Author: noorali

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For Golfers, There is No Time Like Tee Time

By the time you read this column, the Masters tournament at Augusta will be over. Did Tiger win again, or was it Phil, may be Ernie? Well, somebody is going to win. And somebody is going to lose. The winner will shed tears of joy. The loser will shed tears of lost opportunity. This will be done in public with millions of people watching on television. For some men, golf is a serious business. That is why they are pros. They don’t mind crying in public.

For regular golfers, golf is meant to be fun. But you know how most golfers take the game seriously. You know that from their body language. You know it from the amount of cursing and swearing they do when the ball does not go where they want it to go. A golf ball is not like your favourite pet, like an obedient dog. There is no training or obedience school for golf balls. What a shame.

Last week, I wrote how women love chocolate more than sex. So, a friend emailed me to ask what I would do if I had a choice between golfing and eating chocolate. I said I like to do both. Then he asked “…and…?” I knew what was on his mind. The “s” word. Well, do you know any man who would give up sex for golf?

This brings me back to the Masters tournament at Augusta. A Golf Digest survey taken sometime ago asked, “Would you give up sex with your spouse to become a member at Augusta National? Thirty percent said “yes” and 70 percent said “no”. Would this apply to golf in general?

In any case, I am excited to see that finally we can get on the golf course and hit some balls and socialize with our friends. I am also eager to see if I can play better and make a dent on my stubborn handicap which has refused to budge for the last few years. This year has to be a turning point.

Is that some crazy wishful thinking? Looks like it is. It has been shown that even among the most dedicated players; only 25 percent will improve their handicap index by at least one stroke during a 12-month period. So, what happens to the rest of the players? Do they get worse?

Here is the result of another survey. At the request of the Golf Digest, the U.S. Golf Association studied the handicap indexes of more than 1.1 million golfers from 2002 to 2003 and found that only two percent of players improved by five strokes or more during that 12-month span. The biggest shocker: 50 percent of players got worse!

So, you wonder why I would be interested in golfing. Investing so much time and money in membership fees, clubs (every year there is something new to spend your money on), golf balls, clothings, golf trips and other “collateral damage.” The reasons are simple – I play golf for fun, for good company, for a good walk in the park and vitamin D. Not for my handicap!

Golf is also good for burning some fat, as long as you don’t eat a big burger after nine holes and drink a dozen beers in four hours. You can burn 250 to 500 calories an hour. Golf is not good for building stamina. But it is good for flexibility and has a small effect on building strength.

I like to take precautions against sun burn, skin cancer, dehydration, mosquito bites and hunger. It is good to pack snacks which do not contain refined flour, sugar or trans fats (they can clog arteries). Try nuts, seeds, fruits, and low carbohydrate bars.

Ok, time to get on the golf course and hit some balls and have some fun. Forget about the handicap.

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Forget love… I’d rather fall in chocolate!

Spring is here. So is Easter. There is love in the air. And there is smell of chocolate everywhere. Would you rather fall in love or fall in chocolate?

Forget love… I’d rather fall in chocolate!

May be I had rather fall in love and have chocolate as well. Both can be very aphrodisiac and good for libido. The Mexican Emperor Montezuma believed that chocolate was an aphrodisiac that he purportedly drank 50 golden goblets of it each day. I am curious to know if his sex life improved.

If you had a choice between having sex and having chocolate – what would you prefer? My guess is most men prefer sex because they seem to be in constant sex drive while women’s sexual drive is cyclic. So, they probably go for chocolate.

Two years ago there was an article in the Globe and Mail (February 10, 2007) discussing a woman’s libido and craving for chocolates. It said, “According to a 2006 survey in Redbook, an alarming 70 per cent of women prefer chocolate over sex. And last month a study by 50Plus Research.com revealed that 25 per cent of respondents said chocolate would be harder to give up than sex – while only three per cent thought sex would be tough to skip.”

An average North American consumes about five to six kilograms of chocolate a year. Did you know 40 per cent of world’s almonds, 20 per cent of world’s peanuts and eight per cent of world’s sugar is used by chocolate manufacturers? No wonder too much chocolate is fattening.

Chocolate is made from roasted cacao beans. Hot chocolate drink has been around since Christopher Columbus and others brought cacao beans to Spain in 1521. In 1643, a Spanish princess took solid chocolate to France and chocolate became very popular all over Europe.

There are three varieties of chocolates: dark, milk and white chocolate. Chocolate liquor is the main ingredient in dark and milk chocolate and white chocolate has no chocolate liquor.

Dark chocolate provides more than twice the level of flavanols than milk chocolate. White chocolate has no flavanols. Flavanols is a naturally occurring nutrient abundant in fresh cocoa known to improve blood vessel function, raise good HDL cholesterol, lower bad LDL cholesterol, reduce blood platelet stickiness, improves blood flow and reduces blood pressure. Researchers have found that cocoa has higher antioxidant capacity than tea and red wine.

Chocolate contains about 30 per cent saturated fat. Saturated fat is known to raise bad cholesterol level. But chocolate has saturated fat which is poorly absorbed in the intestine. So it does not affect our cholesterol level. There is no evidence to show that excess consumption of chocolate causes chocolate addiction, chocolate acne and chocolate migraine.

But, there is a catch. Chocolate is high in calories. Besides being fattening, chocolate can cause dental caries. So enjoy your chocolate, but in moderation, so your heart and sex life stay healthy.

So, honey, what will it be tonight? A golden goblet filled with dark yummy chocolate or sex or both!

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Controversial Role of PSA in Early Detection of Prostate Cancer

Controversy regarding the use of PSA (prostate-specific-antigen) in early detections of prostate cancer continues with the recent publication of an article in the New England Journal of Medicine (NEJM).

Prostate cancer is the most frequent cancer and the second leading cause of death from cancer in men, exceeded only by lung cancer. In 2008, an estimated 24,700 men were diagnosed with prostate cancer and 4,300 died of the disease.

The walnut size prostate gland lies below the urinary bladder in front of the lowest inch of the rectum, through which it can readily be felt on digital rectal examination (DRE). The gland has an important role in the proper flow of urine. It also provides the proteins and ions that form the bulk of the semen. In conjunction with other smaller glands in the vicinity, the prostate gland produces secretions that serve to lubricate the reproductive system and provide a vehicle for storage and passage of sperms.

Once upon a time, “the old finger” i.e. DRE was the only crude way to pick up early prostate cancer. Although DRE has a cancer detection rate of only 0.8 to 7.2 percent, it remains an important test that can be done easily in a doctor’s office. It also checks for anal and rectal tumours.

The PSA test was introduced in North American medical practice by the end of 1980s. PSA was expected to replace the embarrassing and uncomfortable DRE. And it was promoted as an ideal test for screening and early detection of prostate cancer. But this hope has not materialized. PSA blood test has a false positive rate of 20 to 50 percent and false negative rate of 25 to 45 percent. That means 30 to 50 percent of the time the test is wrong.

The editorial in the NEJM says, “In the United States, most men over the age of 50 years have had a prostate-specific–antigen (PSA) test, despite the absence of evidence from large, randomized trials of a net benefit. Moreover, about 95 per cent of male urologists and 78 per cent of primary care physicians who are 50 years of age or older report that they have had a PSA test themselves, a finding that suggests they are practicing what they preach.”

Recent clinical trials have shown that PSA screening without DRE was associated with a 20 per cent relative reduction in the death rate from prostate cancer at a median follow-up of 9 years, with an absolute reduction of about 7 prostate cancer deaths per 10,000 men screened. Critics say that this is at best a modest effect on prostate cancer mortality and the benefit comes at the cost of substantial over-diagnosis and over-treatment. There is net harm compared with potential benefits.

Experts agree that PSA testing is an imperfect screening tool. They say the test is as effective as programs such as mammography for breast cancer and fecal occult blood testing for colorectal cancer.

The Canadian Cancer Society recommends that men aged 50 and older discuss the benefits and risks of PSA testing with their physician, and the society does not plan to change its recommendation based on recent research.

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Alcohol, Drugs, Date Rape and Unwanted Pregnancy

“The contribution of alcohol and other drugs to sexual assault has been increasingly recognized during the last 15–20 years,” says an article in the Canadian Medical Association Journal (CMAJ March, 2009). The authors report that 20.9 per cent of victims of sexual assault met the criteria for drug-facilitated sexual assault, also known as date rape.

As we know, rape occurs when sexual intercourse is non-consensual. A person forces another person to have sex against his or her will. It is not uncommon to find that drugs and alcohol are involved in the rape. Rape includes intercourse in the vagina, anus, or mouth. Rape is among the most serious crimes a person can commit. Men as well as women and children can be raped.

The person who commits rape uses violence and fear to force the person to have sex. Victims of rape are physically and emotionally traumatized. Unwanted pregnancy and infection may be some of the unfortunate outcomes.

Date rape occurs when a substance is administered to a person which lowers his or her sexual inhibition and increases the occurrence of unwanted sexual intercourse. Usually, the victim and the person who commits the crime are known to each other and have been together socially in the past.

Rape is common with an estimated lifetime risk of up to one in four for women. About 25 per cent of the 1400 women who contact the Canadian Sexual Assault Centre each year report that drugs were a factor in a rape.

The drugs used in date rape usually have no colour, smell or taste and can easily be mixed with different kinds of drinks without the victim’s knowledge.

Drugs most commonly used in date rape are alcohol, marijuana, benzodiazepines, cocaine, heroin, amphetamines, GHB (gamma hydroxybutyric acid), Rohypnol (flunitrazepam), and Ketamine (ketamine hydrochloride). This list is extensive. Most of these drugs are often metabolized and excreted before the victim even perceives that a sexual assault may have occurred. Unfortunately, this contributes to the underreporting of drug-related sexual assault.

Alcohol is involved in most of the cases of date rape. Urine samples submitted by rape victims to treatment centers across the United States within 72 hours of a suspected drug-facilitated rape, alcohol was detected in 69 per cent of the samples, marijuana in 18 per cent and cocaine in 5 per cent.

The patient requires immediate attention regarding safety, management of injuries, forensic examination, emergency contraception, prophylaxis for sexually transmitted infections and psychosocial support.

Prevention is better than cure. If you are out drinking then vigilance is the key word. Drink your beverage slowly, keep an eye on your drink when mixed and obtain a fresh one after leaving the drink unattended. Do not accept drinks from strangers.

If you think that you have been drugged and raped then go to the police station or hospital right away. Get a urine test as soon as possible. Do not douche, bathe, or change clothes before getting help. You will destroy the evidence you need to find and convict the offender.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!