The Benefits of Coffee

Recently, there have been numerous studies indicating that drinking three cups of coffee per day may be beneficial to health rather than cause other health problems. There has often been a grey area associated with coffee and caffeine and the study sheds some more light onto this area.

“Roasted coffee is a complex mixture of over 1000 bioactive compounds, some with potentially therapeutic antioxidant, anti-inflammatory, antifibrotic, or anticancer effects that provide biological plausibility for recent epidemiological associations.”

The study showed that there were 19 positive outcomes, 6 negative outcomes and 34 neutral health outcomes to drinking coffee. It is clear that the positives outweigh the negatives, however due to the small sample size and high frequency of neutral results we simply cannot ascertain whether or not the consumption of caffeine is positive, for now it has a ‘clean bill of health’.

Coffee consumption is associated with a decrease in rates of death associated with cardiovascular disease, coronary heart disease and stroke. The study has shown that the largest reduction in health risks occurs when someone drinks three cups of coffee per day. There were also variations in accordance with sex. Women often received greater benefits from drinking coffee for coronary heart disease and cardiovascular disease however the reduction of risk of stroke had a more pronounced affect in men.

There was an overall reduction in risk of cancer for coffee drinkers however this varied with whether or not the person was a smoker or not. “In a separate article, in non-smokers there was a 2% lower risk of mortality from cancer for exposure of one extra cup a day.”

There were negative associations with drinking coffee when pregnant and an increase risk of fracture in women. At present data available is of low quality and many believe that randomised control trials will be needed to accurately research this area.

References:

http://www.bmj.com/content/359/bmj.j5024

http://www.bbc.com/news/health-40567047

http://www.bbc.com/news/health-36540417

http://www.bbc.com/news/health-42081278

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Vaginal Mesh Implants

At present, the vaginal mesh implant scandal has been compared to the thalidomide scandal which plagued women of the 1960s and their infants.

The synthetic polypropylene implants were used as an alternative to more invasive procedures for the treatment of urinary incontinence and prolapse that occurs after childbirth. Many patients began to complain about chronic pain, bladder spasms and continual pelvic pain due to the mesh cutting through vaginal tissue as well as an inability to walk after sex.

The mesh implant launched by Johnson & Johnson without a clinical trial has led to law suits on all fronts and an estimated $57 million dollars was given to one woman alone as compensation.

It was revealed earlier this year that over 800 women will be taking legal action against the NHS for its part in the scandal. Thousands of woman had been advised to have tension-free vaginal tape surgery across the United Kingdom. Over 92,000 women have had these implants from 2007-2015. Despite having the implants being removed, many women will have to deal with permanent side effects both psychological and physical. A campaign known as Sling the Mesh has been launched.

Professor Carl Heneghan from the University of Oxford compared the scandal to the thalidomide scandal as the thalidomide scandal resulted in an immediate change in drug regulation and this scandal will do the same with the regulation of devices and implants.

Many have criticised the medical proffession and doctors of all ranking after the scandal. There was a desperate need to have stricter regulations and a better approach to the complaints made by women post-operatively as this could have resulted in many of them not having to deal with permanant side effects. This scandal has been incredibly eye opening and will hopefully result in stricter regulations worldwide when dealing with implantation of devices.

References:

http://www.bbc.com/news/uk-scotland-27887766

https://www.theguardian.com/society/2017/sep/29/revealed-johnson-johnsons-irresponsible-actions-over-vaginal-mesh-implant

https://www.theguardian.com/society/2017/aug/31/vaginal-pelvic-mesh-explainer

http://www.bbc.com/news/uk-41671020

http://www.bbc.com/news/health-39567240

http://www.independent.co.uk/news/long_reads/transvaginal-mesh-vaginal-procedure-surgery-tvt-gynaecology-thalidomide-womens-health-psychology-a7862126.html

http://www.telegraph.co.uk/health-fitness/body/vaginal-mesh-scandal-could-bigger-thalidomide/

https://www.theguardian.com/society/2017/oct/19/vaginal-mesh-implants-if-i-lift-my-leg-my-whole-body-shakes

https://slingthemesh.wordpress.com/

 

Malaria Breath Tests

In recent news it has been made apparent that we can now test for the presence of malaria using breath tests. This will make diagnosis more streamlined and more accessible for those in rural and impoverished areas who may be unable to access adequate healthcare.

Malaria is a life threatening disease caused by Plasmodium parasites transmitted to humans through the Anopheles mosquito. There have been more than 400,000 deaths associated with malaria in the past year. In those who are not immune, symptoms usually appear around 5-10 days after the initial bite. The usual symptoms that follow are fevers, chills and headaches, however due to the nature of these symptoms it can be incredibly difficult to accurately diagnose.

The prototype invented was used to detect 6 different odours to detect malaria. This non-invasive and relatively cheap method compared to analysing blood samples is currently being tested and has recently achieved a success rate of 83% when detecting malaria in children. Despite this seemingly positive figure, the prototype has not yet been mass-produced as additional testing is needed due to the small nature of the group under study. This method also does not require any technical expertise; staff do not need to be trained to use it. Therefore, it can be used in rural areas by villagers to test one another for the presence of the malarial parasite. The rapid testing devices operate by detecting the presence of the protein HRP2 in the breath of its users. Unfortunately, some malarial strains e.g. Plasmodium falciparum have mutated and are now beginning to stop producing this particular protein. As well as the original six odours the scientists were testing for they found high concentrations of terpenes. Terpenes are molecules that are usually associated with the odour from pine trees and conifers and are natural attractants for mosquitos.

“Prof James Logan from the London School of Hygiene and Tropical Medicine said: “The rapid detection of asymptomatic malaria is a challenge for malaria control and will be essential as we move towards achieving the goal of malaria elimination. A new diagnostic tool, based on the detection of volatiles associated with malaria infection is exciting.””

References:

http://www.who.int/mediacentre/factsheets/fs094/en/

http://www.bbc.com/news/health-41820346

https://www.wired.com/story/a-malaria-breathalyzer-its-closer-than-you-think/

http://www.who.int/features/factfiles/malaria/en/

http://www.theaustralian.com.au/news/health-science/australian-research-leads-to-malaria-breath-test/news-story/aa728b63b78a0586a7ff368ef69f5982

 

 

 

 

Dr Sanduk Ruit

Dr Sanduk Ruit is a world-renowned eye surgeon from Nepal. After the loss of his sister to Tuberculosis when he was 17, Ruit immediately decided on medicine as his vocation. As he came from a remote Nepalese village he was forced to make long journeys to study, yet he did so to achieve his goal of having a career dedicated to the care of others.

Dr Ruit is known as the ‘God Of Sight’ due to his significant advancements in the field of ophthalmology. Dr Ruit utilises small incision cataract surgeries using intraocular lenses to treat cataracts in some of the most inaccessible and remote places on the planet. Ruit often provides cataract surgeries free of charge as part of his charity ‘ Himalayan Cataract Project’ to treat those who may not have the means or ability to reach medical centres.

In 1986, whilst working in Australia, Ruit and his colleague, Professor Fred Hollows, created the Small Incision Cataract Surgery (SICS) strategy, this procedure used intraocular lenses. After this, Ruit became the first Nepalese doctor to utilise intraocular lenses. Ruit then returned home to Nepal, where he utilised the  procedure to provide good quality eye care for those in remote parts of the country. Dr Ruit often camped and trekked to remote locations with a team to operate suturelessly in order to treat cataracts. However, the procedure was still expensive which made it difficult for use on a wider scale. Therefore, in 1995, Ruit devised an international standard intraocular lens which was just a fraction of the price of the ones produced in the developed world.

The procedure is as follows:

” Dr. Ruit’s innovative small-incision cataract removal technique involves modifying the superior incision to a temporal incision. A sutureless external incision of 6 mm to 7 mm is enlarged to 10 mm internally with a keratome. The nucleus is then removed through the anterior chamber.”

In 1994, Dr Ruit founded the Tilganga Institute Of Ophthalmology, which aims to provide high quality and effective eye care for patients worldwide at an affordable price. The institute is closely linked with the Himalayan Cataract Project and other organisations in order to provide cataract surgeries, often free of charge to people in some of the most dangerous and remote places in the world.

A study published by Dr Ruit and his colleagues in 2007 indicated that his procedure and technique was cheaper, faster, had a smaller recovery time and led to significantly less side effects.

In the past 30 years, Ruit has restored the sight of more than 100,000 people worldwide. In 2006, Ruit treated people in North Korea after gaining special permission from the country to enter. Whilst treating, Ruit was part of a documentary series called ‘Inside – Undercover in North Korea’ alongside Lisa Ling. The documentary was filmed illegally which led to the mission being incredibly dangerous, yet Dr Ruit proceeded with his goal to treat as many people as possible, in total around 1000 North Koreans were aided by Ruit and his team during this period.

References:

http://www.nbcnews.com/id/35935864/ns/health-more_health_news/#.WbwC47KGPIU

https://www.healio.com/ophthalmology/news/print/ocular-surgery-news-asia-pacific-edition/%7B8ec07d3b-a963-4a73-a770-0b06574ff9a0%7D/surgeon-brings-innovative-techniques-to-ophthalmologists-worldwide

http://tilganga.org/

http://vairochana.com/interviews/item/35-an-interview-with-dr-sanduk-ruit-%E2%80%9Cgod-of-sight%E2%80%9D.html

http://www.imdb.com/title/tt0987374/

http://www.cureblindness.org/who-we-are/founders/dr-sanduk-ruit

 

http://edition.cnn.com/2014/12/14/world/asia/nepal-eye-doctor/index.html

 

Glaucoma

Glaucoma refers to a series of eye conditions that affect vision and can cause blindness if left untreated. It is most common in those who are over 40 and is associated with elevated pressure in the eye (intraocular). It is commonly associated with damage to the optic nerve that is caused by a high pressure in the eye. This is due to a build up of fluid in the eye as fluid takes too long to drain correctly, this is an example of open angle glaucoma. Another risk factor for glaucoma is high blood pressure which can affect and elevate ocular blood pressure as a side effect.

At first, glaucoma presents with no symptoms and vision appears to be normal. However, if left untreated it can lead to loss of peripheral vision (vision to the side), over time central vision can also decline leading to very limited vision and blindness.

There are two types of glaucoma:

  • Open angle glaucoma – The eye drainage system begins to falter and results in a build up of fluid and pressure in the eye.
  • Closed angle glaucoma – When the iris in the eye is close to the drainage area and blocks the draining angle. When the drain becomes completely blocked eye pressure rises rapidly and it is classified an emergency.

Vision loss cannot be recovered with glaucoma, so it is vital that it is caught early. Due to the lack of symptoms in the early stages, it is incredibly difficult to detect and necessitates regular visits to an ophthalmologist or optician.

Symptoms:

  • Open angle – Loss of peripheral vision, tunnel vision and patchy spots.
  • Close angle – Eye pain, nausea, vomiting, headaches, severe eye pain, blurry vision, rainbow coloured rings or halos around lights.

The cause of primary glaucoma is unknown. However, secondary glaucoma may be due to pre-existing conditions such as diabetes, cancerous tumors, advanced cataract or inflammation.

There are a number of risk factors associated with glaucoma, which include:

  • Old Age
  • Cataracts
  • Diabetes
  • Ethnic Background – East Asians/African Americans/those of Hispanic descent are more likely to develop glaucoma.
  • Myopia (short-sightedness)
  • Eye surgeries and other eye conditions.

 

References:

http://www.glaucoma.org/glaucoma/glaucoma-awareness-video-with-robert-fechtner-md.php

https://www.glaucomafoundation.org/about_glaucoma.htm

http://www.medicalnewstoday.com/articles/9710.php

https://nei.nih.gov/health/glaucoma/glaucoma_facts

https://www.aao.org/eye-health/diseases/what-is-glaucoma

http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/symptoms/con-20024042

http://www.medicinenet.com/glaucoma/article.htm

 

The Ethics Surrounding The Use of Animals In Clinical Trials

The use of animals in the trials of medicines, cosmetics and other equipment for use by humans has always been a controversial topic. In recent years, activism from groups such as PETA has brought this problem to the forefront of the public eye.

The main arguments against the use of trials on animals stem from the idea that if we are testing goods for use on humans we should subject the trials to humans rather than animals. Many also disapprove of the conditions animals are kept in, which include small boxes. A variety of trials also involves inducing animals with a particular disease and/or inhibiting their food and water intake to observe a response to additional stimuli. After successful campaigning, there are now stricter regulations on the environment an animal is kept in, which animals can be used. Many companies have to get clearance from the home office to trial on animals and as part of this clearance have to disclose the nature of their trial, how many animals they will use and the basic procedure which is then reviewed by a panel. These laws and regulations have proven to be successful in a number of first world countries, however, they are difficult to enforce in third world countries

Those who are pro the use of animal testing often speak of the supplementary benefits of trials on animals before trials on humans. One argument is a reduction in human casualties. If we test on animals before going to human trials any adverse reactions to the medication/trial conditions can be noted and it can be modified for human use. This is another area of controversy and many argue that animals have equal rights to humans and as they are unable to choose to take part in these trials, they should not be subjected to them. At present, a large percentage of trials are first trialed on animals before moving to the next phase. Many people believe that trialing is a necessary evil and is needed for the greater good of humanity. Some pro trial advocates are against trials for cosmetics as they are not a necessity but are pro using trials to test medications.

References:

http://animal-testing.procon.org/

https://www.peta.org/issues/animals-used-for-experimentation/animal-testing-101/

https://www.crueltyfreeinternational.org/why-we-do-it/what-animal-testing

 

Brain Imaging Breakthrough

In recent news, researchers at the Cardiff University Brain Imaging Centre have produced new scanning equipment to show the workings of the brain. One user has stated that the research was akin to using the Hubble telescope after years of using binoculars.

The scan shows the wiring of the human brain. White areas/matter make up the inner part of the brain and are made of dense fibres packed in a tight arrangement. Siemens engineers used the latest computer tools to create 3D images mapping the brain and the nerve impulses and signals of a patient. The scanner uses colour coding to highlight the direction of travel of the impulses and density of fibres to produce a more refined image and a new way of viewing brain mappings. This technology can be used to learn more about and possibly aid the treatment of dementia, MS and epilepsy along with numerous other neurological conditions.

References:

http://www.bbc.com/news/av/health-40487049/the-most-detailed-scan-of-the-wiring-of-the-human-brain

http://www.9news.com.au/world/2017/07/05/15/17/worlds-most-detailed-scan-of-the-human-brain-shows-how-information-travels

http://businessnewswales.com/cardiff-university-brain-research-imaging-centre-cubric-wins-major-science-buildings-award/