Author: noorali

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Why do I love to laugh?

“Only three things in life are real:
God, human stupidity, and laughter.
But the first two pass our comprehension;
we must do what we can with the third,”

– Aubrey Menen in The Ramayana.

Is God real? Answer to this question depends on who you talk to.

Is human stupidity real? I don’t think there is much disagreement on that subject. I have done many stupid things in my life. And I know you have done the same.

Is laughter real? Yes, laughter is real. But we have to do something about that.

If you find something to laugh about every day then you are doing well. That will compensate for all the stupid things you have done that day, as long as you haven’t hurt somebody deliberately.

I love to laugh. I like to work hard and have fun. And I like to make people laugh – whether it is a member of my family, a friend, a patient I have met for the first time or a server at a restaurant. A funny one-liner is a good way to break the ice. Some people are just too serious and have no sense of humour. They seem to be angry about everything in life. They have no patience. I feel sorry for them. They miss out on so much fun. And this will affect their health.

We all face adversity in life. To survive such adversity is not funny. But laughter is our best weapon against life’s miseries. Scientific studies have repeatedly shown that there is a lot of truth in the old saying, laughter is the best medicine. The happier you are the better you feel. Ashley Montagu has written about the origin of laughter. She says the only animal that speaks is the only animal that laughs. Laughter is an expression of joy and can be infectious. This is one infection worth spreading!

Montagu says, “It is well known laughter has a tonic effect on the mind and body, suffusing the body with a feeling of well-being that few other activities are able to provide, refreshing, relieving, enlivening, and involving the whole body in its happy convulsion.”

We are lucky. We are blessed with the greatest gift of all: capacity to laugh.

Mark Twain said, “The human race has only one really effective weapon and that is laughter.” But the weapons we use against our fellow humans are weapons of terror, destruction, greed, treachery and hypocrisy.

In his bestseller, Anatomy of an Illness, Norman Cousins writes about his battle against painful condition of joints and muscles. He says, “I made the joyous discovery that 10 minutes of genuine belly laughter had an anaesthetic effect and would give me at least two hours of pain free sleep.”

Laughter has been known to be therapeutic for many centuries. But laughter is becoming a rare event in most of our lives as the world becomes faster, smaller and complicated. We live in a world of instant gratification and Band-Aid solutions. This does not allow us time to explore the beauty of the gift of laughter.

There are positive and negative aspects of laughter.

In a negative way, people use laughter to intimidate others and gain stature over them by humiliating them. We laugh when we compare ourselves with others and find ourselves superior. We laugh at the infirmities of others.

In a positive way, we laugh in order not to cry. We use laughter as a remedy for painful experiences. We laugh to show our happiness.

The average six years old laughs 300 times a day, the average adult laughs about 170 times a day. Can adults do better? Sure, we can do better if we have the determination to do something about it. First, we need to have a strong desire to live a pain free, stress free, happy and healthy life. Second, we have to be creative so that laughter is fun rather than a chore to be accomplished.

Next week: how laughing makes you stronger, friendlier and sexier.

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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Genital Warts Can Be Difficult To Eradicate

This is the most common sexually transmitted disease. It is estimated that one per cent of adults who are sexually active have warts in the genital or anal area. In the U.S. alone, one million people will develop genital warts each year. Of these, 25 per cent will have recurrent warts. And that is frustrating for the patient and the doctor.

Genital warts are also called condylomata acuminate or venereal warts. The warts are benign and are caused by human papillomavirus (HPV). There are at least 60 types of HPV. Genotypes six and 11 are found in over 90 per cent of cases of genital warts and genotypes 16 and 18 cause cervical cancers.

The virus is transferred from person to person or from contact with something someone has touched. In women, genital warts can grow on the outside or inside of the vagina, on the cervix, in the urethra or around the anus. In men, warts can grow on the tip or shaft of the penis, on the scrotum, in the urethra or around the anus.

How do you get genital warts?

Most, but not all, genital warts are sexually transmitted. Generally speaking warts are more common amongst people whose immune system is poor. But most people who get warts are healthy and well.

How do you know you have genital warts?

Most people with genital warts have no symptoms. By the time a person is infected and by the time the warts appear may be many months or years. The good news is most of those who get infected never develop warts.

The warts are soft fleshy lumps on or near sex organs or anus. Some people have itching or burning. Warts may be hidden in the vagina or anus.

What are the implications of the disease for patients?
The lesions are benign but they do cause psychosocial distress and may affect relationships as the warts are disfiguring and can be transmitted sexually. Genital warts also increase the incidence of cancer in the genital and anal area. Practicing safe sex is important. It is advisable to use barrier protection with new sexual partners. Condoms can reduce the risk of getting genital warts but warts can spread from areas not covered by a condom. Patients who are in stable relationship may not need barrier protection because the partner is already exposed to infection by the time patient sees a doctor.

How do we manage warts?

No specific treatment is appropriate for all patients and a person will need more than one treatment to clear the warts.

Most treatment plans will achieve clearance of virus within one to six months. In 20-30 per cent of patients new warts will occur over months or even years. Patients can treat themselves with podophyllotoxin (0.5 per cent solution or 0.15 per cent cream) and imiquimod (5 per cent cream). Imiquimod is expensive and podophyllotoxin takes longer to cure the condition.

Physicians can treat warts in the office by using trichloroacetic acid or by physical removal using cryosurgery (liquid nitrogen), electrosurgery and excision or laser treatment. In my surgical practice I use electrosurgery and/or excision.

The US Food and Drug Administration (FDA) has approved a new indication for a quadrivalent recombinant vaccine (Gardasil, Merck & Company, Inc) for the prevention of genital warts caused by human papillomavirus (HPV) types 6 and 11 in boys and men aged nine through 26 years. Since the vaccine does not cover all the viruses, about 30 percent of cervical cancers and 10 percent of genital warts will not be prevented by the current vaccines.

The HPV vaccine will not have an impact on an existing infection or any consequences of infection, such as anal and genital warts and cancerous or pre-cancerous changes that you may already have. It is very important to practice safe sex with your partner.

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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Is meditation good for your health?

According to an article in the American Scientific Mind, the Dalai Lama meditates four hours a day. In the fall of 2005, the Dalai Lama gave the inaugural Dialogues between Neuroscience and Society lecture at the Annual Meeting of the Society for Neuroscience in Washington, DC. The Dalai Lama said meditating for four hours was hard work. He said if neuroscientists were able to find a way to put electrodes in his brain and provide him with the same outcome as he gets from meditating, he would be an enthusiastic volunteer. 

What kind of outcome do we get from meditating?

There is significant scientific evidence that even a short-tem meditation improves attention and cognitive enhancement. That means it improves conscious intellectual act – the mental process of knowing, awareness, perception, reasoning and judgment. 

How does meditation change the brain?

Regular deep meditation makes the gamma waves fire very rapidly in harmony. Neuroscientists have figured out which brain cells are responsible for the gamma waves. They can induce these brain waves in mice. The next thing is to use this technology and transfer to the humans. This way we can create artificial meditation (meditation on demand) and reap the benefits of meditation.

Writing in the Scientific American Mind (Nov/Dec, 2009) Peter B. Reiner says, “At the very least, it is safe to say that the prospect of using advanced technology to mimic at least some of the brain activity present during meditation states has moved from the realm of science fiction to that of scientific possibility.”

What are the other benefits of meditation?

In one scientific study, a group of 40 undergraduate Chinese students were given five days of 20-min integrative training on meditation. The result showed greater improvement in conflict scores, lower anxiety, depression, anger and fatigue and higher vigour, a significant decrease in stress-related cortisol and an increase in immune-reactivity.

Medical and psychological studies have shown that meditation is effective to varying degrees in the symptomatic control of migraine headache, hypertension and other conditions. It helps in the purification of body, mind, and soul. Meditation has been found to reduce heart rate, pulse rate, respiratory rate and plasma cortisol level and to increase electroencephalogram alpha waves associated with relaxation (Shapiro, 1995).

Meditation or for that matter any relaxation exercise appears to impact more strongly when the anxiety is primarily psychological, such as excessive worrying.

In 2008, the American Journal of Hypertension reported that regular practice of transcendental meditation was associated with reductions of 4.7 mm Hg in systolic pressure and 3.2 mm Hg in diastolic blood pressure compared with control groups. These reductions were equivalent to those seen after adding a second anti-hypertensive pill to a treatment regimen. This reduction would be expected to significantly reduce cardiovascular disease risk.

Other studies have shown medical benefits of relaxation exercises such as meditation, breathing, and progressive muscle relaxation in tension headaches, anxiety, psoriasis and cardiovascular diseases. Thus it can increase longevity, reduce use of medical care, medical costs in treating chronic pain, smoking cessation and serum cholesterol level in elderly and others.

As Pythagoras (580 B.C. – 500 B.C.), a Greek philosopher and mathematician said, “Learn to be silent. Let your quiet mind listen and absorb.” Blaise Pascal (1623 – 1662), a French philosopher said, “All man’s miseries derive from not being able to sit quietly in a room alone.”

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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Meditation Techniques

It is not difficult to meditate. But it is difficult is to find time to meditate. There are easy ways to meditate and there are elaborate ways to meditate. There are numerous books out there where you can learn different techniques. Today’s column is just an introduction.

Meditation should be effortless. It requires concentration to a visual image, a repeated word or a body sensation such as breathing.

One easy method I have found useful is called walking meditation. I learnt about this at a medical conference. You have to walk clockwise around a room while holding your one hand closed in a fist, while the other hand grasps or covers the fist. You take each step after a full breath.

You can do this during a lunch hour at work or at home when you find 10 minutes or more. Do not worry if your co-workers think you are crazy walking in a circle in your boss’s office. They have probably seen too many movies where they see people walking in circles in mental institutions. We do not believe in stereotyping and profiling.

Walking meditation is a form of meditation in action. The difference between walking meditation and sitting meditation is that our eyes are open, we do not withdraw our attention from the outside world, it is easier to meditate and fit into our schedule and perhaps we are more easily aware of our bodies when we are walking than sitting. The relaxation experienced while walking is more intense than sitting.

Some researchers have come up with an idea of combining relaxation and exercise into one activity. Such as aerobic exercise. It was found that compared with a control group, volunteers who focused their thoughts on a word or phrase while riding a stationary bike had an 11 per cent lower metabolic rate. An anxious, type A individual may do better with this technique because it gives an active mind something to focus on.

Drs. Martin and Marion Jerry’s book (Sutras of the Inner Teacher – The Yoga of the Centre of Consciousness, 2M Communications, Canmore, Canada) discusses in great detail the role and technique of yoga and meditation in the Himalayan Tradition. A serious student of yoga and meditation should read this well researched book.

Other techniques include Zen technique that requires sitting for hours in a position which can be painful and tiring. According to Dictionary.com, Zen is a Mahayana movement, introduced into China in the 6th century a.d. and into Japan in the 12th century, that emphasizes enlightenment for the student by the most direct possible means, accepting formal studies and observances only when they form part of such means. Enlightenment can be attained through meditation, self-contemplation, and intuition rather than through faith and devotion.

The Transcendental Meditation (TM) technique is a form of mantra meditation introduced in India in 1955 by Maharishi Mahesh Yogi (1917–2008). His famous disciples were Beatles. Meditation involves the use of a sound or mantra and is practiced for 15–20 minutes twice a day, while sitting comfortably with closed eyes.

There are many more techniques. If you are a busy person, and most people are, just find a quiet room, close your eyes, pick a word and say it again and again. You can use a rosary to help you concentrate. Or say the word when you breathe in or out. Snoring does not count. But I consider snoring as a kind of meditation after a hard day’s work. And my wife agrees with that as long as she does not have to hear the noise.

So, find a technique which works for you in your busy schedule, name it after somebody you like and enjoy the peace and tranquility. Next week, we look at the medical benefits of meditation.

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