Author: noorali

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The World in Turmoil

A recent opinion poll says that Canadians are worried about their future. They do not feel as secure as they did one year ago.

Life is getting very depressing for many Canadians. How do you feel?

Summer is supposed to be one of the best times of the year. But this year, things don’t seem to be the same – or do I have a short memory? You know what I am talking about. We complained about the late snow and rain. Now we have the heat wave. Then there are mosquitoes. Their bites are itchy – they burn for days! That can be depressing.

But compared to the rest of the world, we are in heaven. The economy is booming. Crime rate is not as bad as other countries. There is no civil war – the one within the Liberal Party is not killing anyone. And most Canadians are enjoying the standard of living which some, in other parts of the world, can only dream of.

And look at the rest of the world!

The world at large continues to be in turmoil. The death and destruction in the Middle East, the Indian sub-continent and Northern Ireland continues. There are many other wars which kill thousands of people but never get reported.

AIDS is taking its toll in Africa and other places. Poverty, famine, floods, disease and deaths in thousands continue to plague the vast majority of the world.

Women and children continue to be kidnapped and murdered. Sex, violence and profanity continue to be glorified in music, movies and TV. The war against drugs and alcohol continues without any sign of success.

The big corporations continue to swindle the poor stock holders who trust their life’s savings on the basis of glorified but sometimes false reports of success. The same corporations dish out large sums of money to our politicians and the political parties. They keep the democracy alive! It’s all in the family! What can we teach our children about business and about their future careers?

Did I leave anything out? We do face some of these problems here as well. But everything is relative.

What about the millions of unspoken heroes who continue to battle unfairness in everyday life? What about their contribution to make this world a better place to live? Without them there would be no hope. One would feel less depressed if one would think about and follow the examples of these unsung heroes.

So there is hope. Every season comes to an end. Daylight comes whether we keep a wake-up alarm or not. In life certain things are going to be out of our control. But wonderful things can happen if we take care of what we can do in a positive way.

Sometime ago, my niece, Rehana, sent me an e-mail titled, “Control your destiny”. In part it said:

“Wonderful things can happen when we decide to be responsible for:
Everything we put into our mouths,
Everything we put into our minds,
And everything we put into our hearts”.

So, don’t worry, be happy. Do your bit and have a wonderful summer – don’t forget your mosquito repellent, sunscreen and a cold drink. This column will take a break for summer as well.

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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Oral Contraceptive Pill

There is good news about oral contraceptives, says an editorial in the New England Journal of Medicine (NEJM).

“The development of oral contraceptives stands as a major advance in women’s health in the past century. By virtue of their ability to prevent pregnancy in 99 percent of women who use them properly, oral contraceptives have revolutionized reproductive choices for women,” says the editorial.

How safe is the oral contraceptive, also known as “the pill”?

A study in 1986 did not show any association between oral contraceptive use and breast cancer. But ten years later, studies of oral contraceptive use showed that women had a slightly increased risk of breast cancer while on the pill. But there was no increase in the breast cancer rates 10 years after quitting the pill.

So, what’s the good news now?

A well-conducted, population-based study, published in the recent NEJM, shows no association between past or present use of oral contraceptives and breast cancer.

That indeed is very good news for women who are currently on the pill or who have been on the pill in the past.

And there is more good news in the NEJM!

Use of oral contraceptives reduces the risk of uterine cancer by 40 percent after 12 months of taking the pill. There is also a 40 percent reduction on the risk of ovarian cancer after as short a period as three to six months of use, and 10 or more years of use was associated with an 80 percent reduction in the risk of ovarian cancer.

But nothing is hundred percent safe in life. Use of the pill is associated with some side-effects in a small percentage of women. These are:

-Deep vein thrombosis (blood clot in the legs)
-Pulmonary embolism (blood clot in the lungs)
-Stroke
-Liver cancer
-Heart attack in women over 35 years of age who smoke

But for most women, the advantages of the pill out weigh disadvantages. Besides the benefits mentioned earlier, there are other advantages to using the pill:

-Greater regularity of menstrual cycle
-Reduced menstrual blood loss and hence prevention of anaemia
-Reduced incidence of painful periods

Today, despite the threat of AIDS, users of oral contraceptives outnumber condom users by two to one. There are approximately 100 million women world-wide who use the pill. And these women should be thankful to a nurse named Margaret Sanger. In 1914, Sanger defiantly championed women’s right to have sex without fear of pregnancy in “The Woman Rebel”.

Based in Brooklyn, Sanger spread the gospel of voluntary motherhood relentlessly, says the Life Millennium book on the 100 most important events and people of the past 1000 years. Her birth control clinics were raided by the police and in 1914 she also faced an obscenity charge which was later dropped.

In 1960, six years before Sanger’s death, the U.S. Food and Drug Administration approved the birth control pill. One of the developers of the pill, Dr. Gregory Pincus, dedicated his research to Sanger’s “pioneering resoluteness”. The pill was cheap, convenient and reliable. It instantly became popular with doctors and patients.

So where do we go from here?

Women’s right to have sex without fear of pregnancy has been established. The next challenge for the scientists is to develop a pill which will have no side-effects affecting the heart and the lungs.

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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Heat Wave and Heat Stroke

Hot days are here. Some like it hot. Others find it unbearable. But hot days can be dangerous. Especially during a heat wave.

What is a heat wave?

Three or more consecutive days during which the air temperature is more than 32.2 degrees Celsius. Because of the global warming, the intensity of the heat waves is expected to increase over the years to come.

What is a heat stroke?

“Heat stroke is a life-threatening illness characterized by an elevated core body temperature that rises above 40 degrees Celsius and central nervous system dysfunction that results in delirium, convulsions, or coma”, says an article in the New England Journal of Medicine (NEJM).

Extreme heat can cause other minor to moderate ill effects called heat stress and heat exhaustion. If not controlled or prevented then these conditions can lead to heat stoke and eventually death.

Heat strokes can occur due to exposure to high environmental temperature or from strenuous exercise.

The NEJM article says that the most complications of heat stoke are those falling within the category of multiorgan-dysfunction syndrome. That means many systems of the body are affected – brain (encephalopathy), muscles (rhabdomyolysis), kidneys (acute renal failure), lungs (acute respiratory injury), blood (bleeding complications).

Who is prone to heat stroke?

Usually very young or elderly persons and in those who have no access to air conditioning, says the article. It is also common among persons with chronic mental disorders or heart and lung problems.

How can we prevent heat stroke?

Heat stroke can be prevented. Authors of the NEJM article propose the following actions to prevent heat stroke:

-acclimatize yourself to heat
-schedule outdoor activities during cooler times of the day
-reduce your level of physical activity
-drink additional water
-consume salty foods
-increase the amount of time you spend in air-conditioned environments.

We cannot change nature. But we can adapt to our environment and create conditions to protect ourselves.

Prevention is better than cure! Enjoy the summer and stay cool!

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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Money, Health, Happiness

“They’ve bought the BMW, and they have the $3 million Mill Valley house. And they still wake up in the morning and say, ‘I don’t feel good about myself’,” says Stephen Goldbart, psychologist and cofounder of the Money, Meaning and Choices Institute, highlighting the perils of Sudden Wealth Syndrome.

So, how about you? How do you feel each morning? Do you feel good about yourself?

“Plan for a better you in 2002” was the title given to my column on December 27, 2001. This was about New Year’s resolutions. Many of us promised to make changes in our lives so we can feel good about ourselves. Six months have gone by. What have we achieved? Are we better off today than six months ago?

There are many barriers to making a positive change in life. Some of these are:

-Failure on our part to accept that change is required.
-Failure on our part to have a strong will power to work toward that change.
-Failure on our part to find time to make the required change.

But if you have set certain goals in your mind then such barriers are only there to test your determination. Henry Ford says, “Obstacles are those frightful things you see when you take your eyes off your goal.”

The goal should be a reasonable one knowing your own strength and limitations. Rome was not built in a day. And you cannot make all the changes overnight. But six months is a good time to review the progress.

Review involves asking two questions:

-What is important in my life?
-What stops me from living my life on the basis of those important things?

“The aim of a life review is to step back and look at it as a whole, identify any problems, and consider what changes are needed to make it more fulfilling and pleasurable”, says an article in the New England Journal of Medicine (NEJM).

The article says that we play many roles in our lives. To balance these different roles is a real challenge. Lack of balance is one of the most frequent problems people face in their lives.

How can we find balance in life?

By simplifying life!

It’s all about choice and making sacrifices. We just have to learn to choose how we live our lives instead of letting life make all the choices for us. If we don’t, then we’ll have to face the grim reality – in trying to have everything all the time, it may just end up killing us!

So where do you stand with your New Year’s resolutions? Do you feel good about yourself each morning – with or without a BMW? Have you made the right choices? Have you found a right balance in your life? Have you begun to simplify your life? Is greed dominating your agenda?

A Chinese proverb says, “Love is blind and greed insatiable”. So make the right choices. Don’t worry and be happy! And if you want to know – that’s exactly what I plan to do – without a BMW!

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