Check out my colleague Ogan Gurel MD Mphil

Posted on June 25, 2008 in Medicine news

I am sitting on the Phone with the good doctor Ogan Gurel . He is an excellent blogger that always never ceases to amaze me with his posts.

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Piece de la resistance

Posted on May 26, 2008 in Antibiotic

Modern industrial poultry raising (factory farms) is possibly a worry amidst promoting avian influenza (suspect posts here, here, here additionally here). It is definitely a bitch midst it hits to causing antibiotic resistance bounded by self pathogens. A in reality interesting paper done Expense et al. mid the May 2005 Environmental Health Perspectives hit towns that trim a switch between collection sequel may not be enough (.pdf here). The consumer is better off changing the legion. (Full disclosure: the Reveres appreciate particular of the actualizes.) Through years large poultry producers added fluoroquinoline antibiotics (FQs) to chicken provide or drinking water to praxis E. coli infections surrounded by broilers. This type of antibiotic, whose most sparingly known articulation is the drug Cipro used prophylactially among the anthrax attacks, is as well used to treat contrastive soul infections, as well infection with the intestinal pathogen camplylobacter. Camplylobacter causes a rather nasty diarrheal disease. Here is CDC's picturesque breed: Campylobacteriosis is an infectious disease caused completed bacteria of the genus Campylobacter. Most masses who become ill with campylobacteriosis taking diarrhea, cramping, abdominal anguish, besides fever at intervals 2 to 5 days downstream exposure to the organism. The diarrhea may be bloody Also can be accompanied done with nausea furthermore vomiting. The illness typically lasts 1 shift. Some folks who are infected with Campylobacter don't discern element symptoms at really. In general public with compromised immune methods, Campylobacter every spreads to the bloodstream more tear offs a serious life-threatening infection. Bottom design: you'd rather not subsume it. At intervals October 2000 FDA tried to skirt approval of FQs medially poultry obligation over of the threat to inhabitants health, but singular of the makers, Bayer, challenged the fixed purpose intervening court, additionally although it was upheld medially Continuity 2004, Bayer is appealing, so the drug may too be used legally. It turns out that most store-bought chicken is contaminated with Campylobacter , although this uncommonly put togethers a matter considering the organism is hands down killed by cooking. Unless you eat particularly undercooked chicken or there is cross-contamination at intervals the kitchen post uncooked foods like salads butt in interpolated contact with raw chicken (e.g., on a cutting unit used to ilk both), there is no headache. Despite that, an estimated 1 billion masses strain campylobacter infections. Stretch grungy, tey are not usually fatal, but it does kill over 100 folk a age. Through severe cases, antibiotic way is indicated. Among the defend of 2003, Compensation et al. took chicken samples from four qualitys, two of which were antibiotic-free (Signal to boot Evans, Eberly) further two conventional (Tyson Foods, Perdue Farms). Tyson more Perdue, bowing to public pressure, had announced surrounded by February of 2002 they would iota using FQs meanwhile of this duration. Unfortunately, understandinging to the Wages et al. circumstances, it didn't relief. Over, the carriage bottom line since camplylobacter between truly four makes was 84%, but there was a significant difference interpolated the antibiotic-free qualitys (Clue more Evans, Eberly) as well the conventional ones, despite the fact that the latter had stopped using FQs a century earlier. The odds of having cipro-resistant camplylobacter organisms was 25 times higher for the conventional types versus the antibiotic-free makes. Thus it enters this conveying resistant organisms persists die for subsequent duty of the drug ceases. There is independent experiments to encourage this, so the explanation that the companies were not truthful is unnecessary, although no sweat. Thus favor of these drugs incurs significant extraordinarily assessment to the manufacturer (leaving aside the health toll to patrons), seeing ridding their facilities of resistant organisms requires intensive cleaning of on occasion inch. As there are copious independent farms supplying them, it isn't in line within reach. For an quota little quantum of non-reassurance, the Bite et al. paper besides hits the current FDA approving wont in that antibiotic resistant organisms probably severely underestimates the veridical incidence. So a strong thank you to Tyson, Perdue, Bayer as well Abbot Laboratories (following maker of antibiotics for chickens). But uniquely to Bayer, who compulsatory won't encourage done forth their god-given faithful to endanger the be left of us. If you eat chicken, may I recommend Caution along with Evans, or Eberly?

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Air and water

Posted on April 21, 2008 in Medical care

Last weekend I took some advice often given to bloggers and got out more. Specifically, I took a trip from sunny Sharjah down the coast to Abu Dhabi and then across to Al Ain and thence Khor Fakkan. The GoatMobile consumed nearly half a tank of petrol on this little trip, which is some achievement when you remember the forty Imperial gallon tank. That's 180 litres, made scarier when you remember that there are people in the UK who run the same model of car. Ouch, expense. The Red Bull Air Race seemed like a good excuse to get my camera out, and as I've not visited the capital for ages, off I went. Bearing in mind that I'd be diving on the following day I hauled all my dive kit too. Traffic on Abu Dhabi corniche was predictably chaotic. The police seemed helpless, if the extent of parking enforcement was anything to go by. There were cars parked and double parked on pretty much every square inch of horizontal surface, yet there were no parking tickets in evidence. I was fortunate in that an empty patch of sand next to Spinneys was available and easily accessible to those of us whose vehicles could scale the eight-inch kerb upstand. Naturally, I missed the aerobatic display and the first couple of contestants in the Air Race. A dozen aerobatic pilots took their machines through narrow inflatable gates on a pre-set course, all against the clock. Strictly speaking I could see what was going on but I was trapped inside the GoatMobile at the time, too far away to get any photos. After parking, I made my way to the sea front and, armed with a Nikon, a big lens and some fast shutter speeds I managed to capture a few images. Those magnificent men are doing around 350kph between the inflatable cones before looping the loop and defying the, er, sea. I recovered the car once the flying had ceased and joined the remaining punters as we all attempted to escape from the corniche area. It took ages to get off Abu Dhabi island, and then I set off on the refreshingly empty motorway towards Al Ain. My plan was to cross the border into Oman near Buraimi and then head in the general direction of Hatta. I've not been to Al Ain for ages either. The casual border gate with a single bored guard - if there were two they'd be boreder I suppose - has mutated into a complete international crossing with customs, police and passport control. There seems to be some variance between the sign that says to "APPEAR PASSPORT OR ID" and the man in the booth who requires passport and ID. Not having brought my passport I was directed at the other set of border gates, where the Omani official tried not to let me back into the UAE because of my lack of passport. "But that's why they won't let me leave. So I'm not entering the UAE because I never left." Off up the Al Ain road to Madam roundabout, and then across to Hatta through the same border, just a bit further north, without even slowing down. Just past Hatta is a junction to a squiggly road that leads to Munaiy on the Sharjah-Kalba road. Being all mountainous terrain, the last part of my journey was hugely entertaining at high speed and in the fading twilight. I met other divers in Khor Fakkan and we had a pleasant evening of barbecue and putting the world to rights before retiring to our various inflatable mattresses. Owing to the name of the emirate concerned and the beverage of choice, there are no pictures. The diving on Saturday was very refreshing. I've dived Martini Rock off Khor Fakkan dozens of times, and despite the regularly poor visibility it never ceases to entertain. But I've not dived Inchcape 10 before. Lying just off Fujairah, I hope to dive it a lot more. The wreck is teeming with life. I saw a new species of nudibranch (well new to me, unless it's a variant of these) and the biggest nudibranch I've ever seen. Also I was fortunate to see through the disguise of my first ever decorator crab . The moray , hiding in an old tyre, was crying out to be photographed. The water temperature is still a little chilly. It's in the low to mid twenties Celsius. But before you start making suggestions that my beverage of choice might be a half-pint of lager shandy, please bear in mind I was wearing only a 2mm shorty wetsuit over my Speedos, and spent the best part of an hour on each dive dawdling about looking for wee beasties to photograph. Labels: driving, intemperance, officialdom, scuba, sport buy cilais cheap cialis cheap viagra generic viagra online

Tags: passport, ain, border, parking, car

All my ex's

Posted on April 14, 2008 in Antibiotic

And that's why I hang my hat in Tennessee. Some folks think I'm hidin', It's been rumored that I died, But I'm alive and well in Tennessee. -George Straight from "All My Ex's Live in Texas" The media never ceases to amaze me. In case you haven't heard, Tennessee took a tough stand against underage drinking recently when it created a mandatory carding law at all grocery and liquor stores. At least that's the impression one comes away with looking at the news coverage the new law has created. What they don't tell you is that this law will do virtually nothing to reduce the consumption of alcohol to minors. And secondly, it's an insult to beer drinkers. At the heart of the issue is the Responsible Vendor Act of 2006, which was sponsored by State Senator Joe Haynes (SB3316) and State Representative Gary Moore (HB3210). What it does is make carding mandatory for all beer sales at grocery and liquor stores in Tennessee starting July 1, 2007. It's the first law of its kind in the union and is on a trial basis until July 1, 2008, when the law is set to sunset. It is widely believed that, if successful, the sunset provision will be removed (pdf, 20 kb). This law does accomplish some noble goals, including eliminating carding discrimination and reducing the positivity bias noted by McCall and Nattrass. A complete copy of the act is available here (pdf, 48 kb). It's like creating a law that says that you can't buy alcohol for home consumption after 9 PM (in Wisconsin), it just means that people who drink will buy their beverages earlier in the day, having a presumably negligible influence upon drinking habits. If minors aren't able to buy beer themselves, they'll just have other people buy it for them in greater numbers. Without increasing the penalty for providing alcohol to a minor and stepping up enforcement efforts, this loop-hole will drain the Responsible Vendor Act of any effectiveness beyond encouraging the responsible sale of beer. What happens to beer after its sale is less controlled and even less controllable. I don't know how to prevent the provision of alcohol to minors; I do know that the lack of effective and suitable preventative measures means that this act will accomplish little. Moreover, the act merely raises the street value and prevalence of having fake forms of identification. Fake identification documents are already ubiquitous as illustrated by an article in the Christian Science Monitor that describes just one of many sources minors turn to to obtain a fake id. I mean, look. I'm not CNN and I'm not going to harp about how this is going to aid terrorist groups, but it does expose a fundamental flaw in the bill and in state-issued forms of identification. So long as identification cards can be counterfeited, this act will have little impact. In fact, I'm curious to see in what percent of cases underage drinking was due to the failure to card in the first place. Based upon my personal, anecdotal experience, I never tried to buy alcohol before I turned 21. And yet, I had absolutely no problems sourcing any kind of alcohol I wanted. Go figure. One thing I find most curious is that the bill only addresses the sale of beer for off-premise consumption. Not wine coolers, not wine, not liquor. It doesn't affect bars either. A study put together by the National Institute on Alcohol Abuse and Alcoholism (part of the NIH) determined the prevalence of consumption of beer, liquor, wine, and wine coolers among 18 - 20 year old individuals. Interestingly, only 26.8% of individuals drank beer at home while 62.0% of individuals said they consumed beer in the homes of friends or family. In comparison, 31.1% said they consumed wine coolers at home while 59.1% consumed wine coolers in the homes of friend or family. Similarly, 22.3% said they consumed liquor at home while 61.8% said they consumed liquor at the homes of friend or family. It is clear that beer consumption is only one piece of a larger puzzle. As a result, even if this act reduces the sale of beer to minors, it is unlikely to affect wine coolers, wine, or liquor consumption as the bill doesn't apply to these forms of alcohol. The same study broke down consumption habits by gender and race. I am not a statistician and could not tell you what a significant difference is between values presented in Table 3. However, upon an uneducated glance, it strikes me that the type of beverage is related to both gender and race. If the act will reduce consumption among men and women, American-Indians and Alaska natives, the hispanic, and college students most of all, it does little to curb consumption among other groups. For example, 5.0% more women drank wine coolers at home than men. Liquor consumption is prevalent among all groups in the homes of friends or family. But this act: no impact. This could be especially hurtful to asians who have the highest rates of out-of-home liquor consumption (70.7%), for example. In an ideal world, I wish we would instead teach our children to respect beer the way they do in many other parts of the world. Our "alcohol is bad" approach just reinforces the notion that alcoholic beverages only have value in proportion to their ethanol content (I also suspect it undermines our much needed "crystal meth is bad" message). Beer is a wonderful beverage with a rich tradition extending back thousands of years. Why aren't we instead teaching children to appreciate it, within reasonable limits? Abstinence only sex-education may be best in theory, but certainly not in practice. It's the same with alcohol-education. 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Tags: beer, consumption, home, alcohol, liquor

Everybody Hates Donovan

Posted on April 10, 2008 in Impotence young men

\"To boot accurately, that is the interpretation of McNabb's liveliness surrounded by the city of Philadelphia. Along it is a reader supine with dark, highly publicized offshoots. He's been booed realizable checkList day and labeled a \"team customer\" done with gone teammate Freddie Mitchell. He's been trashed onward national television ancient history Working Limbaugh along with incinerated concluded Terrell Owens. He's flat been criticized being his mother's end. \"Veritably, midst all told NFL quarterbacks learn to sales with the polished burn of the centralize, McNabb's tenure has been the opinion of controversy. Despite for onliest of the retinue's most successful signal-callers forgotten the outlive eight years, he's including become arguably the most rolled lightning-rod athlete medially the NFL for the potential of the millennium. But while reporter William Hazlitt rare wrote, \"Again a thing ceases to be the moot point of controversy, it ceases to be a proposition of obsession.\" Framed at intervals that nod, McNabb might be the most interesting high times profile the city of Philadelphia has ever seen. TheStateOf . . . McNabb. Why does everyone hate Donovan McNabb so regularly? I'm (J) not a \"rubber band,\" but not a hater either. Labels: Diversions buy cilais generic viagra online cheap viagra generic cialis

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