, aldactone ARB, verapamil-nifedipine CCB.

Q. How long do you wait to decide that this drug is not working alone and you should add another?

RESISTANT HYPERTENSION
When a patient who is adhering to maximum dosage of a 3 drug regimen (including a diuretic) and has excluded potential identifiable causes and still cannot acheive the goal blood pressure.
Possible things to further investigate include;
. The proper cuff is being used, if its too small or the person is too big, its gonna give a false reading
. Try different drug combinations
. Check fluid overload- from the patient sprinkling excessive salt over his food or having a palate for especially salty foods.....
. Is the patient on any other Drugs? from NSAIDS to cocaine to OCP's and other steroids to simple cold meds n decongestants
. Any dietary obsessions? from some herbals (ie. ma huang) and dietary supplements...even licorice!

Basically you gotta find a cause, and fix it.

PHC definition of Hypertension

Doctor; Basic Question, did you read up on hypertension?

Me; Yes, i even printed out the JNC 7 thing you told us about (big grin)

Doctor; All of it, why?

Me; not the actual one, the PHC's summary one

Doctor; oh good, yes thats handy, did you read it?

Me; Not all of it yet...(grin slowly disapearing)

Doctor; ok..do you have any questions so far?

Me; Not really...its pretty clear

Doctor; So whats the definition of hypertension?

Me; uhhh...when the blood pressure is above...when the systolic pressure is above 120..no 140, and the diastolic above 80.

Doctor; specifically 140/80? Is the the cut off point? (deep breath) okay....finish reading then come back to discuss it.

btw- I still havent finished reading it but this is what my answer should have been like;

The cut off point of hypertension IS 140/90 Hmmg, Buts its not just that simple,

Above 120/80 and below 140/90 is known as prehypertension

(which does require lifestyle modifications- will focus on the DASH diet later)

and then hypertension is divided into stage 1 (140/90 <) and stage 2 (160/100<)

Banned Visa and a Book

I was reading up on how Peer, the israeli tennis player was banned a visa to come play in dubai, and then now they've allowed Ram, a male israeli player, AND the WTA is gonna fine dubai a whole bunch of money for not following the rules...to treat all players equally regardless of race/color/nationality/religion.

The reason the dubai tennis people used as their defence is that when she was playing in New Zealand there was a small but noisy pro palestine protest in her honour (yay for our future kids being half nzers)...so imagine what may have happened had she been allowed here (lets overlook the fact that protests in the U.A.E need permission from the ministry of something).

Along the same lines, well not really the same...the Dubai literary Festival, sponsored by Emirates airlines is being held here soon, and theyve banned the launching of a book that is based in a fictional gulf state, and has an arab sheikh in a homosexual relationship with a british guy. even tho he's not the main protagonist but its still in there and therefore was deemed culturally insenstive. so other writer's are considering cancelling their attendance, the full story is here; Atwood pulls out of Dubai festival in censorship protest...maybe they should have considered this before sending out invitations...well as long as penny vincenzi is still coming! They should make her books into a tv serial, not just a one time movie like they did for the shopaholic series...that was a sad one, pulling random bits out of 5 books and bunching them up into a movie! there was no space for the events to roll into place. Oh and about banning books, in highschool i got hold of a list of 25 books that have recently gotten banned from public highschool libraries, so all that did for me was to go out and search for those books, and the first one i got hold of was Catcher in the Rye by Salinger...which was a disapointment, talks about a young male student and his superficial exposure to prostitutes, and a gay male teacher's advances on him. After that i gave up on my attempts to gain access to banned books.

8 babies all squished together

THIS POST IS DEDICATED TO MASS - THE ONLY BLOG READER I HAVE LEFT WHO KEEPS STOPPING BY AFTER MONTHS AT A TIME OF MY SILENCE. THANK YOU:)

Pregnancy and childbirth is difficult enough, with the labour pains, and all that pushing, just for one kid!!! how on earth can someone do it for 8 babies!!! EIGHT!!!!!

"Nadya Suleman, whose decision to give birth to the octuplets after undergoing fertility treatment despite already having six children, was expected to return home later this week, Michael Furtney told AFP" The rest of that story is here

And pics of the babies, all of them doing well and healthy - tho i think they were a bit premature (obviously with EIGHT of them in there!!) and you can even send them comments here

May God help the infertile couples in the world!!

TB & Air Travel - Part 3

RANDOM THINGS FROM THE REPORT THAT I FOUND INTERESTING OR MIGHT NEED TO BE REMINDED OF LATER ON
Criteria for deciding whether to inform passengers and crew:
Once notified, the health authorities must evaluate the risk of M. tuberculosis transmission and decide whether it is necessary to inform passengers and crew of the potential exposure.
For this purpose, the following criteria should be used:

-Infectiousness of the index patient
-Duration of exposure; if over 8 hour.
-Time elapsed between the flight(s) and the notification of the case.
-Proximity of other passengers and crew to the index patient.

Before any further action is considered in such cases, health authorities must confirm whether the person has pulmonary or laryngeal TB.

RECOMMENDATIONS For physicians
3. Physicians should inform all infectious TB patients that they must not travel by air on a flight exceeding eight hours until they have completed at least two weeks of adequate treatment.
4. Physicians should inform all MDR-TB patients that they must not travel by air – under any circumstances or on a flight of any duration – until they are proven to be culture-negative.
5. Physicians should advise TB patients who undertake unavoidable air travel of short duration (less than eight hours) to wear a surgical mask when possible or to cover the nose and mouth when speaking or coughing at all times during the flight.
6. Physicians should inform the relevant health authority when they are aware of an infectious TB patient’s intention to travel against medical advice.
7. Physicians should immediately inform the relevant health authority when an infectious TB patient has a recent history of air travel (i.e. within three months).

For the rest of the recomendations, ie FOR PASSENGERS AND AIR CREW, PUBLIC HEALTH AUTHORITIES, AIRLINE COMPANIES, please check out the original report at this link;

Tuberculosis and Air Travel - Guidlines for Prevention and Control - Second Edition - WHO

TB & Air Travel - Part 2

RANDOM THINGS FROM THE REPORT THAT I FOUND INTERESTING OR MIGHT NEED TO BE REMINDED OF LATER ON

IHR 2005 regulations
-To share information – flight details, itinerary, seating plans
-Notification of disease, by patient or health care officials to airlines, and vice versa of the suspected before arrival of flight
-Personal data kept confidential

An 'affected traveller' is a traveller who is infected or contaminated or who carries sources of infection or contamination, so as to constitute a public health risk.
A 'suspected traveller' is a traveller who has been exposed, or possibly exposed, to a public health risk and who could be a possible source of spread of disease.

Although the captain of an aircraft can legally deny boarding to a person if he or she has a valid concern that the person is a threat to the health and/or safety of other passengers and crew, in practice this may be difficult to apply. If a passenger is obviously very ill and with signs and/or symptoms suggesting an infectious disease, a medical consultation may be obtained before boarding. National laws vary significantly in different countries and air crew may be hesitant to deny boarding when privacy concerns may protect the individual passenger and discrimination charges may be an issue.

Known cases cannot travel till 2 weeks of adequate treatment

AIRCRAFT VENTILATION
Once the aircraft has left the stand and the engines have been started, the APU is shut down and the air supply to the cabin is drawn from some compressor stages of the engines. This 'bleed' air supply is at high pressure and temperature and the environmental system cools and conditions the air to comfortable levels before introducing it into the passenger cabin. Air is distributed evenly throughout the passenger cabin via ducts running the entire length of the aircraft.

Air enters the cabin from overhead distribution outlets and flows downwards in a circular
pattern towards the outflow grills along both sidewalls of the cabin near the floor. Air enters and leaves the cabin at approximately the same seat row, and airflow in fore and aft directions is minimal. Movement of passengers and crew in the cabin has minimal impact on the intended airflow patterns.

According to a study by the United States Department of Transportation: "If the ventilation system is not operating, passengers should not stay aboard the plane for long time periods (i.e. greater than 30 minutes)

The most efficient HEPA filters will capture 99.99% of particles (bacteria, fungi, and larger viruses) between 0.1 and 0.3 μm. The tubercle bacillus is approximately 0.5–1 μm in size.
Therefore, HEPA filters remove any M. tuberculosis organisms from the re-circulating air, thus eliminating the risk of exposure for passengers and crew from this source.

If during a flight a passenger is suspected of having infectious TB because he or she informs the cabin crew of, or experiences, severe symptoms such as haemoptysis, the cabin crew should try to relocate the passenger in a more comfortable and isolated area if space is available.
One cabin crew member should be designated to look after the ill passenger, preferably the crew member who has already been dealing with him or her. The ill passenger should be given a surgical face mask. If no mask is available or if the mask cannot be tolerated, the passenger
should be given an adequate supply of paper handkerchiefs (or towels if necessary) and instructed to cover his or her nose and mouth at least when speaking or coughing. The cabin crew should follow standard universal precautions when handling potentially infectious material (e.g. wear gloves, place disposables in sealed plastic bags). The designated cabin crew member may wear a mask if available, especially if the ill person cannot tolerate a mask.

Tuberculosis and Air Travel - Guidlines for Prevention and Control - Second Edition - WHO

TB & Air Travel - Part 1

RANDOM THINGS FROM THE REPORT THAT I FOUND INTERESTING OR MIGHT NEED TO BE REMINDED OF LATER ON


Interferon-gamma release assay: An assay for cell mediated immunity to TB that measures interferon-gamma (IFN- ) released from peripheral blood T cells stimulated in vitro with TB antigens.
Acid-fast stain (e.g.carbol-fuchsin or auramine – Ziehl-Neelsen method)
Tuberculin. Purified protein derivative (PPD) – a mixture of antigens from a culture filtrate extract of M. tuberculosis that is used for skin testing; many of its antigens are non-species specific.
multidrug-resistant TB (MDR-TB): tuberculosis caused by
strains of M. tuberculosis that are resistant to at least isoniazid and
rifampicin;

The quality of the air on board commercial aircraft is high, and under normal conditions
cabin air is cleaner than the air in most buildings. On short flights, there is minimal risk of disease transmission.
Some countries (e.g. Australia, Canada and the United States of America) require TB screening to be done in the country of origin (a chest radiograph, tuberculin test) for adolescents and adults, and sputum smear examination if the chest radiograph is suggestive of TB disease. No person with a positive smear examination is permitted to immigrate.

Some countries (e.g. Switzerland, United Arab Emirates and the United Kingdom) screen immigrants and refugees when they enter the country.

A few countries require medical examination both in the country of origin and when entering (e.g. Bahrain, Kuwait, Qatar and Saudi Arabia). Thus, people with infectious TB would often be identified as having infectious TB only after they have travelled.

TB is an infectious disease, caused in most cases by M. tuberculosis and transmitted by exposure to tubercle bacilli in airborne droplet nuclei produced by a person with infectious TB during expiratory efforts, such as coughing, sneezing or singing.

To date, no case of active TB has been identified as a result of exposure on a commercial aircraft.
In the first report, evidence of transmission was limited to cabin crew with at least 12 hours' exposure to the infectious source. In the other, transmission of infection occurred to only a few passengers seated in the same section as and in close proximity to the passenger with infectious
TB, and only on one flight lasting more than eight hours.

Other potentially serious airborne or droplet-transmitted infections
that could merit public health interventions if encountered during air
travel are influenza (both seasonal influenza and any unusual strain such
as avian influenza affecting humans), measles, meningococcal disease
and SARS.

Tuberculosis and Air Travel - Guidlines for Prevention and Control - Second Edition
WHO

Sex on TV

oooh i'd be interested to know what examples of tv shows they asked them about..
an interesting article from medscape medical news "Teen Pregnancy Linked to Watching Sexually Explicit Television" by Marlene Busko. Sad tho that they needed a whole study to be done so that people would beleive them..isnt it along the same lines of violence in movies and kid's cartoons?

"Teens watch an average of 3 hours of television a day, said Dr. Chandra. Sexually explicit television programs may not prepare teens to make responsible and informed decisions about sex because such shows rarely highlight the possible consequences of sexual activity, including the risk of pregnancy or sexual transmitted disease, or the potential value of condom or contraceptive use.

The researchers focused on 23 television programs that were widely available and popular with teens and had sexual content ranging from physical flirting to intercourse and sexual talk. The programs included dramas, comedies, reality shows, and animated cartoons."

Addressing the issue of HIV in the UAE

Dont expect any guidelines to the solution here, but just some ideas after a brain storm discussion...just some basis I may want to build up on later..

An initial step is to Remove the stigma

1. Admit, acknowledge the problem does exist. Admit it to who? A committee. We need a group of dedicated, committed members.
   
2. Data collection. Find the prevalence. Prevalence and not incidence (new cases) cos it’s an ongoing thing. We are trying to find people who already have it. for example newly diagnosed hypertension patients have had hypertension for a while, it just was silent so we didn’t know it was there. Predictive (P) value > 0.05 (the higher the value the less accurate it is. The lower the value (0.005) the more scientific it is. )
   Records could be obtained through – the compulsory premarital testing
   - elective surgeries (hospital records) i know this then brings up the question of confidentiality
   
3. Study the factors. Research factors around the stigma - random community samples –health care workers –culture / religion –laws that discriminate (If your an expat, you get kicked out of the country, if your local, you most likely will lose your job). Risk factors, try to pinpoint common causes particular to this region. Documentation of needle pricks.
   COOL policy ? (i'm still clueless about this)
   
4. Benchmarking, learn from the experiences, other countries policies.link 1
   link 2 Can be divided into intrinsic (own practice or past policies) or extrinsic (in this case would be other countries). An American visa wouldn’t be granted to HIV positive candidates until only recently. link

Pine Trees all in a Row

One of the amazing things about Melbourne is that you can plant trees and then watch them grow. Or even come back a few years later and be amazed at their height (and width in the case of pine trees)
Trees that were my height as a child are now more than twice the height of our one story home!!

Work for this world in proportion of the time you are going to spend in it.
Work for the next world in proportion of the time you are going to spend in it.
Work for the fire in proportion to how much patience you would have in it.
Work for Allah swt in proportion to your need of Him.
-ABDUL HAKIM MURAD

A Job For European Muslims

"when they say we don't want them to come, they are dealing with cultural fears not economic rationals."



"Not to use the immigrants to shed suspicion on the citizens, but to use the citizens to help the immigrants to be more integrated."

My Ramadhan Post

I heard from a brother attending the IISNA convention mention a few interesting points, since it is ramadhan ill start with this one, that there are two types of muslims (im sure we can break it down to more but for the sake of this point...) who fast ramadan, the ones who abstain from food / drink / marital relations / bad talk etc, and those who also refrain from the same things but also continue living their normal lives. Rather than taking it easy the whole day, leaving early from work to go home and nap till late late asr etc. In order to appreciate the aims of fasting we need to place ourself in some sort of hardship/ difficulty by continuing the exact same chores we would have done on other days... i just found this interesting, as it is attempting to break the tradition of the extra long nap everyone takes right after work till like 5 mins pre adthan:) well except those who have to prepare the elaborate meal- which should also be simplified cos ramadhan should not be about the food either...but then again its become one of the joys of fasting is to look forward this meal. One of the two most happiest times of a beleiver is when he breaks his fast, right?

but the original idea does make sense dont you think?

Also the other thing i wanted to write about was about the new practice of attacking our prophet (S.A.W) by the media. Instead of blindly lashing out the way muslims already do, we need to make it a cultural taboo to talk about these issues. For example now its unacceptable for a non African American, say Arab to walk around calling black people Niggers. He would make himself into a social outcast. Its known that this in not appreciated (put aside them using it themselves but it is insulting for an outsider to use it- theres a real nice post about this by imam suhaib web - ill try to link it later) So basically this is what we need to do. To peacefully and calmy make it socailly not acceptable...How? well first it could be by not attacking them back, not to seem passive but this tactic does seem to backfire doesnt it? These type of muslims need to grow up.

Ill try to get who said what exactly, it would be only fair to quote the sheikhs names to their ideas.

Indian Cafeteria Delivery Guy

Ive always gotten extra sugar in my tea, even when we're a big bunch of doctors in a clinic, or I'm sitting at the nurses station discussing the other doctors, the Indian cafeteria delivery guy always knows that the one with milk and extra sugar is mine and so places that cup with the torn Lipton label in front of me.
Today we did something new, we ordered tea to our oncall room, I've never been the one to make the call to the cafeteria, so they were hesitant, making sure i actually was calling form the doctors ward and that I'm not a patient who just messed up the directions.
When they finally knocked on our door, i was welcomed with a big smile and a very surprised 'YOU!!'

I like our cafeteria delivery guy, i always greet him in the corridors and he always gives me my correct change!

Chippies