EDUCATION UPDATE

Watch Football Game Streaming Live For Free

2014-12-02T02:22:00.001-08:00

To watch any game of football click on the link below :
goo.gl/CfXhOR

Wednesday, December 3

Man United

1:45 AM

Stoke City

Leicester City

1:45 AM

Liverpool

Burnley FC

1:45 AM

Newcastle

Swansea City

1:45 AM

QPR

Crystal Palace

2:00 AM

Aston Villa

West Brom

2:00 AM

West Ham

Thursday, December 4

Sunderland

1:45 AM

Man City

Chelsea

1:45 AM

Tottenham

Everton

1:45 AM

Hull City

Arsenal

1:45 AM

Southampton

Saturday, December 6

Newcastle

6:45 PM

Chelsea

Liverpool

9:00 PM

Sunderland

Stoke City

9:00 PM

Arsenal

QPR

9:00 PM

Burnley FC

Tottenham

9:00 PM

Crystal Palace

Hull City

9:00 PM

West Brom

Man City

11:30 PM

Everton

Sunday, December 7

West Ham

7:30 PM

Swansea City

Aston Villa

10:00 PM

Leicester City

Tuesday, December 9

Southampton

2:00 AM

Man United

All times are in Bangladesh Standard Time

Saturday, December 6

Newcastle

6:45 PM

Chelsea

Liverpool

9:00 PM

Sunderland

Stoke City

9:00 PM

Arsenal

QPR

9:00 PM

Burnley FC

Tottenham

9:00 PM

Crystal Palace

Hull City

9:00 PM

West Brom

Man City

11:30 PM

Everton

Sunday, December 7

West Ham

7:30 PM

Swansea City

Aston Villa

10:00 PM

Leicester City

Tuesday, December 9

Southampton

2:00 AM

Man United

Saturday, December 13

Leicester City

9:00 PM

Man City

Sunderland

9:00 PM

West Ham

Crystal Palace

9:00 PM

Stoke City

Burnley FC

9:00 PM

Southampton

Chelsea

9:00 PM

Hull City

West Brom

9:00 PM

Aston Villa

Arsenal

11:30 PM

Newcastle

Sunday, December 14

Man United

7:30 PM

Liverpool

Swansea City

10:00 PM

Tottenham

Tuesday, December 16

Everton

2:00 AM

QPR

All times are in Bangladesh Standard Time

Saturday, December 20

Man City

6:45 PM

Crystal Palace

West Ham

9:00 PM

Leicester City

Tottenham

9:00 PM

Burnley FC

Hull City

9:00 PM

Swansea City

Aston Villa

9:00 PM

Man United

Friday, December 26

Chelsea

6:45 PM

West Ham

West Brom

9:00 PM

Man City

Sunderland

9:00 PM

Hull City

Everton

9:00 PM

Stoke City

Leicester City

9:00 PM

Tottenham

All times are in Bangladesh Standard Time

MH370: Plane search signal 'important lead'

2014-04-06T01:11:00.001-07:00

Australian co-ordinators in the search for a missing Malaysian plane say a Chinese ship has detected a pulse signal for a second time, within hours of it being heard earlier on Saturday.

Air Chief Marshal Angus Houston called the discovery in the southern Indian Ocean an "important and encouraging lead".

He warned that the data were still unverified.

British naval ship HMS Echo is sailing to the area to investigate further.

It is expected to arrive in the early hours of Monday.

Australian aircraft were also on their way, Air Chief Marshal Houston told reporters. Australian naval vessel Ocean Shield would be heading to the latest search area once it had investigated a third acoustic detection elsewhere.

Both HMS Echo and ADV Ocean Shield have technology able to detect underwater signals emitted by data recorders.

Malaysia Airlines flight MH370 disappeared on 8 March with 239 people on board. Investigators believe it crashed in the Indian Ocean although no confirmed debris has been found. The battery-powered signal from the "black box" recorders fades after 30 days.

Caution urged

After confirming details of the first pulse detected on Saturday which had "characteristics consistent with" an aircraft's flight recorder, Air Chief Marshal Houston told a news briefing at Pearce Air Base near Perth of a second signal.

"[Saturday] afternoon Perth time, there was another acoustic detection less than 2 km (1.2 miles) from the original."

The second signal lasted about 90 seconds, he said.

The search co-ordinator insisted the latest developments should be treated as unverified "until such time as we can provide an unequivocal determination".

"We are working in a very big ocean and within a very large search area, and so far since the aircraft went missing we have had very few leads which allow us to narrow the search area," he said.

"I assure you that we will follow up and exhaust every credible lead that we receive."

A dozen military aircraft and 13 ships are already searching three areas about 2,000 km (1,240 miles) north-west of the Australian city of Perth.

They will cover some 216,000 sq km on Sunday.

Australian Prime Minister Tony Abbott earlier said he was "hopeful but by no means certain" that the signal detected on Saturday was linked to missing flight MH370.

Haixun 01 picked up the first so-called "ping" signal at about 25 degrees south latitude and 101 degrees east longitude, state-run Xinhua news agency said.

The signal reportedly had a frequency of 37.5kHz - the same as that emitted by the flight recorders.

Three people on board the boat were said to have heard the pings, which were not recorded as they came suddenly.

Xinhua also reported that a Chinese military plane had spotted a number of white floating objects about 90km away a few hours earlier.

Flight MH370 disappeared en route from Kuala Lumpur to Beijing four weeks ago.

Malaysia earlier announced it had set up three ministerial committees to help co-ordinate the search, and a new investigation team which would include members from Australia, China, the US, the UK and France.

- Source BBC (6th April 2014)

Sex and STD's

2013-12-01T00:37:00.001-08:00

Talking about 'sex' among us will automatically grab the attention of
any person making it more inquisitive. Everyone hesitate to talk about
sex, they take it as a bad thing not even the parents as well as the
teachers. Teachers in school doesn't provide the adequate knowledge
about 'sex' and their associated diseases to the students, and so on
the increasing age increases the desire of sex among the youngsters,
which is a normal physiological phenomenon and oneday they may get
involved in such activities called 'sex'. But talking about STD, we
know these get transferred in people during unprotected sexual
intercourse, not only the sex but the sexual activity where there is
involvement of genital secretion and as well as unscreened or poorly
screened of blood transfusion also transfer these diseases.

Age group of 18 - 25 years are the main victims of STD's. In context
of Nepal the most common is Gonorrhoea, as it is caused by the virus
it has got cure till now, but HIV AIDS is the matter of concern
because it develops slowly and sometime it may be asymptomatic and on
later stage make the person immunocompromised and favour other
infections. And now the Genital Herpes has come to contrast and is
increasing. HIV and Genital Herpes both are caused by the viruses, but
death due to HIV take years than Genital Herpes. Due to less anti
viral drug these viral infections can't get a proper cure.

People rarely visit doctor in Nepal, usually they feel shy and also
they fear of disclosing their secrecy. So most of the patient remain
out of treatment in the primitive stage of the disease and at last
when the disease get worsen they come alone or with their family.
Doctor should also be faithful and concerned about disclosing the
patient privacy.

People should be aware that most of the STD's are curable, so if they
have any genital problems they should consult the doctor soon as
possible, as there is a saying "Stitch in time, saves Nine". To stop
transmission always use a condom, do regular check up and do timely
screening of blood. So, practice safe sex and enjoy a happy life.

Seasonal Change and Common Cold

2013-11-24T05:48:00.001-08:00

As we can see nowadays many people suffering from cold as the winter
season is on its way, this cold happens to be, due to change in
season. In context of Nepal, its prevalence increases slowly after the
end of Dashain or we can say from 1st week of Kartik and remains high
to last week of Kartik or it may extend to the 2nd week of Mangshir
aswell (October-November), and than it slowly declines. Seasonal
change in realtive humidity may also affect the prevalence of colds.
As well as, many schools and colleges remain shutdown for winter
vacation which prompt people spend more time indoors which increase
the chances of spread of cold viruses from one person to another.

The most common cold causing viruses survive better when humidity is
low, the colder months of the year. Cold weather also may make the
nasal passages lining drier and making more vulnerable to viral
infection.

¤ Spreading of Colds

It usually depends on various means, and most of all it depends on the
type of the virus. Any or all of the following routes may be the cause
of transmission:-

1) Touching:- Infectious respiratory secretions can be present on any
material or article or surfaces. This mode is most common and gets
transmitted while touching the infectious particle and then touching
the eye or nose.

2) Inhalation:- This usually occurs in a close confined room or in the
crowdy places. It can be sub-divided in two parts,

i) Inhaling relatively large particles of respiratory secretions
transported briefly in air, and

ii) Inhaling droplet nuclei, these are the smaller infectious
particles suspended in the air for long periods of time.

Rhinovirus, the most common virus known to cause the common cold,
which are shed in highest concentraion in the nasal secretions. A
person is most likely to transmit rhino viruses in the second to
fourth day of infection, when the virus in the nasal secretion is
highest. Latest study reveal that treatment of colds increase the
amount of virus in the nasal secretion which make the sufferer more of
a hazard to others.

¤ Prevention

Handwashing is the simplest and most effective way to keep from
getting rhinovirus colds. Not touching the nose or eyes is another.
Individuals with colds should always sneeze or cough into a facial
tissue, and promptly throw it away. If possible, one should avoid
close, prolonged exposure to persons who have colds. Because
rhinoviruses can survive up to three hours outside the nasal passages
on inanimate objects and skin, cleaning environmental surfaces with a
virus-killing disinfectant might help prevent spread of infection.

Donate Car to Charity California

2013-11-23T12:57:00.001-08:00

The way you think is better than other and your work of car donation
will be blessings to you from all the people. You get life once, if
you are capable than why not to donate something to needy, if it can
help them? Car donation is the better way to help & support to people
who have to need without bothering himself. You are donate the car for
remove the old car. It is good alternative for people who have old car
by getting rid of an old useless vehicle. With this donation you are
also help to other people. There are no need to a better condition car
for donation. Cracked or Broken cars may also donate. You have also
other choice to donate money through your old car. There are many
social company are make the auction of this type of cars and make the
profit. The profit is use in social works. After the car donation you
can get your donation receipt. There are 20 percent of Poor families
are not able to purchase the car. They are spent large budget of their
income in transportation. Social companies provide them a car or money
through your donation. The poor families are also happy through
getting the car or money.

Other benefits of your car donation in California is free towing
services offered. In this offer you are not required to take the car
at Center for Car Donation. The Center Authorities providing pickup
facility to you. They pick up the car from your home. For the car
donation you have to prepare some important documents like insurance &
registration and if you do not have the title, the Center Authority
provides you duplicate form of title.

Donation center also give the facility for donate your car. At the
time of pick up the car the donation center give you the tax form
which is very important for you because this tax form is provides tax
deduction from your tax. You can ask the picker about the form
filling. They are introduce to you about the tax form. Donation of
your car is one of the most rewarding work. When you donate the car,
you do support the people who are poor & you shining other's life by
helping poor peoples. There are many homeless family in California &
their children are not able for go to school. By helping this type of
peoples you get great blessings from the mouth of poor families.

***Views Shared From in public interest for "Donate Car to Charity
California" for betterment of poverty and wishes of poor people.

Mesothelioma

2013-11-23T12:34:00.001-08:00

Mesothelioma is a rare and very serious form of cancer. The only known
cause of mesothelioma is exposure to asbestos. that develops from
cells of the mesothelium, the protective lining that covers many of
the internal organs of the body. The most common anatomical site for
mesothelioma is the pleura (the outer lining of the lungs and internal
chest wall), but it can also arise in the peritoneum (the lining of
the abdominal cavity), the pericardium (the sac that surrounds the
heart), or the tunica vaginalis.

Signs and symptoms of mesothelioma include shortness of breath due to
pleural effusion (fluid between the lung and the chest wall), chest
wall pain, and constitutional signs such as unexplained weight loss.
The diagnosis may be suspected based on chest X-ray and CT scan
findings, but must be confirmed either by examining serous effusion
cytology or with a biopsy (removing a sample of the suspicious
tissue). A thoracoscopy (inserting a tube with a camera into the
chest) can be used to acquire biopsy material, and allows the
introduction of substances such as talc to obliterate the pleural
space (a procedure called pleurodesis), preventing more fluid from
accumulating and pressing on the lung. Despite treatment with
chemotherapy, radiation therapy or sometimes surgery, mesothelioma
carries a poor prognosis. Research about screening tests for the early
detection of mesothelioma is ongoing.

It is not usually transferred from male to female by any sexual means
but, in the developing country such as south asia the house wifes wash
the clothes of their husband and similarly the wife washing the
husband clothes who work in the asbestos industry are likely to get
affected aswell.

As it is rare but a serious medical conditions so many companies that
used asbestos have set aside billions of dollars in trust funds to
compensate victims of this disease. They have introduced Mesothelioma
Law Firm that is recognized nationally in USA their representation of
product liability and mesothelioma victims, and for our understanding
of and compassion for injured parties and their families.

The Thyroid, Thymus and the Parathyroid Glands

2013-10-04T05:10:00.005-07:00

The Thyroid Gland

Development

The thyroid gland develops as a median down growth of a column of cells from the pharyngeal floor between the first and second pharyngeal pouches (subsequently marked by the foramen caecum of the tongue). The canalized column becomes the thyroglossal duct which is displaced forwards by the developing hyoid bone and then, below the hyoid, lies slightly to one side, more commonly the left. The duct bifurcates to form the thyroid lobes and a portion of the duct forms the pyramidal lobe (Fig. 162)

Congenital anomalies

A few clinically relevant developmental errors may occur.

Ectopic Thyroid Tissue: Ectopic thyroid tissue may lie anywhere along the line of descent and May in rare instances, be the only thyroid tissue present. An occasional site for this anomaly is in the base of the tongue. Ectopic thyroid tissue can be identified by isotope scanning.

Thyroglossal Cyst: A thyroglossal cyst results from persistence of a portion of the thyroglossal duct. It is the commonest congenital error and presents as an asymptomatic swelling somewhere along the course of the duct, but usually below the level of the hyoid bone. These cysts usually become clinically evident in the late teens, presumably because the lining becomes secretory. There is often thyroid tissue associated with the cyst and, in some cases, this may represent the only thyroid tissue present. This fact must be established before surgical excision is performed to avoid rendering the patient hypothyroid.

Anatomy

The thyroid gland occupies an important position in the centre of the visceral compartment of the neck, lying astride the trachea just above the thoracic inlet. Normally weighing about 25 g. the anatomy of this vital endocrine gland is relevant both to the non-operating clinician and in operative surgery.

The gland has two lobes, shaped roughly like slender pears, hugging the anterolateral aspect

of his cervical trachea from the level of the thyroid cartilage to the 5th or 6th tracheal ring. The right lobe is often larger than the plastered quite firmly to the anterior surface of the trachea, at the level of the 2nd and 3rd tracheal rings. A variable -sized, but usually small, pyramidal lobe arises from the isthmus somewhere along its upper border near the midline. The thyroid gland is covered by fascia and the strap muscles and more laterally, it is tucked under the diverging anterior borders of the sternoclidomastoid muscles.

Anatomy

Clinical beginners often search for the gland too high in the neck. It should be palpated from behind the subject with the middle and index fingers lying just above the sternoclavicular joint across the trachea, as though spreading the converging sternoclidomastoid muscles. Because of its fascial attachments, the gland moves upwards with swallowing and, therefore, it slides under the examining fingers. The normal gland can be felt in thin necks. It is soft and supple and the tracheal rings can be palpated through it.

The Vascular Supply

As would be expected from its endocrine function, the blood supply of the thyroid gland is very rich in the hyperthyroid state, and there may be an enormous increase in the volume of blood circulating through the gland. Each thyroid lobe is supplied by a superior and an inferior thyroid artery and drained by three veins.

The Superior Vascular Pedicle: The superior vascular pedicle contains the superior thyroid artery, which is the first branch of the external jugular vein. The external laryngeal nerve is closely related to this pedicle and is discussed below. The superior vessels enter the upper pole of the gland at its apex with branches to the front and back of the gland. These superior vessels are easily dealt with surgically, because the lose space between the two capsules is developed at the upper pole of the thyroid lobe and a ligature is placed close to the upper pole, to include both vessels and exclude the external laryngeal nerve.

The Inferior Thyroid Artery: The inferior thyroid artery and vein do not relate to each other al all. The artery arises from the thyrocervical trunk, passes behind the carotid sheath and then runs transversely across the space between this and the thyroid gland to enter the deep surface of the gland as several separate branches close to the tracheothyroid groove. These terminal branches of the inferior thyroid artery are uncomfortably close to the recurrent laryngeal nerve and the inferior parathyroid gland and should be surgically shunned. If the inferior thyroid artery is to be ligated, it should be done in its transverse portion medial to the carotid sheath.

The Vascular Supply

The Inferior Thyroid Veins: The inferior thyroid veins, of which there are always a few on each side, leave the lower border of the gland and pass through the loose fascial space to join the left brachiocephalic vein. They are fragile and require being ligated single.
The Middle Thyroid Veins: The applied anatomy of the middle thyroid vein is important because it is a short, thin-walled vessel, leaving the middle of the gland and directly coursing laterally to pass in front of behind the carotid artery and enter the internal jugular vein. It is the first vessel encountered in thyroidectomy and merits careful ligation when it is met early on during the development of the intercapsular space mentioned above.
The Thyroidea Ima Artery: The Thyroidea Ima artery from the brachiocephalic trunk extending in front of the trachea is small and surgically irrelevant.

The Parathyroid Glands

The number of parathyroids very from 2 to 6, but, in 80 percent of cases, there are 4 (2 on each side). The total weight of 4 normal glands is about 140mg.

Embryology: The upper parathyroids arise from the 4th branchial pouch and come to lie in close association with the upper part of the lateral lobes of the thyroid. This position is constant.

The lower parathyroids arise from the 3rd branchial pouch in association with the thymus, and descend with the thymus. Because of this embryological migration they may be found anywhere from the upper pole of the thyroid to the anterior mediastinum.

Anatomy

The glands are the size of a split pea. They are pink or brown in colour, but are frequently covered by fat, making them difficult to recognize.

The superior glands lie on the posterior surface of the middle third of the thyroid, usually above the inferior thyroid artery, but well posterior to this plane. If enlarged they may descend into the posterior mediastinum.

The inferior glands are mostly found on the posterior surface of the lower pole of the thyroid or within 1 cm below the lower pole. The may be higher or lower, occasionally as far down as in the thymus in the anterior mediastinum. They lie in a more anterior plane than the upper glands.

A parathyroid gland located within the surgical false capsule of the thyroid, when diseased, remains in place locally. A gland outside the capsule is often displaced into the posterior mediastinum. Sometimes the parathyroids may be embedded in the thyroid gland.

Blood supply

A special small parathyroid artery supplies each gland. The lower parathyroid artery comes from the inferior thyroid artery and is a guide to the gland if it lies below the lower margin of the thyroid.

The upper parathyroid artery arises from the inferior artery or from an anastomosing artery joining the superior and inferior thyroid arteries and only very occasionally from the superior thyroid artery.

There is a good collateral arterial supply from the tracheal vessels and adequate parathyroid function persists even if all four major thyroid arteries are ligated.

Examination of the Thyroid

Instruction
Examine the thyroid.
Test this patient’s thyroid status.
Look at the neck.

Salient features

l Introduce yourself to the patient and while shaking hands note whether his or her palms are warm and sweaty.

l Inspection of the neck:

Look for the JVP

Scars of surgery.

Enlarged cervical lymph nodes.

Goiter.

l Palpation (always begin by palpating from behind):

Seat the patient comfortably.

While palpating the gland ensures that there is a glass of water to swallow.

Palpate the thyroid and note the following:

Size

Mobility

Texture- simple or nodular

(Solitary or multiple)?

Tenderness.

Pembertion’s sign (on raising the arms above the head patients with retrosternal goiters may develop signs of compression, i.e. suffusion of the face, syncope or giddiness).

l Palpate cervical lymph nodes.

l Feel the carotid arteries.

l Palpate for tracheal deviation.

l Percuss for retrosternal extension.

Auscultate over the gland for bruit, carotid bruits.
Test sternomastoid function (this muscle may be infiltrated in thyroid malignancies).

l Thyroid function should then be assessed:

1. Eye signs:

l Lid lag.

l Exophthalmos.

l Lid retraction (sclera visible above the cornea).

l Extra ocular movements.

2. Hand:

l Pulse for tachycardia or atrial fibrillation

l Tremor.

l Palmer erythema (thyrotoxicosis).

l Supinator jerks (inverted in hypothyroidism).

l Proximal weakness in the upper arm.

3. Skin: look for pretibial myxoedema.

4. Elicit the ankle jerks.

Graves ’ disease
Instruction
Look at this patient.
Determine this patient’s thyroid status.

l Salient features

l Patient is fidgety and restless.

l While shaking hands with the patient note the warm sweaty palms.

l Look for tremor, thyroid acropachy, onycholysis (Plummer’s nails) and palmer erythema.

l Check pulse (for tachycardia or the irregularly irregular pulse of atrial fibrillation).

l Comment on proptosis (after looking at the eyes from behind and above).

l Check for lid lag.

l Check for scars of previous tarsorrhaphy.

l Examine the neck for goiter and auscultate over the gland.

l Mention previous thyroidectomy scar if present.

l Check the shins for pretibial myxoedema (bilateral pinkish, brown dermal plaques).

l Test for proximal myopathy.

l Tell the examiner that you would like to ask the patient about the following:

- Easy irritability.

- Weight loss with increased appetite.

- Frequent defecation.

- Oligomenorrhoea.

- Dislike for hot weather.

- Family history of thyroid disease.

Exophthalmos
Instruction
Examine this patient’s face.
Perform a general examination of this patient.

l Salient features

l Prominent eyeballs.

l Look at the patient’s eyes from behind and above for proptosis.

l Comment on lid retraction (the sclera above the upper limbus of the cornea will be seen); this is Dalrymple’s sign.

l Comment on the sclera visible between the lower eyelid and the lower limbus of the cornea (i.e. comment on the exophthalmos). Most patients have bilateral exophthalmos with unilateral prominence.

l Check for lid lag (ask the patient to follow your finger and then move your finger along the arc of a circle from a point above his or her head to a point below the nose- the movement of the lid lags behind the globe); this is von Graefe’s sign.

l Check for extraocular movements and comment on the cornea.

l Look for the following:

- Signs of thyrotoxicosis

(Fast pulse rate, tremor, sweating).

- Goiter (listen for bruit).

- Post-thyroidectomy scar.

Pretibial Myxoedema
Instruction
Look at this patient’s legs.

Investigation:

l It is important to confirm the presence of thyrotoxicosis biochemically by more than one test of thyroid function in view of the likely need for prolonged medical treatment or destructive therapy. Serum T3 and T4 are elevated in the majority, but T4 is in the upper part of the normal range and T3 raised (T3 toxicosis) in 5% of patients. In primary thyrotoxicosis, serum, TSH is undetectable at less than 0.05mU/l. Further tests, which may be required to establish the aetiology of thyrotoxicosis, include measurement of TSH receptor antibodies (TRAB, elevated in Graves’ disease, and isotope scanning.

Management:

l Definitive treatment of thyrotoxicosis depends on the underlying cause, and may include antithyroid drugs, radioactive iodine or surgery. In all patients with thyrotoxicosis a non-selective b adrenoceptor antagonist (b-blocker), such as propranolol (160 mg daily) or nadolo (40-80mg daily), will alleviate but not abolish symptoms within 24-48 hours. Beta-blockers cannot recommended for long-term treatment, but they are extremely useful in the short term, e.g. for patients awaiting hospital consultation.

Alcohol and Energy Drinks a Dangerous Combination

2012-12-30T23:25:00.001-08:00

As the New Year is coming near there are many youngster and adults who want to celebrate with loads of fun, and many of the times during parties and all.

The Australian Medical Association(AMA) has warned people against taking up the dangerous habit of mixing alcohol and highly caffeinated energy drinks in an effort to extend their 'party time'. AMA President, Dr Steve Hambleton, said that mixing alcohol and energy drinks has become popular among young people and adults because they want to celebrate for longer periods of time.

"New Year's Eve will be a time of risky behaviour because people will start partying early and will want to be still celebrating into the night to see the New Year in," Dr Hambleton said.

"This is not a safe or healthy way to behave."

"It can lead people to consume excessive amounts of alcohol and excessive amounts of caffeine, both of which can be harmful on their own, but potentially lethal when consumed together."

"The combination reduces the perception of intoxication and allows people to drink for longer periods of time."

"It is a trend that has become popular among crowds at music festivals and many people will try it this holiday period."

"The holiday season is a busy time for emergency departments, which don't need further casualties lining up due to misadventures from mixing alcohol and energy drinks."

The potential for harm falls into three main categories:

The combination of alcohol and highly caffeinated energy drinks can increase the risk of dehydration (leading to diarrhoea, nausea, vomiting, headache, increased heart rate, muscle cramp, and a more severe hangover). Warm weather and extended periods of dancing or being in crowds may also contribute to problems;
The combination of stimulant (caffeine) and depressant (alcohol) sends mixed messages to the nervous system, which can result in cardiovascular problems as well as sleep disturbances;
The combination of alcohol and energy drinks reduces the feelings/perception of alcohol intoxication, leading to increased alcohol consumption and significantly impaired judgement and decision-making.

Dr Hambleton said that public health advocates remain very concerned that the marketing of energy drinks to young people is similar to the marketing strategies used to sell tobacco and alcohol.

"The AMA will continue to raise these concerns with governments and relevant agencies in 2013," Dr Hambleton said.

- Source Australian Medical Association

Volcano in Rasuwa, Nepal - Begining of The End Of The World

2012-12-20T03:37:00.001-08:00

"A volcano eruption has been reported at the area of Mt Langtang in
Rasuwa district on Thursday morning. According to Nepal Army personnel
deputed at the Rasuwa-based Langtang National Park, they had witnessed
a sudden explosion with smoke and flames at the area at around 10 am
and subsequently informed to the NA headquarters about the
incident.The location of the site is four kilometers northeast from
the Mt Langtang. The nearest human settlement, the village of Linling
Sherpa Gaun and Briding, lies at a distance of a day´s walk from the
area. A Nepal Army helicopter has also been sent to find details about
the incident."

- REPUBLICA ONLINE (www.myrepublica.com)
Posted on 2012-12-20

Is the world really gonna end this so fast, as the time for the dooms
day is just ticking around, today morning volcano erupt in Rasuwa,
Nepal. The war has started between the nature and the living thing but
'' Is God going to turn around so fast and say, 'I'm going to kill all
my children'. I hope probably not.

21 December 2012 - World End; Real or Unreal

2012-12-17T12:22:00.002-08:00

All around the world, in each and every people talk, on each corner of the road they are talking about the topic "IS WORLD REALLY GONNA END???". Some of they say that, 'Ya! its really gonna end.' some say 'aahh its just a hoax, i don't even care'. As the coming date 21 December is no longer that long but its just 3 days to go from today. Regarding this topic there were many things people made on the internet, many of them were just a hoax. We can't predict if it really gonna end, but some changes may come on the Earth as some planets are going to align on the same plane on that day.

This thing has come come from the Mayan's Civilization. Do you really thing that they had predicted that when the world will come to an end? We may come up to two question from the Mayan's Civilization, first one is that, when we start to do some work we complete it, when armies goes for a war they accomplish the mission, when boss gives you to do some work you complete it, so can't it be possible that the people of that civilization has made the calendar from begining to the end of the world? The last question that may arise is, who has that much time to make the calendar of years and years, they may have started that they would make a calendar for years but after making some they may have got bored and left that thing as it is. But for kind concern the mayan calendar is built in a round circles of each circle for months and years, so as it is you are coming back to the same point from where you have started.

Hope that this world won't end,because after Saturday it comes Sunday, after day the night and vice versa. So, this may not be the END of the WORLD but can be just a begining of the new day.

Though I am not GOD that I can predict what the outcome can be, so you can leave your thoughts about this day on the comment and we can see that what other thinks of the world end.

Japan team create liver from stem cells: report

2012-06-08T04:22:00.003-07:00

TOKYO — Japanese researchers have created a functioning human liver from stemcells, a report said Friday, raising hopes for the manufacture of artificial organs for those in need of transplants.

A team of scientists transplanted induced pluripotent stem (iPS) cells into the body of a mouse, where it grew into a small, but working, human liver, the Yomiuri Shimbun said.

Stemcells are frequently harvested from embryos, which are then discarded, a practice some people find morally objectionable. But iPS cells -- which have the potential to develop into any body tissue -- can be taken from adults.

A team led by professor Hideki Taniguchi at Yokohama City University developed human iPS cells into "precursor cells", which they then transplanted into a mouse's head to take advantage of increased blood flow.

The cells grew into a human liver 5 millimetres (0.2 inches) in size that was capable of generating human proteins and breaking down drugs, the Yomiuri reported.

The breakthrough opens the door to the artificial creation of human organs, a key battleground for doctors who constantly face a shortage of transplant donors.

Taniguchi's research could be "an important bridge between basic research and clinical application" but faces various challenges before it can be put into medical practice, the Yomiuri said.

An abstract of Taniguchi's research was delivered to regenerative medicine researchers ahead of an academic conference next week, but Taniguchi declined to comment to AFP before the meeting.

Two separate teams, one from the United States and one from Japan, discovered iPS cells in 2006.

- via AFP

SLC Result 2068 Published

2012-06-06T11:26:00.001-07:00

SLC result has been published, results can be seen in the websites and through SMS.

Exam Control Board said that this year maximum number of students have passed in SLC exam, and almost cent percent regular candidates has passed the Iron Gate.

To See your result:- SMS to 1400 or 8080.

To See only result:-

With marksheet:-

www.educationsansar.com

This year Nepal Telecom is unable to publish the SLC result via IVR system, so you can better check it through SMS;

Type slc and send sms to 1400

Example :- Type SLC 0123456A and send it to 1400

Glaucoma: The vision-stealer

2012-06-05T15:24:00.000-07:00

Severe headache, nausea, vomiting, blurring of vision, pain in the eyeballs, halos and watering from the eyes — when you experience either of these sensations, you perhaps won’t take it seriously. Only when it becomes unbearable, will you visit your eye doctor, perhaps waiting till the last moment. You are impatient for the doctor’s diagnosis and when the wait is over, it will perhaps be discovered that you are suffering from — glaucoma.

Though scary, this is a possibility. But the point is not to scare you; it is only to make you aware. And if you already have an idea, then spread the word. This is essential because “most of glaucoma is detected late as it is symptom-less,” says Dr Sudhir Gautam, Medical Director and ophthalmologist at Lions Eye Hospital.

But what about the aforementioned aspects, are they symptoms? “In some type of glaucoma, patients come up with such symptoms,” mentions Dr Gautam.

Adding more on the point, Dr Manmohan Lal Shrestha, Ophthalmologist at Nepal Eye Hospital says, “Dizziness, photo phobia and unable to look at the light can also be considered as some of the symptoms.”

What is Glaucoma?

Of course only knowing the symptoms is not enough; you have to have sound knowledge about what glaucoma is. “Constant or intermittent, permanent or temporary rise of pressure of the eye ball beyond the tolerance limit of an individual causing permanent or temporary, structural or functional damage of optic nerve,” answers Dr Gautam. In layman’s term, like high blood pressure, even the eyes have their pressure and when its high, the optic nerve, the main nerve responsible for vision, gets damaged due to which vision depletes leading to glaucoma.

Of course understanding about glaucoma, a question immediately props up, why does it occur or what are its causes?

“Drainage of the fluid (aqueous humor) inside the eye into blood vessels is obstructed and the pressure in the eye is raised that damages the optic nerve,” informs Dr Gautam.

This fluid is like food for the eyes, it consumes as required and discards the excess, “but when it stops processing in such a manner, you suffer from glaucoma,” adds Dr Shrestha.

With this you have to know the different types of glaucoma. Some important types are, open angle glaucoma, narrow angle or angle closure glaucoma, congenital glaucoma, normal tension glaucoma etcetera.

Vulnerable ones

Usually most of the diseases are age-specific, but it’s not the same with glaucoma, because anybody can get it, “commonly it is inherited”. Nonetheless, glaucoma is not very common in Nepal, “those who suffer from it, usually go blind because of ignorance about the condition,” mentions Dr Gautam and Dr Shrestha and they further add that “most of the glaucoma cases in Nepal are detected during routine check-ups of the eye”.

So people with a family history ought to go for a regular check-up. And, “an ideal time for regular check-up is every six months,” advises Dr Shrestha. He also highlights that if glaucoma in the west is the second main cause of blindness, in Nepal it is the third. “It has been found out that suffering from glaucoma depends on the lifestyle, however, the reason is still unknown.”

Besides this, there are people who are at increased risk of getting glaucoma. “Children of glaucoma patients, long term use of steroid drugs, trauma, diabetes, hypertensive retinopathy, and structural defect of eye are the risk factors for glaucoma,” says Dr Gautam.

Referring to the eye structure Dr Shrestha explains that “frequent power change is a reason to worry about and is an indicator for immediate check-up”.

Diagnosis and treatment

There are three major signs to conform the diagnosis of glaucoma,“raise of intraocular pressure, cupping of optic nerve disc (pressure mark on the optic nerve) and defect in field of vision,” mentions Dr Gautam.

When it comes to treatment, it is not the same, so there are different types — eye drops, laser therapy and surgery.

You may wonder, these treatments are perhaps expensive and not available in the country. Fortunately, “All the aforementioned types of treatment are available in Nepal,” assure Dr Gautam and Dr Shrestha.

The best part is still not over as “eye services in Nepal are not expensive and one doesn’t need go abroad for it”

Unfortunately, people are not aware about glaucoma. As it has no symptoms, only preventive measures that remain are “awareness programme in the community, glaucoma screening programme and proper diagnosis on time”.

- Shradha Pal, The Himalayan Times

Ewings Sarcoma

2012-04-27T11:57:00.002-07:00

Synonym- Endothelial sarcoma of bone

Swings sarcoma is an uncommon but highly malignant sarcoma arising from endothelial cells in the bone marrow.

Age incidence- usually between 10 and 20 years.

Common sites- shaft of femur, tibia, fibula, humerus or clavicle.

Pathology:

The tumour tissue is soft and vascular. As it expands it gradually destroys the bone substance. There is striking reaction beneath the periosteum, where abundant new bone is formed in successive layers. Macroscopically the tumour is lobuloted and often fairly large. It may look Grey (like brain) or red (like red current jelly) if hemorrhage occur into it. Microscopically, sheets of small dark polyhedral cell with no regular arrangement and no ground substance are seen.

Clinical Feature:

1. Pain- Often throbbing is character with rapidly increasing swelling over the shaft of a long bone.

2. Pyrexia, warm, tender swelling which is fusiform in shape and firm in consistency.

Investigations:

1. X-ray a. Onion-peel appearance

b. Sunray appearance and codman’s traingles are also present.

2. CT & MRI - Reveal both osseous & extra osseous component of tumour.

3. Chest X-ray P/A view - Show pulmonary metastesis.

4. Radioisotope scan - Markedly in creased uptake of the isotope in the region of the tumour.

5. FNAC.

Differential Diagnosis

1. Subacute osteomyelitis

2. Syphilitic osteoperiostitis

3. Reticulur cell sarcoma

4. Metastetic neuroblastoma.

Treatment:

The best results are achieved by a combination of all three methods a course of preoperative chemotherapy; then wide excision (or amputation) if the tumour is in a favorable site or radiotherapy followed by local excision if it is less accessible and then a further course of chemotherapy for 1 year.

Multiple Myeloma

2012-04-27T11:56:00.002-07:00

Multiple myeloma is the commonest of all primary malignant bone tumour arises from the plasma cells of the bone marrow.

Clinical Features:

i) Aged 45-65 years Women > Men.

ii) Weakness

iii) Backache

iv) Bone pain

v) Pathological fracture

vi) Anaemia due to red marrow function

vii) Thrust, polyuria, abdominal pain due to hyper calcaemia

viii) Infection due to decreased antibody

ix) S/S or renal dysfunction, spinal cord or root compression.

Investigations:

1. Blood- decreased Hb%, increased ESR, increased Serum creatinine, increased scrum calcium.

2. Urine- Bencejones protein-present

3. X-ray- i) Generalized ostecoparosis

ii) Vertebral compression fracture

iii) Multiple punched out-defects with soft margin in the skull, pelvis, proximal femur and vartebra.

4. Sternal puncture- show plasma cytosis with typical myeloma cells.

Pathology:

At operation, the affected bone is soft and crumbly. The typical microscopic picture is of sheels of plasmacytes with a large ecentric mucleus containing a spoke like arrangement of chromatin.

Prognosis

The tumour is uniformly fatal, through its progress can often be checked for several years.

Treatment:

i. Pain control

ii. Treatment of pathological fracture

iii. Correction of fluid balance and hypercalcaemia

iv. Perioperative antibiotic

· The tumour foci respond to radiotherapy for while and pain is well relived.

· Chemotherapy- Malphan together with prednisolone can be given. Malphan in conjunction with doxorubicin, curmastine and cyclophosphamide also can be given.

· Fractures are best treated with internal fixation and packing of cavitics with methylmethacrylate cement. Spinal fractures need immedicate stabilization either by effective bracing or by internal fixation.

Osteclastoma

2012-04-27T11:55:00.001-07:00

· A lesion of uncertain origin.

· Usually benign but may recur after local removal or curettage.

· In about 10% cases if behaves as frankly malignant tumour. Metastasising through the blood stream to the lung.

· Common sites- Epiphyseal region

o The lower end of the femur

o The upper end of the tibia

o The lower end of the radius

o The upper end of the humerus

Those ends of the long bones at which most growth occurs (growing ends)

Pathology

Characteristically it occurs in the end of the bone, occupying the epiphysical regions and often extending almost to the joint surface. It destroy the bone surface, but new bone forms beneath the periosteum, so tumour, giving a faintly loculated appearance (soap bubble appearance). Pathological fracture is common.

The tumour has a reddish fleshy appearance; it comes away in pieces quite easily when curetted, but is difficult to remove completely from surrounding bone. Aggressive lesions have a poorlydefined edge and extend well into surrounding bone.

Histologically, the striking feature is an abundance of multinucleated giant cells scattered on a background of stromal cells (spindle calls) which little or no visible inter cellular tissue.

Clinical Features:

The patient is usually a young adult.

i. Gradually increasing local swelling in the end of a long bone.

ii. Pain the end of a long bone

iii. There may be a history of trauma

iv. Pathological fracture occurs in 10-15% of cases

v. May be tender on firm palpation.

Differential Diagnosis

i) Subacute osteomyelitis

ii) Syphilitic osteo-periostitis

iii) Other bone tumours

iv) Metastatic suprarenal neuroblastoma (Histologically)

Investigations

X-rays

i) A radiolucent area situated eccentrically at the end of along bone and bounded by subchondral bone plate.

ii) The centre has a soap-bubble appearance due to ridding of the surrounding bone.

iii) The cortex is thin and sometimes ballooned; aggressive lesions extend into the soft tissue.

CT & MRI - Will reveal the extent of the tumour, both within the bone and beyond.

Arthoscopy - To establish whether the articular surface has been broached or not.

FNAC or Open biopsy - To confirm the diagnosis.

Treatment

· Well-confined, slow-growing lesions benign histology-Thorough curettage and stripping of the cavity with burrs and gouges, followed by swabbing with hydrogen peroxide or by the application of liquid nitrogen; the cavity is then packed with bone chips.

· More aggressive tumours- Excision followed, if necessary, by bone grafting or prosthetic replacement.

· If the affected bone is one that can resonably be dispensed with- such as the clavicle or fibula- Excision of part of the bone.

· Tumours in awkward sites (e.g. spine) may be difficult to eradicate; supplementary radiotherapy is sometimes recommended but it carries a significant risk of causing malignant transformation.

Osteocarcoma

2012-04-27T11:53:00.003-07:00

Site : Metaphysis of the lower end of the femur, the upper end of the tibia and humors.

Age incidence

- 10-25 years (prior to epiphyseal fusion)

- Old age (Secondary to paget’s disease)

Sex- Boys > Girls

The tumour extends within the medulla and across the physeal plate and extending into the soft tissue. Grey white invasive and destructive masses having focal haemorrhase & nerosis. There are areas of bone loss and cavitation alternate with dense patches of abnormal new bone.

Clinical Features

Ø Pain, swelling, near a joint with history of trauma

Ø Overlying skin stretched & shiny

Ø Local rise of temp due to increased vascularily

Ø Firm in consistency

Ø Sign & symptoms of bronchitis, pnenmonia if there is lung metastasis

Ø Pathological fracture

Spread- haematogenous spread to lung, usually sometimes to other bone.

Types:

a) Primary or Secondary

b) Dahlin’s prognostic classification

Ø Osteoblastic

Ø Chondroblastic

Ø Fibroblastic

c) Geschickter and copeland classification

Ø Selerosing type

Ø Osteolytic type

Ø Both osteoblastic and osteolytic (Mixed)

Ø Telangicetatic.

X-ray

1. Both osteolytic (Radiolucent) & osteolbastic (Dense) areas

2. Sunray appearance – due to deposition of tumour osteoid along the vessels.

3. Codman’s triangle- due to raised periosteum

CT & MRI: To see extend of the tumour

X-ray Chest: To see pulmonary metastasis.

Biopsy

1. FNAC

2. Open biopsy

Varients of osteosarcoma

Parosteal : A thin gap between cortex & tumour, cortex is not corded.

Periosteal : A superficial defect of the cortex

Paget’s sarcoma : Feature’s of paget’s disease + Bone destruction with soft tissue invasion.

Treatment

· Multi-agent chemotherapy for 8-12 weeks

· Resection of the tumour or amputation

· The pathological specimen is examined to assess the response to preoperative chemotherapy. It tumour necrosis is marked, chemotherapy is continued for another 6-12 months.

· Bone gap is filled by a large bone graft and custom-made implant.

Bone Tumor

2012-04-27T11:51:00.002-07:00

CLASSIFICATION OF BONE TUMOUR

A. Primary bone tumour

	Origin	Benign	Malignant
1.	Cartilage	Osteochondroma Chondroma Chondreoblastoma Chondromyxoid fibroma	Chondrosarcoma
2.	Bone	Osteoid osteoma Osteoblastoma * Osteochondroma (Commonest benign bone tumour)	* Osteosarcoma (Commonest in adolescent)
3.	Bone marrow	Parosteal osteosarlomia	*Multiple Myeloma (Commonest primary bone tumour in old age) Malignant hymphoma
4.	Fibrous tissue	Fibroma	Fibrosarcoma
5.	Vascular tissue	Aneurysmal bone cyst Haimagioma Angioima	Malignant haemangioma
6.	Unknown origin	Giant cell tumour Fibros histocystoma	Malignant giant cell tumour Ewing’s tumour adamantinoma
7.	Synovium	Synovioma	Synovial sarcoma

B. Secondary bone tumour

Metastatic tumour usually comes from

1. Thyroid

2. Breast

3. Lungs

4. Kidney

5. Prostate

The Principle of management of bone tumour:

1. Diagnosis of bone tumour either benign asymptomatic, benign symptomatic or malignant

2. Treatment of the tumour

3. Follow-up.

Diagnosis depends on:

1. History- Age incidence

Young adult (osteosarcoma)

Children (Ewing sarcoma)

Old age (Multiple myloma, secondary bone tumour)

Slowly growing growth- Benign

Rapidly growing growth- Malignant

History of Trauma (though trauma is not the cause) osteosarcoma

2. Clinical Feature

ü Size & shape regular- Benign; irregular- malignant

ü Margin- well defined- Benign; ill-defined- malignant

ü Over lying skin normal- Benign; fixed- malignant

ü Local temperature normal- Benign; Raised- malignant (Osteosarcoma)

ü Over lying structure free- Benign; fixed- malignant

ü Regional lymphode-not enlarged- Benign; May be enlarged- malignant

ü Usually no pain & tenderness-Benign; Pain & tenderness- malignant

ü No systemic features- Benign; Systemic features- malignant

Investigations:

I. X-ray- small radiolucent nidus- osteoid osteoma

well defined exostosis emerging from the meaphysis- osteochondroma

Sun ray appearance + Codman’s triangle- Osteosarcoma

Onion peel appearance- Ewing sarcoma

Soap Bubble appearance- Giant cell tumour.

1. CT * Show cortical crosion or fracture

* Show intraosseons and extraosseons extension of tumour and the relation ship to surrounding structure.

* Can detect pulmonary metastasis.

2. MRI- The best method for evaluation soft tissue tumour

3. Radionuclide scanning with 99m Tc- HDP

4. Blood for i) Hb%- decreased ii) ESR- raised

5. Unire for Bence- jonces protein (i.e. multiple myeloma)

6. Scrum alkaline phosphatase- increased

7. Scrum acid phosphatase (in case of ca. prostate which cause secondary bone tumour)

8. Biopsy - FNAC

- Open biopsy- tissue is taken from boundary zone.

Histopathological findings will confirm the diagnosis either benign or malignant. If malignant what type of the lesion is.

Treatment:

a) Benign, asymptomatic tumour-treatment in not required; excision or curettage of the lesion can be done.

b) Benign, symptomatic or enlarging tumour- They can generally be removed either by local (marginal) excisionor (in case of benign cysts) by curettage.

c) Suspected malignant tumours- Treatment regions amputation, limb sparing operations and different types of adjuvant therapy.

Methods of Treatment:

1. Tumour excision-

a. Intra-capsular (intralesional) excision and curatase

b. Marginal excision

c. Wide excision

d. Radical resection

e. Limb sparing surgery

f. Amputation – for high grade tumour.

The preferred method for intra-capsular lesion is now wide excision together with pre and postoperative chemotherapy.

The resulting defect is dealt with in one of several ways:

1. Vascularized or nonvascularized bone graft.

2. Custom made implants

3. Large allografts

4. Custom made prosthesis

5. Allograft prosthetic composites

6. Extendible implants

7. Grafting and arthrodesis

8. Distraction osteosynthesis.

2. Multi-agent Chemotherapy:

This is now the preferred neoadjuvant and adjuvant treatment for malignant bone and soft tissue tumours. Modern chemotherapy regimes effectively reduces the size of the primary lesion. Prevent metastatic seeding and improve the chances of survival.

Drugs currently in use are methotrenate doxorubicin (adriamycin), cyclophosphamide, vincristine and cisplatin, Treatment is started 8-12 weeks preoperatively and the effect is assessed by examining the resected tumour. If there is little or no neurosis a different drug is selected for postoperative treatment. Maintenance chemotherapy is continued for another 6-12 months.

3. Radiotherapy:

High energy irradiation has long been used to destroy radio scrsitive tumour or as adjuvant therapy before operation. indications- for

1. Highly sensitive tumours (such as Ewing sarcoma)

2. Tumours in inaccessible sites

3. Metastatic deposit and marrow cell tumour (i.e. myeloma & malignant lymphoma).

OSTEOCHONDROMA

(Cartilage capped exostosis)

Mushroom like or cauliflower like tumour with degeneration and calcification in the canter of the cartilage cap. – osteochondroma.

Ø Origin- from epiphyscal cartilage.

Ø It is the commonest benign fumour of bone.

Ø The stalk and part of base of the tumour are of bone, but it is capped by cartilage.

Ø Tumour appears to migrate along the shaft towards its centre as the bone grows in length.

Ø Theory of histogenesis- ‘perichondrium’ perverted activity of periousteum which form cartilage & bone or accumulation of embryonic connective tissue at the points of tendinous insertion.

Clinical Features:

Ø Circumscribed hard swelling near a joint of a (knee, Ankle, hip, shoulder, elbow) teenager or young adult.

Ø Pain and tenderness suggests bursitis, malignant change, fracture of bony stalk, pressure on nerve etc.

Ø Any further enlargement often the end of the growth suggestive of malignant transformation.

Differential Diagnosis

1. Hereditary multiple exostosis

2. Ivory exostosis (compact osteoma)

Investigations

X-ray:

Ø Well defined exostosis emerging from the metaphysic.

Ø It looks smaller than it fells because the cartilage cap is not seen on X-ray.

Indication of Operation:

i. Joint interference- large osteochondroma obstruct joint movement

ii. Painful bursitis

iii. Of bony stalk due to traum

iv. Malignent change

v. Pressure on the neighboring vessels & nerves give rise to neurovascular complications.

Operation- Excision of the tumour along with its periosteal cover to prevent recurrence of the tumour.

Sudden increase in size & pain suggests malignancy.

Osteoarthritis

2012-04-27T11:48:00.001-07:00

Introduction:

Worldwide, osteoarthritis is the most common joint disorder. In western countries, radiographic evidence of this disease is present in the majority of persons by 65 years of age and in about 80 percent of persons more than 75 years of age.¹ Approximately 11 percent of persons more than 64 years of age have symptomatic osteoarthritis of the knee.²

With the continued growth of the elderly population in the United States, osteoarthritis is becoming a major medical and financial concern. Appropriate medical management requires that physicians be able to diagnose osteoarthritis early, recognize factors that may affect the prognosis or complicate the disease, and make effective use of the many available treatments.

Ideally, treatment of the disease involves relief of the symptoms, and controls the progressive degeneration of the articular joints. Modern drug therapy has concentrated on symptomatic relief of pain using simple analgesics such as aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. These drugs do not stop joint degeneration, and many are associated with side effects such as the production of potentially fatal stomach ulcers.

Glucosamine sulphate is a natural substance, termed a "chondroprotective agent", which relieves the symptoms of OA without serious side effects, and also appears to slow the progression of the disease

Pathophysiology

Biomechanical and biochemical forces are involved in cartilage destruction, which is at the core of osteoarthritis. Cytokines and growth factors are thought to play a role in the pathophysiology of the disorder. Interleukin-1 and tumor necrosis factor-b may function to activate enzymes involved in proteolytic digestion of cartilage.³ Growth factors such as tissue growth factor-b and insulin growth factor-1 may play a role in the body's attempts to repair cartilage through cartilage synthesis.⁴

When catabolism exceeds cartilage synthesis, osteoarthritis develops. Collagenolytic enzymes are thought to contribute to the breakdown of cartilage. Collagenase 1 (matrix metalloproteinase-1 [MMP-1]) is a fibroblast collagenase, and collagenase 2 (MMP-8) is a neutrophil collagenase. Collagenase 3 (MMP-13) may be particularly important because of its highly potent collagenolytic activity.³

Fig.: 1, Reducing joint space & Osteophytic changes of Knee joint

Glucosamine Sulphate Working Against Osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis and typically damages the weight-bearing joints such as the hips, knees and spine.

Although primarily considered a disease of aging, OA can also result from sports-related injuries. In fact, about 10% of OA sufferers are in their 20’s. Figures from the Australian Bureau of Statistics reveal that more than 1.1 million Australians suffer from OA.

The Role Of Glucosamine

OA is caused by a degenerative process which affects the cartilage of the articular joints, resulting in symptoms of inflammation, pain and restricted movement. The degeneration appears to be caused by a disruption in the synthesis of important compounds (such as proteoglycans) from amino sugars within the chondrocytes (cartilage-producing cells).

Glucosamine is one of these amino sugars, and it is produced in the body from the sugar glucose and the amino acid glutamine through the action of the enzyme glucosamine synthetase.

Glucosamine stimulates the synthesis of proteoglycans, glycosaminoglycans (more commonly referred to as mucopolysaccharides), and collagen.

It therefore plays a role in the formation of cartilage and the cushioning synovial fluid between the joints, hence its "chondroprotective" classification.

The chondrocytes can either synthesize glucosamine themselves, or obtain it from circulating pre-formed glucosamine. Supplementary glucosamine can be an important source of this vital amino sugar for those with reduced capacity to produce glucosamine, such as the elderly.

Glucosamine Sulphate

Compared with other potential chondroprotective compounds such as chondroitin and animal cartilage, glucosamine is a much smaller molecule that is more readily absorbed and incorporated into cartilage and ligaments.

Glucosamine is available commercially as N-acetyl glucosamine, and the salts, glucosamine hydrochloride and glucosamine sulphate. Glucosamine sulphate is the form used in the majority of clinical studies - probably due to the stabilization of glucosamine with the sulphate ion.

Sulphur occurs throughout the body in amino acids, and occurs as sulfate in connective tissue as a binder and stabilizer. Sulphate is found in sulphated glycosaminoglycans and proteoglycans. Inorganic sulphate compounds have formed an important basis for Blackmores Celloid® Mineral therapy for over 60 years, with sulfate salts being used to help regulate body fluids and to stabilize intercellular connective tissue.

More recently, researchers at the World Health Organization’s Center for Rheumatology have discovered that sulphur inhibits the various enzymes which lead to cartilage destruction in joints.

The stabilization of glucosamine with sulphate appears to enhance the bio availability of glucosamine and potentiate its therapeutic effect.

Clinical Trials With Glucosamine Sulphate

Glucosamine sulphate is the most clinically studied glucosamine compound. It has been used in more than 20 double-blind, placebo-controlled studies involving over 6,000 people, together with hundreds of scientific investigations into its mode of action.

Several important studies have compared glucosamine sulphate with the drug ibuprofen in their effects on osteoarthritis. In one study of the knee OA, 200 patients were divided into two groups, one group taking 500mg glucosamine sulphate three times daily (1500mg daily dosage), the other ibuprofen 400mg three times daily. The study lasted four weeks and patients were assessed weekly according to a standard rating index of relief of symptoms of pain and improvement in mobility.

While improvement appeared sooner in the drug-treated groups in the first week, there was no difference in scores from the end of the second week onward. At the end of the treatment, there was a success rate of 52% in the ibuprofen group and 48% in the group taking 500mg glucosamine sulphate three times daily.

Significantly 35% of patients taking ibuprofen suffered side effects, mainly gastrointestinal, compared with only 6% in the glucosamine sulphate group. The researchers concluded that "glucosamine sulphate was therefore as effective as ibuprofen on symptoms of knee OA".

Several other similar studies compared the relative benefits and drawbacks of glucosamine versus ibuprofen for those suffering from OA. Those studies resulted in findings that while ibuprofen sometimes acted more quickly in the short term in reducing pain from OA, those taking glucosamine ultimately obtained greater and longer lasting pain relief from glucosamine. In addition, far more of the persons taking ibuprofen reported suffering negative side effects than did those persons taking glucosamine.

Of 355 patients screened, 212 were enrolled in the study and randomly assigned to receive glucosamine sulphate or placebo (figure 1). A similar number of patients in the two groups did not complete the 3-year treatment course: 38 of 106 (36%) in the glucosamine sulphate group and 35 of 106 (33%) in the placebo group (p=0·77), without significant differences in reasons for withdrawal. Patients in the two groups had similar demographic and baseline characteristics (table 1). Patients had similar mild to moderate osteoarthritis radiographic grading and joint-space widths at enrolment, with a degree of symptoms expressed by the WOMAC index that was also similar and of mild to moderate average severity. During the 6 months before enrolment, 51% of patients in both groups did not report any pharmacological treatment for osteoarthritis, whereas within the remaining patients 24% had received NSAIDs, 15% simple analgesics, 8% both NSAIDs and simple analgesics, 2% corticosteroids, without differences between groups. Compliance with study treatment was good: the proportion of patients who reported over 70% drug intake ranged between 81% and 91%, without significant differences between groups.

Figure 1: Trial profile

Characteristic All randomised patients Patients assessed for 3 years

Placebo (n=106) Glucosamine sulphate (n=106) Placebo (n=71) Glucosamine sulphate (n=68)

Women 83 (78%) 79 (75%) 55 (77%) 53 (78%)

Age (years) 65·5 (7·5) 66·0 (8·1) 65·3 (7·4) 65·5 (7·2)

Body-mass index (kg/m [2]) 27·4 (2·7) 27·3 (2·6) 27·2 (2·8) 27·2 (2·8)

Duration of knee osteoarthritis* (years) 7·6 (7·5) 8·0 (7·5) 7·9 (7·9) 7·8 (6·8)

Kellgren and Lawrence grading†

Grade 2 74 (70%) 75 (71%) 51 (72%) 51 (75%)

Grade 3 32 (30%) 30 (29%) 20 (28%) 17 (25%)

Total joint-space width‡ (mm) 5·39 (1·29) 5·23 (1·36) 5·46 (1·23) 5·39 (1·30)

Minimum joint-space width‡ (mm) 3·95 (1·24) 3·82 (1·32) 4·01 (1·26) 3·82 (1·23)

WOMAC index§

Total index (mm) 939·7 (484·8) 1030·2 (473·8) 894·0 (494·8) 1024·3 (486·1)

Pain (mm) 172·2 (104·5) 194·1 (101·9) 164·3 (105·1) 189·2 (103·8)

Function (mm) 670·8 (367·8) 740·1 (364·2) 632·8 (376·9) 739·8 (375·6)

Stiffness (mm) 96·7 (54·6) 96·0 (54·8) 96·8 (54·8) 95·3 (57·6)

Values shown as mean (SD) unless otherwise indicated. *Based on patient history. †The Kellgren and Lawrence system grades osteoarthritis on joint radiographs as 0=none, 1=doubtful, 2=mild, 3=moderate, 4=severe, based on the assumed sequential appearance of osteophytes, joint space loss, subchondral sclerosis, and cyst formation. ‡One baseline radiograph missing in the glucosamine sulphate group (n=105). §Sum of visual analogue scale scores.

Summary

· Glucosamine sulphate plays an important biological role in the formation of cartilage and synovial fluid.

· Glucosamine sulphate appears to be more biologically active than other chondroprotective agents.

· Glucosamine sulphate has been studied in many randomized, double-blind clinical studies of osteoarthritis.

· In the case of OA, glucosamine sulphate appears to be as effective as a leading NSAID treatment, but with far fewer side effects.

· Glucosamine sulphate is non-toxic, and is safe for long-term administration.

· Scientific studies of human subjects have shown that glucosamine sulphate is often effective in reducing joint tenderness, swelling, and pain associated with OA when taken in daily doses ranging from 500mg to 2000mg per day. The studies used a variety of glucosamine forms, methods of delivery, and amounts. The most common amount, form, and method of delivery used in the studies was glucosamine sulfate pills several times per day in a daily amount totaling 1500 mg.

Conclusion

:Most patients with osteoarthritis seek medical attention because of pain. The safest initial approach is to use a simple oral analgesic such as acetaminophen (perhaps in conjunction with topical therapy). If pain relief is inadequate, oral nonsteroidal anti-inflammatory drugs or intra-articular injections of hyaluronic acidlike products should be considered. Intra-articular corticosteroid injections may provide short-term pain relief in disease flares. Alleviation of pain does not alter the underlying disease. Attention must also be given to nonpharmacologic measures such as patient education, weight loss and exercise. Relief of pain and restoration of function can be achieved in some patients with early osteoarthritis, particularly if an integrated approach is used. Patients with advanced disease may eventually require surgery, which generally provides excellent results.

REFERENCES

1. Lawrence RC, Hochberg MC, Kelsey JL, McDuffie FC, Medsger TA Jr, Felts WR, et al. Estimates of the prevalence of selected arthritic and musculoskeletal diseases in the United States. J Rheumatol 1989;16:427-41.

2. Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 1998;41:1343-55.

3. Pelletier JP, DiBattista JA, Roughley P, McCollum R, Martel-Pelletier J. Cytokines and inflammation in cartilage degradation. Rheum Dis Clin North Am 1993;19:545-68.

4. Malemud CJ. The role of growth factors in cartilage metabolism. Rheum Dis Clin North Am 1993; 19:569-80

5. Safe, M Joint Account, The Australian Magazine, March 20-21. (1999) p27.

6. Myers S & Callinan P, Celloid® Prescribers’ Reference. Sydney: Blackmores Ltd; 1992.

7. Adinfinitum Agency: Glucosamine sulfate proven superior to other forms of glucosamine and chondroitin sulfate. Press release 1998.

8. Werbach, M. Nutritional Influences on Illness 2nd Edition, Third Line Press, Ca. U.S.A. 1993, page 468, referring to paper by D’Ambrosio L et al. Glucosamine sulphate: A controlled clinical investigation in Arthrosis. Pharmatherapeutica 2(8): 504-8; 1981.

9. Mueller-FassbenderH. et al: Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis and Cartilage (1994)2; 61-69.

10. Noack W etal Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis and Cartilage (1994)2; 51-59.

11. Qiu G, Gao S, Giacovelli G, Rovati L., and Setnikar I: Efficacy and Safety of Glucosamine Sulfate Versus Ibuprofen in Patients with Knee Ostoarthritis. Arzneimittel-Forschung, 48(5): 469-74, May 1998.

12. Vaz, A: Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthrosis of the knee in out-patients. Curr.Med.Res.Opin., Vol.8, No.3, 1982.

13. Thie N., Prasad N., Major P.: Evaluation of Glucosamine Sulfate Compared to Ibuprofen for the Treatment of TMJ Osteoarthritis: A Randomized Double Blind Controlled 3 Month Clinical Trial. Journal of Rheumatology, 28(6): 1347-55, June 2001.

The Construction Of Life

2011-12-13T02:47:00.000-08:00

‘Construction of life’, I would put it as making such a structure out of the parameters of time such that we do justice to the ultimate creation of nature ‘Human Beings’. But how are we supposed to construct our life? Where is the design? Where are the materials? And of course where is the plot? The beer had worked and like always, the neurons that carried philosophical thoughts were running in my mind. I have always loved this connection between alcohol and our body. Damn, how does it trigger every hidden part of us? Not in an attempt to get lost but to search answers to my questions I walked into the darkness. However hard I try, I just can’t live life without trying to figure it out. Probably it is inside my system to think, to reason and at least try to understand things around me. Things that have already occurred to me or perhaps things that are occurring right now, or may be things that is yet to occur. Understanding all these things might help me to find answers to my questions. “Twenty years” my age or a span of time that describes my existence or probably an account number where I have deposited some wonderful memories, experiences and above all some amazing relationships. Whatever it might be, this measure of time holds in it everything that makes me, the person I am today. Everything I think, each decision I make, every person I love, each one I hate is the consequence of my experiences and the lessons I have learned from life. This philosophy makes me believe that a portray of a person cannot be made on the basis of his look, religion or his financial situation. The distance of time that each of us have travelled ultimately carves out our personality, our identity. Hence in the quest to discover mine I close my eyes to travel that distance in the form of memories. I remember my childhood, the warmth of my mother’s lap, that utmost feeling of security on my father’s arm and obviously the incredible view from his shoulder. Our fundamental perception gives the title of god to our parents .It is not just because they made our existence possible but also because it was they who decorated our innocence and shaped our behaviours, preparing us for the mysterious world ahead. Today I realise that the warmth of my mother’s lap wanted to teach me a lesson that this universe flows in a river of love, friendship and a bond of affection starting it’s course right from there. My father’s arm wanted to teach me the lesson of faith and his shoulder wanted me to vision things ahead, it taught me to dream. The wheels of time revolved making me to enter teenage. My world changed from the shadow of my parents to the unknown darkness; the darkness that was in the form of bad company, a shit like environment, confusions, carelessness, misunderstandings, stubbornness etc. But sometimes later I could see the dawn. I met friends, I fell in love (or was probably just a crush), I started dreaming, visioning, analysing and hence forth believing that there will be sunshine. I often wonder why each one of us has to face that darkness. I guess I now have the answer. It’s like you cannot drive a car if you are not allowed to touch the steering and when you are allowed, you cannot drive safely unless you learn all the tricks. It may happen to you that while learning you make mistakes, break rules and end up with accident. A teenager is similar to that amateur driver who is just allowed to touch the steering of a vehicle called ‘life’. He makes mistakes because no one is perfect enough to learn anything overnight. He makes mistakes because he is confused about the road. He breaks the rule because he doesn’t realise how worse the consequences can be. But he never gives up and tries his best because he is passionate about speeding up. I think at this period of time nobody does injustice to their life by making mistakes and breaking rules. They are just the price to learn the most important chapter of life, “Conscience” “Morality”. Having just crossed my teenage here I stand from where, if everything goes well, in a couple of year I will possibly have one of the finest degrees in the world “Bachelor of Technology” so called Engineering. That alcohol triggering my mind makes me ask a question “Do I deserve it? Am I worth a profession on which mankind relies so much?” Frankly speaking I don’t know but I absolutely know that it was my choice and my conscience tells me that I should believe in what I want to do. I remember the lesson of ‘faith’ learned from my father’s arm. And also thanks to that incredible view from his shoulder, i don’t hesitate to dream. Well future certainly is unknown and always unfolds with the command of time. But we do can anticipate it to be better rather than living in a despair thinking how worse it can be. After ending my journey to the past and the future I slowly open my eyes. Gradually seeing things around me I feel as if I have got the answers. I find myself in the place which actually is everything; a hero in the story of time ‘The present’. When we vision things ahead in the future, we are actually designing life ahead. When we look back into the past, we find ourselves gathering materials in the form of knowledge, lessons. Having made the design and having gathered the materials, we start doing the utmost job called ‘The Construction of Life’ in the land called present. Yes the plot for the construction of life is this running time ‘present’ and the materials required are knowledge, lesson of conscience which we get from past. The design is that goal of future, it is in that vision, it is in that dream. Therefore, to construct a heart throbbing structure of life we need to work hard on present with the track of past and the vision of future. If we fulfil all these parameters of time with extreme effort, we then only will do justice to that extraordinary event of universe called ‘Life’.

Food and Your Mood: The Serotonin Connection

2011-08-28T22:36:00.000-07:00

Do you ever find yourself sitting on the sofa with a bar of chocolate when you're feeling stressed, bored, or just lonely?

Or find that you get cravings for certain foods — such as cookies, bread or pastries — even when you're not hungry?

If you answered "yes" to either of those questions, I'm about to explain why it happens... and what you can do about it.

Food and mood

Many people turn to food for reasons other than physical hunger. They put this down to a lack of discipline, get very "down" on themselves... and then eat even more so they feel better again.

This is a little like getting a flat tire, jumping out of the vehicle, and shooting out the remaining three tires!

What they don't realize is that in many cases, these cravings could be due to a drop in the levels of serotonin in the brain.

In fact, some studies show a direct link between obesity (due to overeating) and decreased brain serotonin levels.

What is serotonin?

Serotonin is a type of neurotransmitter known as a monoamine. Neurotransmitters are chemicals that send messages from one nerve cell to another.

In short, a neurotransmitter helps different parts of your brain "talk" to each other. Without adequate levels of serotonin, you'd probably suffer from depression, sleep disorders, and various addictions.

It might also interest you to know that nicotine increases serotonin levels. Nicotine withdrawal has the opposite effect. This is one reason why people who quit smoking find that they rapidly gain weight. They're trying to get their serotonin "fix" from food instead of cigarettes.

The food you eat has the potential to raise or lower your serotonin levels. That's why the ingredients of a meal have such a powerful impact on the way you feel after you eat it.

To understand why, you need to know a little more about an amino acid called tryptophan (pronounced trip-toe-fan), which your body uses to make serotonin.

If you were to eat just tryptophan by itself, then it would enter the blood, flow into the brain, and raise serotonin levels.

So if you want to raise your serotonin levels, all you need to do is eat protein-rich foods that are high in tryptophan, right?

Not so fast.

Tryptophan requires the use of a transport molecule to cross the blood-brain barrier. Several other amino acids (tyrosine, phenylalanine, valine, leucine and isoleucine) "compete" for this transport molecule.

Because whole foods contain other amino acids besides tryptophan, the presence of these competing amino acids can inhibit the transport of tryptophan into your brain.

That's why eating a food high in tryptophan, such as cottage cheese or turkey, is NOT the best way to raise serotonin levels.

Carbohydrate

Although it might sound counterintuitive at first, it's actually meals that are high in carbohydrate rather than protein that have the biggest impact on serotonin [3, 5].

Why?

When you eat a food high in carbohydrate, your body releases insulin. Insulin helps to clear the competing amino acids from your blood.

However, insulin has no effect on tryptophan. Consequently, once insulin has cleared the competing amino acids from your blood, tryptophan is free to enter your brain.

The link between serotonin and sleep is one reason why some people feel tired after eating a high-carbohydrate meal. It also helps to explain why foods high in carbohydrate are often described as "comfort" food.

Dr. Albert Stunkard, a professor of psychiatry at the University of Pennsylvania, thinks that people with an almost uncontrollable urge to raid the fridge late at night are doing it to help themselves sleep by boosting serotonin levels.

If you've ever wondered why diets leave you feeling cranky, low serotonin levels could be the explanation [4, 6, 7]. If you're a woman, the news gets even worse, as the drop in tryptophan appears to be greater in women than it is in men.

Researchers from the University of Oxford, for example, found that just three weeks on a low calorie diet significantly reduced both tryptophan levels and the ratio of tryptophan to competing amino acids in a group of 15 men and women [1].

But despite a similar drop in weight, the decline in tryptophan was greater in the women than it was in the men. This could go a long way towards explaining why dieting seems to cause bigger mood swings in women than it does in men.

Free meals

One solution to the problem of low serotonin levels is to include some kind of high-carbohydrate "free meal" in your diet once or twice a week.

The typical way most people go about dieting is to adopt an "all-or-nothing" approach. Maybe this is something you can relate to.

Let's say that you've been following a diet without any kind of lapse for the last few weeks and your progress has started to slow down. There are days when you feel tired, anxious or just a little irritable.

To make matters worse, you're getting cravings for some of the foods you've cut out of your diet.

Maybe it's something sweet like chocolate, or savory like bread. You hold out for days until finally you give in. It might start with one cookie. But it doesn't stop at one, and you end up eating the whole packet. And that's it. The diet's over. You feel like you've failed again.

As often happens with the all-or-nothing approach, the end result is usually nothing.

A free meal can help you stick to your diet in the long-term because you know you're never more than a few days away from indulging in a few of your favorite foods.

I much prefer free meals to cheat days, mainly because there's an upper limit to the amount you can eat in a single sitting.

While some people will impose some kind of limit on what they eat during a cheat day, others will consume anything and everything in sight. Because of this, a single cheat day once each week has the potential to undo much of the good work you've done during the previous six days.

And if you plan your free meals to coincide with some kind of social occasion, it's possible to follow a diet and have a life at the same time.

Courtesy: thefactaboutfitness.com

Female genital mutilation

2011-08-28T21:46:00.000-07:00

Key facts

Female genital mutilation (FGM) includes procedures that intentionally alter or injure female genital organs for non-medical reasons.
The procedure has no health benefits for girls and women.
Procedures can cause severe bleeding and problems urinating, and later, potential childbirth complications and newborn deaths.
An estimated 100 to 140 million girls and women worldwide are currently living with the consequences of FGM.
It is mostly carried out on young girls sometime between infancy and age 15 years.
In Africa an estimated 92 million girls from 10 years of age and above have undergone FGM.
FGM is internationally recognized as a violation of the human rights of girls and women.

Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.

The practice is mostly carried out by traditional circumcisers, who often play other central roles in communities, such as attending childbirths. Increasingly, however, FGM is being performed by health care providers.

FGM is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person's rights to health, security and physicalintegrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.

Procedures

Female genital mutilation is classified into four major types.

Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are "the lips" that surround the vagina).
Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

No health benefits, only harm

FGM has no health benefits, and it harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls' and women's bodies.
Immediate complications can include severe pain, shock, haemorrhage (bleeding), tetanus or sepsis (bacterial infection), urine retention, open sores in the genital region and injury to nearby genital tissue.

Long-term consequences can include:

recurrent bladder and urinary tract infections;
cysts;
infertility;
an increased risk of childbirth complications and newborn deaths;
the need for later surgeries. For example, the FGM procedure that seals or narrows a vaginal opening (type 3 above) needs to be cut open later to allow for sexual intercourse and childbirth. Sometimes it is stitched again several times, including after childbirth, hence the woman goes through repeated opening and closing procedures, further increasing and repeated both immediate and long-term risks.

Who is at risk?

Procedures are mostly carried out on young girls sometime between infancy and age 15, andoccasionally on adult women. In Africa, about three million girls are at risk for FGM annually.

Between 100 to 140 million girls and women worldwide are living with the consequences of FGM. In Africa, about 92 million girls age 10 years and above are estimated to have undergone FGM.

The practice is most common in the western, eastern, and north-eastern regions of Africa, in some countries in Asia and the Middle East, and among certain immigrant communities in North America and Europe.

Cultural, religious and social causes

The causes of female genital mutilation include a mix of cultural, religious and social factors within families and communities.

Where FGM is a social convention, the social pressure to conform to what others do and have been doing is a strong motivation to perpetuate the practice.
FGM is often considered a necessary part of raising a girl properly, and a way to prepare her for adulthood and marriage.
FGM is often motivated by beliefs about what is considered proper sexual behaviour, linking procedures to premarital virginity and marital fidelity. FGM is in many communities believed to reduce a woman's libido, and thereby is further believed to help her resist "illicit" sexual acts. When a vaginal opening is covered or narrowed (type 3 above), the fear of pain of opening it, and the fear that this will be found out, is expected to further discourage "illicit" sexual intercourse among women with this type of FGM.
FGM is associated with cultural ideals of femininity and modesty, which include the notion that girls are “clean” and "beautiful" after removal of body parts that are considered "male" or "unclean".
Though no religious scripts prescribe the practice, practitioners often believe the practice has religious support.
Religious leaders take varying positions with regard to FGM: some promote it, some consider it irrelevant to religion, and others contribute to its elimination.
Local structures of power and authority, such as community leaders, religious leaders, circumcisers, and even some medical personnel can contribute to upholding the practice.
In most societies, FGM is considered a cultural tradition, which is often used as an argument for its continuation.
In some societies, recent adoption of the practice is linked to copying the traditions of neighbouring groups. Sometimes it has started as part of a wider religious or traditional revival movement.
In some societies, FGM is being practised by new groups when they move into areas where the local population practice FGM.

International response

In 1997, the World Health Organization (WHO) issued a joint statement with the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA) against the practice of FGM. A new statement, with wider United Nations support, was then issued in February 2008 to support increased advocacy for the abandonment of FGM.

The 2008 statement documents new evidence collected over the past decade about the practice. It highlights the increased recognition of the human rights and legal dimensions of the problem and provides current data on the frequency and scope of FGM. It also summarizes research about why FGM continues, how to stop it, and its damaging effects on the health of women, girls and newborn babies.

Since 1997, great efforts have been made to counteract FGM, through research, work within communities, and changes in public policy. Progress at both international and local levels includes:

wider international involvement to stop FGM;
the development of international monitoring bodies and resolutions that condemn the practice;
revised legal frameworks and growing political support to end FGM; and
in some countries, decreasing practice of FGM, and an increasing number of women and men in practising communities who declare their support to end it.

Research shows that, if practising communities themselves decide to abandon FGM, the practice can be eliminated very rapidly.

WHO response

In 2008, the World Health Assembly passed a resolution (WHA61.16) on the elimination of FGM, emphasizing the need for concerted action in all sectors - health, education, finance, justice and women's affairs.

WHO efforts to eliminate female genital mutilation focus on:

advocacy: developing publications and advocacy tools for international, regional and local efforts to end FGM within a generation;
research: generating knowledge about the causes and consequences of the practice, how to eliminate it, and how to care for those who have experienced FGM;
guidance for health systems: developing training materials and guidelines for health professionals to help them treat and counsel women who have undergone procedures.

WHO is particularly concerned about the increasing trend for medically trained personnel to perform FGM. WHO strongly urges health professionals not to perform such procedures.

Courtesy: WHO

Facts About The Human Body

2011-08-28T21:40:00.000-07:00

1. A human being loses an average of 40 to 100 strands of hair a day.

2. A cough releases an explosive charge of air that moves at speeds up to 60 mph.

3. Every time you lick a stamp, you're consuming 1/10 of a calorie.

4. A fetus acquires fingerprints at the age of three months.

5. A sneeze can exceed the speed of 100 mph.

6. Every person has a unique tongue print.

7. According to German researchers, the risk of heart attack is higher on Monday than any other day of the week.

8. After spending hours working at a computer display, look at a blank piece of white paper. It will probably appear pink.

9. An average human drinks about 16,000 gallons of water in a lifetime.

10. A fingernail or toenail takes about 6 months to grow from base to tip.

11. An average human scalp has 100,000 hairs.

12. It takes 17 muscles to smile and 43 to frown.

13. Babies are born with 300 bones, but by adulthood we have only 206 in our bodies.

14. Beards are the fastest growing hairs on the human body. If the average man never trimmed his beard, it would grow to nearly 30 feet long in his lifetime.

15. By age sixty, most people have lost half of their taste buds. By the time you turn 70, your heart will have beat some two-and-a-half billion times (figuring on an average of 70 beats per minute.)

16. Each square inch of human skin consists of twenty feet of blood vessels.

17. Every human spent about half an hour as a single cell.

18. Every person has a unique tongue print. Every square inch of the human body has an average of 32 million bacteria on it.

19. Fingernails grow faster than toenails.

20. Humans shed about 600,000 particles of skin every hour - about 1.5 pounds a year. By 70 years of age, an average person will have lost 105 pounds of skin.

How to use 100% of your brain

2011-08-28T21:18:00.000-07:00

It's easier than you think. You are already doing it.

Contrary to the popular myth that human beings use only a small percentage of their brain, let's say 10%, the truth is all of the human brain is used at one time or another. If you came here to learn how to harness the power of the 90 percent of your brain that you are probably not using, you must be really disappointed right now. Don't fret. I have pretty interesting things to say about the human brain. Know your brain! For one thing, a recent paper by Peter Lennie of the New York University Center for Neural Science suggests that the brain should have a maximum of 3% of its neurons firing at any one time, otherwise the energy required to reset each neuron after it goes inactive becomes simply too much for your brain to handle.

The make-up of the Central Nervous System (CNS)

The central nervous system of a human being is made up of the brain and the spinal cord. It consists of two types of cells: glia and neurons.

Neurons

Neurons are used for processing information. They are receiving input and sending output between one another all the time. Input checks in through the branch-like dendrites of the neuron, output checks out through the cable-like axons.

Dendrites and Axons

Surprisingly, each neuron has up to 10,000 dendrites, and only a single axon. This axon is usually thousands of times longer than the neuron's microscopic cell body. The biggest axon in a giraffe is about 15 ft long.

Synapses

The junctions between axons and dendrites are called synapses. These are the places where electrical impulses are transformed into chemical signals. Synapses are like tiny switches, connecting neurons to one another and turning the brain into a huge network.

Glia or Glial cells

Glial cells constitute the structural framework of the brain; they manage the neurons and keep the house clean by removing debris after neurons die. Glial cells are fifty times more numerous than neurons in the brain.

Brain Network

A single human brain is made up of about 3 million miles of axons, 1 quadrillion (1,000,000,000,000,000) synapses, and as much as 200 billion neurons. The neurons spread out side by side would cover the size of 4 football fields.

Parts of the Human Brain

Anterior Cingulate Cortex (ACC): used to weigh options and make decisions. It’s responsible for worrying, and is bigger in women than in men.
Prefrontal Cortex (PFC): rules feelings and emotions and keeps them at bay. PFC puts the brakes on the instinctual amygdala and is bigger in women than in men. It also matures faster in teen girls than in boys by one to two years.
Insula: used to process gut feelings. Insula is larger and more active in females.
Hypothalamus: conducts the production and distribution of hormones. It starts pumping earlier at puberty in women.
Amygdala: our instinctual center - the beast within. Larger in men and is tamed only by the Prefrontal Cortex.
Pituitary Gland: responsible for the production of fertility hormones, milk and nurturing behavior. The center for turning on the mommy brain.
Hippocampus: the elephant that never forgets a romantic encounter, a tender moment or a fight, for that matter. Bigger and more active in females.

Brain FAQ
What color is the brain?

As long as we are alive, our brain is pink with its color coming from the blood vessels. When the brain is dead, it appears gray.

Around 40% of the living brain is made of gray matter and 60% of white matter, but these are not descriptions of the colors of different areas.

What are gray and white matter used for?

Gray matter uses almost 95% of the oxygen consumption of the brain, as this is the area where the actual information processing is done.

White matter is made of a fatty protein called myelin. It sheathes and insulates the highways of communication inside the brain. It links different parts of the gray matter together.

Venus vs. Mars in terms of brain differences?

Recent studies at the Universities of California and New Mexico showed that men had 6 1/2 times more gray matter than women, while women had 10 times more white matter than men.

The women were found to have white matter in a high concentration in the frontal lobes (center for emotion control and judgment), wherein the men had none.

Men’s and women’s brains are very differently wired, but the output of intelligence is the same.

Does alcohol kill brain cells?

Contrary to popular belief, alcohol consumption does not kill brain cells. It makes new cells grow more slowly.

The temperance campaigners of the early 19th century wanted
all alcoholic beverages banned, so they made up a scientific fact: alcohol kills brain cells.

How does alcohol affect brain cells?

A recent research found that samples from alcoholics and non-alcoholics showed little to no difference in the overall number or the density of neurons between the two groups. A study in Sweden even disclosed that more brain cells are grown in mice that are given moderate amounts of alcohol.

The serious damage caused by alcohol abuse, including damage to the brain, does not stem from the death of brain cells, it is more probable that alcohol abuse doesn't agree with the information processing of the brain.

What is the cause of hangover?

Hangover is caused by the shrinking of the brain due to dehydration. Dehydration causes the brain to tug on its covering membrane, and the membrane becomes sore. The brain has no pain receptors, so it feels nothing, even if you stick a knife in it.

Does alien alcohol exist?

According to a recent astronomical discovery, there is a decent amount of alcohol in our region of the Milky Way. This giant cloud of methanol has a diameter of about 300 billion miles.

Methanol is not ethyl alcohol, therefore it is not consumable by humans. This fact and the cloud's existence suggest that it's for the consumption of some other life-form. This, in turn, suggests that we are not alone.

There are more ways to exchange information in the human brain than the number of atoms in the whole universe. This is the potential that we carry, so whatever percentage of our brains we actually use and however we do it, there is clearly room for improvement.

Courtesy: HubPages

Plan Your Diet And Be Fit

2011-08-28T21:07:00.000-07:00

To be fit you need to have the good diet. Nowadays everyone wants to be smart and look smart and so, many teenager are worried about how they look. Some of them they carryout the light gym classes to be fit. Below are the Science based Facts that will be useful for all age to be fit according to the diet.

1. The growth hormone hGH has for a while been considered a possible potent antidote to aging. The growth hormone replacement therapies substantially increase lean body mass and decrease fat mass in both sexes. Of course this kind of therapy is not widely available and even if it were, it is associated with quite a few adverse effects like heightened glucose intolerance, joint pain, swelling and carpal tunnel syndrome, especially in men. The good news is that fitness exercise, rest, and proper diet and nutrition stimulate hGH secretion. Most of the hormone is released by our body while we are sleeping, during stages three and four of our sleep which are the stages that exercise improves. Intense exercise actually acutely increases growth hormone (it gets released above the anaerobic threshold.

2. Morning exercisers that worked out at least 3.5 to 4 hours per week have easier time falling asleep. Those who exercise aerobically in the evening have more trouble falling asleep than those who exercise in the morning.

3. According to scientific fitness research, resistance training develops greater muscle mass and improves insulin sensitivity and could be helpful in controlling type II diabetes more effectively than just the aerobic exercise.

4. Eating citrus fruits reduces the risk of larynx, stomach, and mouth cancers by up to 50%. This is due to their antioxidant properties which have strengthening effect on the immune system, inhibiting on tumor growth and normalizing effect on the tumor cells.

5. Cheap pedometers (measuring the number of steps we take) may be fun but they are not particularly accurate (read extremely inaccurate). Of course being that placebo effect works well with exercise as long as you believe that it works, you will feel the benefits.

6. We tend to over-focus on our intake of saturated and trans fats. If you happen to love French fries, ice cream or in my case cheese and spinach stuffed pizzas (just thinking about it makes me want it), you need a way to balance things out. Luckily, there is more than one way “to skin the cat”. According to medical science, sonsuming the articles listed below will keep your heart happy:

7. Whole grain: brown rice, breads, pasta, cereals (whole grain), buckwheat, millet, bulgur, oatmeal are all super great for health.

8. Nuts help in lowering down LDL cholesterol levels and prevent heart disease risk. Don't overdo it because of high caloric index (200g/week of walnuts (highest in omega 3s), almonds, Brazil nuts, hazelnuts and pecans should do it).

9. Omega 3s supplements, soy products, flax seed, fish, and krills that are very rich in Omega 3s help in lowering down triglycerides, work as anti-inflammatories, anti-depressants, enhancers of concentration and cognitive function and mood stabilizers.
Start eating fresh water fish at least two times a week but stay away from sea water fish and krills in times of Tsunami’s and nuclear radiation like happened in Japan and if you hear any other problems that comprise the quality of sea water fishes. Also as a general scientific rule, stay away from bottom feeders and large fish as they are high in mercury, supplement with 1-3g or omega3s.

10. Plant Sterols and Stanols help in blocking the absorption of cholesterol. Hard to get through regular diet although they are found in fruits, nuts, seeds, vegetables, legumes, and veggie oils. Also, they tends to be added to butter substitutes or you can take it in capsule form (need about 2-3g for maximum effect).

11. Chocolate (me and my family’s favorite) are rich in flavonoid antioxidants that dilate blood vessels and prevent clotting. Of course there is a catch. The goodness hides in nonfat cocoa solids meaning natural cocoa powder is the best, followed by unsweetened baking chocolate, dark chocolate and then milk chocolate and chocolate syrup.

12. Soy and Garlic - the jury is still out on their ability to lower cholesterol. Garlic certainly can’t hurt (except for the killer breath it gives you) but soy can mess with thyroid function so you should not overdo it.

Courtesy:- HubPages