Author: noorali

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Aspirin

Recently, I saw a 36 year old man in my office with bowel problems. His first question was: Doc, should I take an aspirin a day to prevent colon cancer?

First, let us look back in history.

Hippocrates and the Indians of North America have known the pain killing properties of willow bark, which contains salicylates (aspirin is acetylsalicylic acid), for many hundred years.

Besides it being a painkiller, it also reduces inflammation and fever. Commercially, aspirin became available in 1899 as a result of a search by Felix Hoffman at Bayer Industries to help his father who suffered from rheumatoid arthritis.

By the 1960s, aspirin became the most widely used pharmaceutical product in the world. For example, in U. S. alone, the annual production of aspirin is over 15,000 tons (13,600 metric tons).

In 1985, researchers first established that aspirin can prevent heart attacks. If you have chest pain and are suffering a heart attack, then taking an aspirin will reduce your chance of dying from heart attack by 25 per cent. It also reduces the risk of a second heart attack by 50 per cent. For patients who have suffered a stroke, it offers protection from a second one.

So, what about cancer prevention?

For the last 25 years, researchers have been saying that aspirin, ibuprofen and other anti-inflammatory drugs may play a role in preventing cancer. Studies have found that it could reduce the risk of both colorectal cancer and mouth and throat cancers by two-thirds.

In one recent study, women who took a single ibuprofen tablet at least three days a week for 10years or more saw their risk of breast cancer fall by 49 per cent.

Women who regularly took aspirin saw their risk of breast cancer drop by only 28 per cent.

There is also some evidence that ibuprofen may offer more protection from Alzheimer’s disease. Canadian researchers have shown that ibuprofen may reduce the risk of getting Alzheimer’s by up to 30 per cent.

If this is all true then why physicians do not promote the use of aspirin and ibuprofen as a prophylactic for cancer prevention?

The above findings are from retrospective studies – they look back at men or women who were taking these products for other illnesses and see if they suffered from specific cancers compared to those who did not take aspirins or ibuprofens.

There are no prospective randomized double blind trials to prove that aspirin or ibuprofen is what prevents cancer. There may be other variables which may influence the outcome. Prospective randomized double blind trials eliminate those variables.

Many doctors are cautious about the idea of healthy people taking aspirin or ibuprofen in the hope of preventing disease. More studies are needed to confirm that the benefits outweigh the risks. They don’t know what dose is appropriate, or how many years the drugs must be taken before they offer protection.

These drugs are not always harmless. Internal bleeding is a serious risk. The painkillers can also interact dangerously with other drugs.

Recently, the Globe and Mail wrote, “Randall Harris, a respected professor of epidemiology at Ohio State University, didn’t follow the cautious approach when he announced the results of the breast-cancer study. Instead of recommending waiting until more studies are done, he urged women over the age of 40 to talk to their doctors about taking a standard dose of ibuprofen (200 milligrams) or aspirin (325 mg) daily.”

But there are other reports which say that taking ibuprofen may undo the protective effect of aspirin.

Are you confused? So are the doctors! But my answer to the young man is – there are many other ways of preventing cancer (remember ELMOSS?) – rather than looking for a miracle drug.

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Sugar, the Sweet Poison

I call sugar a sweet slow poison, a weapon of mass destruction. The difference is, we use it on our friends and families, not on our enemies.

It is reported that the North American diet contains about 20 per cent sugar. This is equivalent to 30 teaspoons a day! Most of it is hidden in pop, processed food and baked goods.

Like alcohol, sugar has no nutritional value. It has no vitamins, minerals or fiber.

North American children’s consumption of sugar per day is reported to be between 25 to 35 per cent of total calories. Is this too much? Yes. The World Health Organization recommends daily dietary sugar intake of no more than 10 per cent of total calories.

According to Encyclopedia Britannica, sugar is any of numerous sweet, colorless, water-soluble compounds present in the sap of seed plants and the milk of mammals and making up the simplest group of carbohydrates. The most common sugar is sucrose, a crystalline tabletop and industrial sweetener used in foods and beverages.

Sucrose is found in almost all plants, but it occurs at concentrations high enough for economic recovery only in sugarcane (Saccharum officinarum) and sugar beets (Beta vulgaris).

Sugarcane ranges from seven to 18 percent sugar by weight, while sugar beets are from eight to 22 percent sugar by weight.

Sugarcane, once harvested, cannot be stored because of sucrose decomposition. For this reason, cane sugar is generally produced in two stages, manufacture of raw sugar taking place in the cane-growing areas and refining into food products occurring in the sugar-consuming countries. Sugar beets, on the other hand, can be stored and are therefore generally processed in one stage into white sugar.

The Encyclopedia says that different methods of crystallization of sugar containing syrup are used to produce variety of sugars and at least six or seven stages of boiling are necessary before the molasses is exhausted.

The first three or four strikes are blended to make commercial white sugar. Special large-grain sugar (for bakery and confectionery) is boiled separately. Fine grains (sanding or fruit sugars) are usually made by sieving products of mixed grain size.

Powdered icing sugar, or confectioners’ sugar, results when white granulated sugar is finely ground, sieved, and mixed with small quantities of starch or calcium phosphate to keep it dry.

Brown sugars (light to dark) are either crystallized from a mixture of brown and yellow syrups (with caramel added for darkest color) or made by coating white crystals with brown-sugar syrup.

Beet sugar factories generally produce only white sugar from sugar beets. Brown sugars are made with the use of cane molasses as a mother liquor component or as a crystal coating.

Sugar is dangerous because it causes obesity, diabetes, hypertension and heart disease leading to sickness and death. In the last few months, couple of articles in the Medical Post summarizes the dangers of sugar:

-people have to eat more of sugar containing food to feel satisfied (thus promoting obesity and diabetes) compared to those eating food with artificial sweetener

-sugar contributes to development of high blood pressure

-men who drink sugary drinks have 46 per cent increased risk of stroke, possibly because of sugar’s blood-thickening osmotic effect or its known ability to raise cholesterol levels

-diets high in refined sugar increase the risk of developing Crohn’s disease and colorectal and pancreatic cancer

-eating sugar increases body fat rather than lean body mass. It promotes obesity without any effect on muscle mass, i.e. there is no gain in useful tissue.

Sugar tastes nice and sweet but it is a killer. Sugar in the diet should be kept to a minimum, and if drinks and snacks are consumed, they should be sweetened with artificial sweetener or should be unsweetened.

Sugar is one temptation we should do without!

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

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Hearing Loss

A reader writes: “I am a 62 year old male. I was recently diagnosed with a condition I had never heard before – sudden idiopathic sensorineural hearing loss – in my left ear involving the facial nerve that goes through the middle ear and to the brain.

It started with a ringing in the ear and then I went deaf and the right ear is super sensitive to sound. There is roaring and buzzing in the left ear. Would you be able to provide me with some information on this subject?”

I don’t have much knowledge about this condition. So, I asked our local expert, Dr. Neil Harris, a specialist in ear, nose and throat surgery to enlighten me with some details. Following is the summary of the information he sent me.

Sudden idiopathic sensorineural hearing loss is a condition which may surprise you as the name says – suddenly – like waking up one morning with a hearing loss. Or one may notice hearing loss over a few days

Fortunately, the vast majority of cases of sudden hearing loss affect only one ear, and the prognosis for some recovery of hearing is good.

There are mainly four reasons for sudden hearing loss. It may be due to viral infection in the inner ear, or loss of blood supply to that area, or rupture of cochlear membrane in the inner ear, or due to problems in the immune system.

Many cases, however, fit into the idiopathic category where the cause is not known. That is very frustrating situation when it comes to management.

In the U.S., it is estimated that five to 20 cases are reported per 100,000 persons. Many cases likely go unreported, and the incidence may be higher. A sudden hearing loss may resolve before the patient can be evaluated medically, making it unlikely for that individual to seek help.

Distribution of the condition is equal amongst males and females. Left ear is affected as frequently as the right. Sudden hearing loss in both ears occurs in approximately one to two percent of cases.

All age groups are affected by sudden hearing loss, but fewer cases are reported in children and the elderly. Young adults have incidence rates similar to those of middle-aged adults. The median age at presentation ranges from 40-54 years. The occurrence of sudden hearing loss across all age groups is an indication of the multifactorial nature of this clinical problem.

Sudden sensorineural hearing loss has been considered an emergency situation. Patient evaluation should proceed promptly and expeditiously. Early presentation to a physician and early institution of treatment improves the prognosis for hearing recovery. The immediate goal is to discover a treatable or defined cause of the sudden hearing loss.

There is no preferred treatment regimen for the condition. One textbook says that treatment can be based upon a rational approach – depending on the history, physical examination, and laboratory results. Should no definitive or treatable cause be found, the treatment regimen should be dictated by the most likely factors involved.

It is reported that 47 to 63 percent of patients recover their hearing spontaneously. These figures vary according to different studies utilizing different criteria for degrees of recovery. The true spontaneous recovery rate is unknown.

Unfortunately, existing studies have not provided answers to questions regarding the best method of treatment, prognostic factors in recovery, and the exact cause of sudden hearing loss. These are questions that require a lot of research.

In the meantime it is important that if you experience sudden hearing loss then report the situation immediately to your doctor. Let him decide how to manage the problem.

I hope this helps.

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

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War is Not the Answer

Waste of Blood, and waste of Tears,
Waste of youth’s most precious years,
Waste of ways the saints have trod,
Waste of Glory, waste of God,
War!
Studdert Kennedy G.A. (1883-1929)

The war in Iraq is underway. It is generating a great amount of emotions amongst people all over the world. Some show signs of satisfaction that finally Saddam Hussein will be taken care of. Some are worried about the human cost of the war. Others are worried about the political and economic fallout.

War does not determine who is right – only who is left – Anonymous.

This war is affecting millions of people all over the world – it is the fear factor. Of course, the biggest brunt will be borne by the people of Iraq. Many thousands will die. Millions are or will be without food, water, electricity, and medical help. How many of us can tolerate few hours without these necessities?

Sweet is war to those who have never experienced it – Marcel Proust (1871-1922).

It is easy for us to sit in the comfort of our homes, watching on big screen television sets Baghdad sky lit up with “shock and awe” bombing, and say that it is okay to kill thousands of innocent people in order to get rid of one tyrant. And this is okay as long as our children and family members are safe; our economies are thriving and have cheap gas available to keep us comfortable.

We make war that we may live in peace – Nicomachean Ethics.

This is the best argument advanced by people who support war in Iraq. We wish that would be true. But very few wars are brought to an end tidily (Lord Owen). How many wars have been fought since God put man on earth? If wars solved all our problems then we should have had peace many years ago.

Under conditions of tyranny it is far easier to act than to think – Hannah Arendt (1906-1975).

Dictators who inflict tyranny on their citizens are entrenched in that position by a strong army. There are no democratic means to get rid of them. Historically, most dictators have met their match within the system or have been removed by popular uprisings. But
Saddam has been a tough ruthless dictator. Is war the only option to remove him? Isn’t that a sign failure?

When war enters a country, it produces lies like sand – Anonymous.

If Iraq’s main export would have been sand or dates then I wonder if President Bush would send his young soldiers and spend billions of dollars to liberate the people of Iraq.

A war regarded as inevitable or even probable, and therefore much prepared for, has a very good chance of eventually being fought – Anais Nin (1903-1977).

It is now well documented that the Iraq war was scripted well before Bush became President. The script was written by many of the current members of the Bush administration.

When the rich wage war it’s the poor who die – Jean-Paul Sartre (1905-1980).

The war and the reconstruction in Iraq is going to cost 100 to 200 billions of U.S. dollars. More billions will be required to keep happy the countries who have agreed to support the U.S. position.

If these billions were used to provide clean water, electricity and food to the poor in Middle East, Asia, Africa and South America then I believe this war would have been unnecessary.

Mankind must put an end to war or war will put an end to mankind – John F. Kennedy (1917-1963).

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