Wednesday, 23 February 2011


Western diet may harm kidney function

perhaps this explains some of the sudden decrease in renal function among the Asians who migrate to or live in the USA?

Following a western diet, high in red and processed meat, saturated fats and sugar, may increase the risk of developing kidney function decline, a new study says.

Brigham and Women's Hospital researchers at studied the effect of three different dietary patterns including the Western, Prudent and DASH-style regimens on kidney function for over 11 years in more than 3,100 female US adults.

The DASH (Dietary Approaches to Stopping Hypertension) diet includes high amounts of fruits, vegetables and low-fat dairy foods but is low in saturated fat, total fat and cholesterol. A prudent diet, on the other hand, contains plenty of vegetables, fruit, whole grains, poultry and fish.

According to the results published in the American Journal of Kidney Disease , following a Western diet is associated with increased levels of albuminuria, a urinary protein considered as a marker of vascular disease and inflammation, and increased risk of rapid decline in glomerular filtration rate (eGFR), an index which measures how well the kidney filters blood.

Such a situation, however, was not reported in individuals on the other two diets, the study found.

"The kidney is a highly vascular organ, so we were not surprised to see that the Western diet, which has been linked with an increased risk of cardiovascular disease, is also associated with kidney function decline over time," said lead author Julie Lin.

"Interestingly, this finding, along with other research, adds to growing evidence that albuminuria, which is widely considered to be an early reflection of vascular disease, may be influenced by diet," she added.

Can Whales Predict the Next EarthQuake?

Is New Zealand earthquake linked to the mysterious deaths of more than 100 pilot whales?

By Chris Powers 22/02/2011

Whales and Earthquake (Pic:Reuters and Getty Images)

Twitter was awash today with theories that the bizarre deaths of more than 100 stranded pilot whales in New Zealand may have been a warning that an earthquake was going to hit.

There have been TWO mass whale deaths on NZ’s South Island in less than three weeks.

In the latest bizarre incident on Sunday, less than 48 hours before the earthquake hit, a pod of whales beached themselves near Cavalier Creek on Stewart Island.

Discussing the earthquake and whale deaths on Twitter, Kate Redman 'DolphinSeeker30' asked: “could the stranding of 100 pilot whales be linked to the earthquake?”

CodeNameTanya tweeted: “Over a hundred pilot whales beached themselves in New Zealand and then the earthquake. Wonder if tectonic plate shifts confuse whales. Hmmm.”

VeganWheekers asked: “Could there be a connection between the 107 whales that died on New Zealand beach yesterday and today's earthquake?” while TV New Zealand added: "has anyone noticed the correlation between beached whales and earthquakes?"

Following the discovery of 30 stranded pilot whales on the island earlier this month, RadioLive breakfast show host Marcus Lush tweeted that an earthquake “greater than five” would hit in the next week.

In the past, there have been examples of whales beaching themselves before major earthquakes, most notably before the 2004 Boxing Day tsunami.

Around 170 whales died in Australia and New Zealand in the months before the underwater earthquake in the Indian Ocean.

The resulting tsunami killed over 230,000 people in 14 different countries.

Dr Arunachalam Kumar, a professor from India, believes there is a connection between the beaching of marine mammals and earthquakes.

Three weeks before the tsunami, he was alerted to the whales’ deaths, and wrote: “It is my observation, confirmed over the years, that mass suicides of whales and dolphins that occur sporadically all over the world, are in some way related to change and disturbances in the electromagnetic field co-ordinates and possible realignments of geotectonic plates thereof.

“I would not be surprised if within a few days a massive quake hits some part of the globe.”

Scientists are currently speculating that the cause of death of New Zealand's pilot whales is due to sound reverberations in shallow water.

Monday, 21 February 2011


10 dirty fruits and veggies

By Ashley Macha

Are the fruits and vegetables you buy clean enough to eat?

The Environmental Working Group (EWG) studied 100,000 produce pesticide reports from the U.S. Department of Agriculture and the U.S. Food and Drug Administration to create a list of 49 of the dirtiest and cleanest produce.

So before you hit the grocery store, see how some of your favorite fruits and veggies measured up.

Did one of your favorites make the list? Don't worry, the EWG recommends purchasing organic or locally grown varieties, which can lower pesticide intake by 80% versus conventionally grown produce.

This stalky vegetable tops the dirty list. Research showed that a single celery stalk had 13 pesticides, while, on the whole, celery contained as many as 67 pesticides.

Chemicals fester on this vegetable as it has no protective skin and its stems cup inward, making it difficult to wash the entire surface of the stalk. It’s not easy to find locally grown celery, so if you like this crunchy veggie, go organic.

Peaches are laced with 67 different chemicals, placing it second on the list of most contaminated fruits and vegetables. They have soft fuzzy skin, a delicate structure, and high susceptibility to most pests, causing them to sprayed more frequently.

This red, juicy fruit has a soft, seedy skin, allowing easier absorption of pesticides. Research showed that strawberries contained 53 pesticides. Try to buy strawberries at a local farmer’s market for a sweet dessert.

Apples are high-maintenance fruit, needing many pesticides to stave off mold, pests, and diseases. The EWG found 47 different kinds of pesticides on apples, and while produce washes can help remove some of the residue, they’re not 100% effective.

Blueberries (domestic)
These antioxidant-rich berries have a thin layer of skin that allows chemicals to more easily contaminate the fruit. Domestic blueberries were loaded with 13 pesticides on a single sample, according to the EWG. Imported blueberries also made the list at No. 14 for the dirtiest produce.

Sweet bell pepper
This crunchy, yet thin-skinned, vegetable is highly susceptible to pesticides. According to the EWG, sweet bell peppers showed traces of 63 types of pesticides. While some pesticides can be washed away, many still remain.

Spinach, kale, collard greens

These leafy green vegetables are on the list, with spinach loaded with 45 different kinds of pesticides and kale 57.

In 2006, Dole recalled bagged baby spinach after multiple E. coli illnesses associated with the vegetable made their way across the country.

Grapes (imported)
These tiny fruit have extremely thin skins, allowing for easy absorption of pesticides. And think twice before buying imported wine. The grapes that go into the wine could be coming from vineyards that use too many pesticides.

Have you ever indulged in a potato skin at your favorite restaurant? You might want to think twice before eating the skin. This spud was highly laced with pesticides—36, according to the EWG—that are needed to prevent pests and diseases.

Cherries, like blueberries, strawberries, and peaches, have a thin coating of skin—often not enough to protect the fruit from harmful pesticides.

Research showed cherries grown in the U.S. had three times the amount of pesticides as imported cherries. Because cherries contain ellagic acid, an antioxidant that neutralizes carcinogens, it’s worthwhile to buy organic or seek imported ones.

Thursday, 10 February 2011

Loss of Dr Joel Glaser: Adios mi Amigo

Death of Dr. Joel Stephen Glaser
Loss of a Book that educated you
Dr. Glaser, with his late wife Irena, had been part of every step of my life in Miami. I came here as a graduate student, then as a medical student and later to study Endocrinology, the years happily spent at the Jackson Memorial Hospital. By then Dr. Glaser was already an internationally recognized expert in Neuro-Opthalmology. With his inseparable friend, Dr. Norman Schatz, also another authority on diseases of the Eye/Nerve, we had shared such good times. We had gone together to the north coast of Jamaica, to the beaches of Cayman Islands. But most importantly I would remember Joel and Irena for being an integral part of my Jewish life in Miami. For years, regardless of where I was living at that time, I tried to be at their home for Pesach and whenever I was in Miami, the Friday nights were spent at their home.
They had seen me become, a Jewish boy from Melbourne, Australia grow up to become a Doctor and then an Endocrinologist, shared in my love of travels and shared some memorable occasions including the Hurricane Gilbert in Kingston Jamaica!
What is the lesson you leave me, my dear friend and teacher, Joel?
Apart from your never-ending curiosity about the world? Your knowledge, your critical eyes of looking at the social situations? Your warm friendship and never ending discussions during Pesach. So many things you and Irena gave me… I feel a direct message from you.
First of all dear friend, happy rendez vous with Irena!
I work with one of the most pure thinking groups in this world, the Native Americans.
You have to be where you need to be, said one of them. My visits to Miami during my sister’s sickness always coincided with un anticipated need for my presence.
Day before yesterday I was supposed to leave Paris to go to Bangalore and then on to Cochin, KL and Rangoon. But for weeks I did not feel comfortable with it. And just a few days before, I decided to come to Miami.
I arrived here the night before, Joel passed away peacefully last night. I am so glad to have been breathing the same air, dear friend, as you begin another journey. It is us, Schatz and your three children and your countless friends who have to be pitied for continuing our lives with such a tremendous loss.
Perhaps there is a reason for my trip to Miami, especially undertaken knowing that my sister wouldn't be here, as she is in Cayman Islands. She is usually the only reason for me to come to Miami these days. I do believe what the Indians have taught me, I needed to be here. Yesterday thinking about the reasons to come to Miami, I had these thoughts, written more or less at the time of this eternal Adieu!
Last night at around 8 pm, I wrote this:

Yesterday while flying I thought to myself, by living in Paris, I have forgotten something so fundamentally important to my personal way of thinking. To enjoy the minute pleasures of every day. Perhaps that is the reason for this trip to Miami. Nothing happens without a reason.
I enjoyed meditating this morning, saying thanks to the people who came into my mind, good friends in Tehran and Kuala Lumpur. I let my thoughts invite those who wanted to come and it was curious that people who should be very close to me, such as the real family did not appear in my gratitude list this morning. As we grow older, a friend wrote recently, chosen friends become closer to you than your chosen family.
What do I mean enjoying minute pleasures of every day?
Enjoy having a bath, taking my time, enjoying the soap and the hot water, taking my time to shave and also to clean my teeth. I don’t want to rush through these mundane acts of every day. A friend who is staying in this house of my sister offered to make some Jamaican coffee, which I savoured so fully... the breakfast was against bacalhao with onion and green platanos. Every thing tasted divine, tastier than yesterday.
To be in balance, you have to find time to enjoy these activities
I am certain; this also was a lesson I had learned from Irena and Joel Glaser.


How far can a Flea Jump. Should a Medical Doctor Know the answer?

Fleas can jump two hundred times the length of their own bodies, which is roughly about thirteen inches. If a grown man could jump 200 times the length of their own bodies, they could jump about 900 feet!
Thirteen inches works out to be about 33 cm. let us say 35 cm.
Why is a doctor interested in this spectacular feat of a Flea?
Go back a few years, this medical student from Australia assigned to the Cardiology team at Brompton Hospital in London, listening carefully to the Consultant Cardiologist. Among the many things, he learned, was that one has to be able to guess correctly within a point the Hemoglobin level, i.e. whether the patient is anemic or not. The secondly, one of the conferences at the hospital, famous for its wit, forced subdued nature and erudite professors hard of hearing (Dr Simon, the radiologist was a show in himself!), I listened an argument for the ideal length for the tubing of a Stethoscope.

Early stethoscopes.

The stethoscope was invented in France in 1816 by René Laennec at the Necker-Enfants Malades Hospital in Paris. It consisted of a wooden tube and was monaural. His device was similar to the common ear trumpet, a historical form of hearing aid; indeed, his invention was almost indistinguishable in structure and function from the trumpet, which was commonly called a "microphone". In 1851, Arthur Leared invented a binaural stethoscope, and in 1852 George Cammann perfected the design of the instrument for commercial production, which has become the standard ever since. Cammann also authored a major treatise on diagnosis by auscultation, which the refined binaural stethoscope made possible. By 1873, there were descriptions of a differential stethoscope that could connect to slightly different locations to create a slight stereo effect, though this did not become a standard tool in clinical practice.

Rappaport and Sprague designed a new stethoscope in the 1940s, which became the standard by which other stethoscopes are measured, consisting of two sides, one of which is used for the respiratory system, the other is used for the cardiovascular system. The Rappaport-Sprague was later made by Hewlett-Packard. HP's medical products division was spun off as part of Agilent Technologies, Inc., where it became Agilent Healthcare. Agilent Healthcare was purchased by Philips which became Philips Medical Systems, before the walnut-boxed, $300, original Rappaport-Sprague stethoscope was finally abandoned ca. 2004, along with Philips' brand (manufactured by Andromed, of Montreal, Canada) electronic stethoscope model. The Rappaport-Sprague model stethoscope was heavy and short (18–24 in (46–61 cm)) with an antiquated appearance recognizable by their two large independent latex rubber tubes connecting an exposed-leaf-spring-joined-pair of opposing "f"-shaped chrome-plated brass binaural ear tubes with a dual-head chest piece.

Several other minor refinements were made to stethoscopes, until in the early 1960s Dr. David Littmann, a Harvard Medical School professor, created a new stethoscope that was lighter than previous models and had improved acoustics. In the late 1970s, 3M-Littmann introduced the tunable diaphragm: a very hard (G-10) glass-epoxy resin diaphragm member with an overmolded silicone flexible acoustic surround which permitted increased excursion of the diaphragm member in a "z"-axis with respect to the plane of the sound collecting area. The left shift to a lower resonant frequency increases the volume of some low frequency sounds due to the longer waves propagated by the increased excursion of the hard diaphragm member suspended in the concentric accountic surround. Conversely, restricting excursion of the diaphragm by pressing the stethoscope diaphragm surface firmly against the anatomical area overlying the physiological sounds of interest, the acoustic surround could also be used to dampen excursion of the diaphragm in response to "z"-axis pressure against a concentric fret. This raises the frequency bias by shortening the wavelength to auscultate a higher range of physiological sounds. 3-M Littmann is also credited with a collapsible mold frame for sludge molding a single column bifurcating stethoscope tube with an internal septum dividing the single column stethoscope tube into discrete left and right binaural channels (AKA "cardiology tubing"; including a covered, or internal leaf spring-binaural ear tube connector).

In 1999, Richard Deslauriers patented the first external noise reducing stethoscope, the DRG Puretone. It featured two parallel lumens containing two steel coils which dissipated infiltrating noise as inaudible heat energy. The steel coil "insulation" added .30 lb to each stethoscope. In 2005, DRG's diagnostics division was acquired by TRIMLINE Medical Products.
As you can see from the photograph, I have my own version of the Noise Reduction technology: the ancient form of beading, this one done by a member of the Hocank Tribe of Indians of Nebraska!
(For lovers of History of Medicine, what other Medical phenomena are associated with the illustrious dr Laennec associated with?)
I still treasure the headpiece of my first ever stethoscope, which was a Sprague Rappaport Original. Nowadays you can find Chinese knockouts of the SR model but you can tell their fake origins by the long tubes, much longer than the flight of a flea!

Cambridge University scientists have solved the mystery of how fleas jump so far and so fast.
It was known that the energy to catapult a flea over a distance up to 200 times its body length lay in a spring-like structure in its body.
But scientists did not understand how they transferred this energy to the ground in order to jump.
High-speed footage now reveals that the secret lies in the way fleas use their hind legs as multi-jointed levers.
This "lever-effect" allows fleas to drive their feet onto the ground, and the sudden release of the "coiled spring" hurls the insect forwards and upwards, scientists report in the Journal of Experimental Biology.
Jumping controversy
Half a century ago two groups of researchers first discovered that the energy for the insects' jumping ability was contained in an internal spring, rather than in the fleas' miniature muscles.
Spines on the back of the flea's hind leg grip the ground for "take-off"

Thus the Cambridge University scientists have added to the ontology of our medical knowledge! Thank you… I am grateful.
This piece is dedicated to two future Jewish professionals, whose name in Hebrew mean:
1. Requested of God 2. Delicate

Saturday, 5 February 2011

Eye Examination of patients with type 2 DM: Please consult an Ophthalmologist or Optometrist

Prevalence and progression of visual impairment in patients newly diagnosed with clinical type 2 diabetes: a 6-year follow up study

Niels de Fine Olivarius email, Volkert Siersma email, Gitte Juul Almind email and Niels Vesti Nielsen email

BMC Public Health 2011, 11:80doi:10.1186/1471-2458-11-80
Published: 4 February 2011
Abstract (provisional)


Many diabetic patients fear visual loss as the worst consequence of diabetes. In most studies the main eye pathology is assigned as the cause of visual impairment. This study analysed a broad range of possible ocular and non-ocular predictors of visual impairment prospectively in patients newly diagnosed with clinical type 2 diabetes.

Data were from a population-based cohort of 1,241 persons newly diagnosed with clinical, often symptomatic type 2 diabetes aged 40 years or over. After 6 years, 807 patients were followed up. Standard eye examinations were done by practising ophthalmologists.

At diabetes diagnosis median age was 65.5 years. Over 6 years, the prevalence of blindness (visual acuity of best seeing eye <= 0.1) rose from 0.9% (11/1,241) to 2.4% (19/807) and the prevalence of moderate visual impairment (>0.1; <0.5) rose from 5.4% (67/1,241) to 6.7% (54/807). The incidence (95% confidence interval) of blindness was 40.2 (25.3-63.8) per 10,000 patient-years. Baseline predictors of level of visual acuity (age, age-related macular degeneration (AMD), cataract, living alone, low self-rated health, and sedentary life-style) and speed of continued visual loss (age, AMD, diabetic retinopathy (DR), cataract, living alone, and high fasting triglycerides) were identified.

In a comprehensive assessment of predictors of visual impairment, even in a health care system allowing self-referral to free eye examinations, treatable eye pathologies such as DR and cataract emerge together with age as the most notable predictors of continued visual loss after diabetes diagnosis. Our results underline the importance of eliminating barriers to efficient eye care by increasing patients' and primary care practitioners' awareness of the necessity of regular eye examinations and timely surgical treatment.

Olive Oil for Osteoporosis

Research article
Olive Oil effectively mitigates Ovariectomy induced Osteoporosis In Rats

Nermine K Saleh email and Hanan A Saleh email

BMC Complementary and Alternative Medicine 2011, 11:10doi:10.1186/1472-6882-11-10
Published: 4 February 2011
Abstract (provisional)


Osteoporosis, a reduction in bone mineral density, represents the most common metabolic bone disease. Postmenopausal women are particularly susceptible to osteoporosis when their production of estrogen declines. For these women, fracture is a leading cause of morbidity and mortality. This study was conducted to evaluate the protective effects of olive oil supplementation against osteoporosis in ovariectomized (OVX) rats.

We studied adult female Wistar rats aged 12-14 months, divided into three groups: sham operated control (SHAM), ovariectomized (OVX), and ovariectomized rats supplemented with extravirgin olive oil (Olive-OVX) orally for 12 weeks; 4 weeks before ovariectomy and 8 weeks after. At the end of the experiment, blood samples were collected. Plasma levels of calcium, phosphorus, alkaline phosphatase (ALP), malondialdehyde (MDA), and nitrates were assayed. Specimens from both the tibia and the liver were processed for light microscopic examination. Histomorphometric analysis of the tibia was also performed.

The OVX-rats showed a significant decrease in plasma calcium levels, and a significant increase in plasma ALP, MDA, and nitrates levels. These changes were attenuated by olive oil supplementation in the Olive-OVX rats. Light microscopic examination of the tibia of the OVX rats revealed a significant decrease in the cortical bone thickness (CBT) and the trabecular bone thickness (TBT). In addition, there was a significant increase in the osteoclast number denoting bone resorption. In the Olive-OVX rats these parameters were markedly improved as compared to the OVX group. Examination of the liver specimens revealed mononuclear cellular infiltration in the portal areas in the OVX-rats which was not detected in the Olive-OVX rats.

Olive oil effectively mitigated ovariectomy-induced osteoporosis in rats, and is a promising candidate for the treatment of postmenopausal osteoporosis.

Wednesday, 2 February 2011

Rapid Decline in Kidney Function: Asian Patients may be susceptible?

End-stage renal disease preceded by rapid declines in kidney function: a case series

Peter Lee email, Kirsten Johansen email and Chi-yuan Hsu email

BMC Nephrology 2011, 12:5doi:10.1186/1471-2369-12-5
Published: 1 February 2011
Abstract (provisional)


Few studies have defined alternate pathways by which chronic kidney disease (CKD) patients transition into end-stage renal disease (ESRD).

We studied all consecutive patients initiated on maintenance hemodialysis or peritoneal dialysis over several years at two dialysis units in Northern California. Rapid decline in kidney function was considered to have occurred if a patient was documented to have estimated GFR >30 ml/min/1.73m2 within three months prior to the initiation of chronic dialysis.

We found that 8 out of 105 incident chronic dialysis patients one dialysis unit (7.6%; 95% confidence interval 3.4-14.5%) and 9 out of 71 incident patients at another (12.7%, 95% CI 6.0%-22.7%) suffered rapid decline in kidney function that was the immediate precipitant for the need for permanent renal replacement therapy. All these patients started hemodialysis and all relied on catheters for vascular access. Documentation submitted to United States Renal Data System did not fully reflect the health status of these patients during their "pre-ESRD" period.

A sizeable minority of ESRD cases are preceded by rapid declines in kidney function. The importance of these periods of rapid decline may have been under-appreciated in prior studies of the natural history of CKD and ESRD.