Professor Ralph Steinman

Professor Ralph Steinman was the 2011 recipient of the Nobel prize in Physiology or Medicine. He was also the first person to be conferred the prize after his death which had unfortunately happened 3 days before the award was declared.
But more important than his death was his life--a life for which the whole world of Immunology and Medicine must be thankful for, a life for whom every new dendritc cell based vaccine recipient must be thankful for.
Professor Steinman was conferred the Nobel Prize almost 40 years after his discovery of the dendritic cell whilst peering through the microscope looking at accessory cells in a mouses spleen.

Zanvil Cohn (left) and Ralph Steinman (right) examining data

Fig 2. Nature Medicine 13, 1155 - 1159 (2007)
Published online: 17 September 2007

Prof. Steinman, then a post doc fellow at Prof Zanvil Cohn's lab at the Rockefeller Institute, New York, was trying to figure out the missing piece to the jigsaw in antigen delivery  and T cell activation. Prevailing belief was that the Macrophages were responsible but research could not validate that premise. It was at this juncture that Prof. Zanvil Cohn and Steinman decided to do some basic research. They came across this strange spindly armed cell, which looked very much like a trees branches that they decided to call it the dendritic cell.

Phase Contrast of a Dendritic cell from Spleen

Fig 3. Nature Medicine 13, 1155 - 1159 (2007)
Published online: 17 September 2007

Over the next 20 years Prof. Steinman and his team worked doggedly on the dendritic cell and its functions, initially purifying it and then discovering its role in T cell activation and so on. At one time they were probably the only team in the world working on it. And at times their initial studies were neglected and put aside. But all this changed when the world came to realize the quintessential role that the Dendritic cells play in our Immune System.
In todays world Prof. Steinman has been instrumental in paving the way for Dendritic cell based vaccines which are more target oriented and specific than conventional chemotherapy.
George Bernard Shaw once said  "Science becomes dangerous only when it imagines that it has reached its goal".
Prof. Steinman can be credited as being a man who doggedly pursued his goal, always believing that he has not yet reached it. His life and death is testimony of sciences true quest for the truth.

Coconut Oil Touted as Alzheimer's Remedy

Please watch this video for more information


Coconut Oil Touted as Alzheimer's Remedy

http://www.youtube.com/watch?v=ZZOR-Qd3QSg

Milk and Medicine

From the first mouthful of breast milk till that last bowl of cereal, milk is almost omnipresent in our day to day life. While all milk may be white in colour there does lurk some murky and muddy inconvenient truths hidden within that appealing pale.

When I first heard of Prof Keith Woodford's (Professor of Farm Management and Agribusiness, Lincoln University, New Zealand) presentation to a group of General practitioners in Sydney I was sceptical as well as intrigued. Sceptical of his presentation because of the marketing presence of a particular brand name milk who stood to profit; intrigued because I have heard a lot of anecdotal evidence about milk et al during my extensive online research into autism, autoimmune conditions and allergies.

I have to confess here that I am an autoimmune disease sufferer. In fact my life is plagued by two wonderful autoimmune diseases - two diseases which have prompted me to scour the length and breadth of medicine to find a cure, to find causatives and preventatives. More often than not conventional textbooks hold very little and with the help of the internet, 'anecdotal' evidence on a large scale coupled with case studies have proved more beneficial in my personal quest.
Personal issues aside let me continue with the story of milk.

Apparently most of us in the western world drink milk from the wrong kind of cow. The big black and white cows that we are fond of seeing--the holsteins and its ilk give a slightly different kind of milk than the older breeds like the Asian, African and Jersey cows. The main difference in the milk is the type of milk protein that they contain. Beta Casein comprises around 30% of the milk protein and our older cows produce milk with the A2 variant of beta casein, whereas most of the industrially reared cows in the western world as well as in New Zealand and Australia  produce milk which has both the A1 and the A2 variant.
Unfortunately for us this A1 variant is not a very stable one and it easily lets go of BCM-7 in the digestive tract of animals and humans drinking milk with A1 beta casein.

Ground breaking book by Keith Woodford

As the devil is in the detail we now need to understand why and what BCM-7 or beta-casomorphin - 7 can do in our gut. BCM -7 is an opioid peptide(see the word morphin at the tail end!).This opiate BCM 7 has been shown in the research to cause neurological impairment in animals and people exposed to it, especially autistic and schizophrenic changes. BCM 7 interferes with the immune response, and injecting BCM 7 in animal models has been shown to provoke Type 1 diabetes. Dr. Woodford presented research showing a direct correlation between a population’s exposure to A1 cow’s milk and incidence of auto-immune disease, heart disease (BCM-7 has a pro-inflammatory effect on the blood vessels), type 1 diabetes, autism, and schizophrenia. 

One of my GP friends used to tell me to switch to goats milk as she had felt that giving her children goats milk instead of cows milk had brought a significant reduction in them catching colds and being 'mucussy'. The real reason behind that presumption lies in the research that shows that BCM-7 selectively binds to the epithelial cells in the mucus membranes (i.e. the nose) and stimulates mucus secretion!

Now for some Russian research which has actually been ground breaking and an eyeopener to many. This group of 12 Russian scientists from four leading research institutions has developed a test for measuring BCM-7 in the blood. They have also shown that babies fed formula milk do indeed absorb BCM-7 into their blood. Both of these are huge breakthroughs. More importantly they have shown that some of the babies can get rid of the BCM-7 rapidly from their systems, but that other babies retain it in the bloodstream. And then comes the final blow. Those babies who are unable to rapidly breakdown and excrete the BCM-7 from their systems are at very high risk of delayed psychomotor development!

They also showed that the human form of BCM-7 (which is quite different in its biochemical structure to the bovine form found in A1 milk), and which is found only in breast milk, is actually a good casomorphin, that enhances psychomotor development and works best in those children who don’t break it down quickly. It is only the bovine form that causes issues.

Last but not the least we need to look at ways around this particular problem. Our babies and us may or may not be able to rapidly get rid of BCM-7 from our systems. So what do we do.--and especially if we feel that we do have symptoms associated with the consumption of milk?
The first option is the most obvious---stop drinking milk and stop formula feeds for babies--only give them breast milk.
The second option, if taking away milk from your diet is too radical a step, is to substitute the commonly available supermarket shelf milk for goats milk or milk that is entirely composed of the A2 variant of Beta casein, otherwise known as A2 milk(TM).
For a bit more on milk please read Dr. Thomas Cowan's article here.

References
1. Crit Rev Food Sci Nutr. 2006;46(1):93-100.
Health implications of milk containing beta-casein with the A2 genetic variant.

Bell SJ, Grochoski GT, Clarke AJ.

2.Diabetes Metab Res Rev. 2001 Jan-Feb;17(1):51-4.

Bovine beta-casein antibodies in breast- and bottle-fed infants: their relevance in Type 1 diabetes.

Monetini L, Cavallo MG, Stefanini L, Ferrazzoli F, Bizzarri C, Marietti G, Curro V, Cervoni M, Pozzilli P; IMDIAB Group.

Source

University of Rome Tor Vergata, Rome, Italy.

3.Kost NV, et al. Β-casomorphins-7 in infants on different types of feeding and different levels of psychomotor development. Peptides 2009 Oct; 30(10):1854-60.

4.http://keithwoodford.wordpress.com/2010/02/20/russian-breakthrough-unravels-bcm7-mysteries/
5.http://thebovine.wordpress.com/2009/03/20/the-devil-in-the-milk-dr-thomas-cowan-on-how-a2-milk-is-the-answer-to-the-mystery-of-why-even-raw-milk-sometimes-does-not-seem-to-be-enough-of-an-improvement-over-store-bought/

Lose weight in 5 easy steps.

Ok! Lets be honest losing weight is never easy, right? Wrong! It can be easy as well as fun. It all depends on how we look at it and how we work toward it.

The Five Steps

1. Find out what gives you the best kick of all -- is it more money in the bank, a career promotion, more power, or more food in the fridge -- whatever it is have a think about it.

2. Determine how many kilos you want to lose. Be realistic. And don't set a time frame. Even if you do set a time frame make it a jolly long one.

3. Been overweight for a while? Then your metabolism might be a little slow. Do something/anything  heart thumping for 15 minutes each day - skipping, dancing, running, jogging, running on the spot, or just about anything that will get your heart beating faster.  The key point to note is that it should be something that can be easily done, and preferably done in the comfort of your own home. If you really want to push yourself a bit more do this twice a day - once in the morning and once in the evening or night. Caution: do a few stretches and flexes before hitting the ground - who needs sprains and strains on the first day?

4. Fooooooood is NOT your enemy.  Enjoy it but in good measure. The simplest and greatest service you can do to yourself to help you lose those kilos is this - when you feel hungry and its time for a meal help yourself to some water. A glass full is good, two glassfuls even better. And always begin your day with a glass or two of water. Now eat till you are no longer hungry and feel a bit satisfied. Never eat just to finish up what's on your plate. If you hate wasting food buy yourself a smaller plate and serve smaller portions - but never stuff yourself full of food - that poor tummy can't handle it!

5. Get rid of all the in between snacks and deserts from your freezer and pantry cupboard.

Now lets put 1,2,3,4, and 5 together. We'll do this bottom to top.

Getting rid those inbetweeners and deserts takes away temptation. Whilst working as a Slimming consultant I realised that most of my patients don't really count those inbetweeners as real food! So they find it difficult to understand how is it that they put on so much / or lose so little weight by eating so very little! Deserts are easier to understand and easier to avoid. So the best way to do it is get rid of the temptation!

Water is not only good for you and helps in detoxification, but is also a zero calorie tummy filler! Works almost like a gastric band ( but not quite) and makes you feel fuller faster. So make it your new best friend. Often our hunger pangs could just be because we are thirsty - so refuel frequently with water and especially before sitting down for a meal. And get that smaller plate - a smaller plate means less waste and decent portions.

A bit of exercise which does not need any special equipment and is easily done in the comfort of ones home is better than that New Year gym membership that never gets used or if used just once a week. Keeping things simple is key - especially if you've tried and tried and felt like failure. Just do it - anything at all - for 15 heart thumping minutes - and get that metabolism going. As said previously if you can do it twice a day - good! But don't berate yourself for not being able to make it twice. Once is good enough. Once your metabolism is kick started your body automatically begins to burn more calories than it did when it was sluggish. So bear that in mind.

Now you know how much you want to lose. So after putting these steps into action weigh yourself once every week. Not before 7 days at any rate. Make a record of how you are doing - record the date started, date weighed and weight. Initial it and get a friend or family member to review it with you if possible.

Now for point number one. Why on earth should you think about what gives you the best kick? Well it's important. It's important to you as you get the best buzz out of it.  So link your weight loss kilos mentally to whatever it is that gives you the best high or buzz in life. If its money link it to your bank balance and visualise it growing as your weight loss kilos grow, if its more power, imagine the weight loss kilos giving you more power and so on. This kind of visual imagery boosts our mental positivity and creates a buzz within ourselves. It offer us mental fuel to go on and add to that bank balance, it urges us on and forward and deters us from stopping before we reach our goal!

All the very best and don't forget to let me know how well you are getting on or follow me here for more updates and news.
I know many of you are reading my posts -- why not stop and say hi in the comments section? Would love to hear from you!

Danger Doctors - Beware!

The Sunday Telegraphs Health leads with the eyecatching, heart thumping headline of  '3 in 4 of Britains danger doctors are trained abroad'!

Now lets go a little more into their eyecatching, heart thumping headline and news.

They acquired the statistics using the freedom of information act so we can conclude that this juicy detail was actively sought to make a news article. Well that explains the catchy headline at least! 

The general tone of the article is obviously slanted toward   ‘overseas doctors are bad doctors compared to our native trained doctors’ though they cant hide the fact that 37% of those struck off or suspended are indeed native doctors, probably born and bred here, in addition to being wholly trained in Britain; doctors whose first language will be English and who know the nuances and cultural delicacies of the native population.

They also cannot hide the fact that in fact 17% of those struck off from among the Britsih trained doctors were referred by patients and only 11% in the same category for overseas doctors. Therefore it begs the question as to why more overseas doctors are being referred to the GMC by Hospital authorities, NHS trusts etc.

Another juicy subheading indicts Indian Doctors directly and fortunately comes with a table  so those who can read beneath the headline can get a better picture.

The subheading reads - Worst five countries by number! The figures beneath the headline tells us that doctors who have done their undergraduate training in India are in fact 25989 and thereby the largest group by a good measure than any of the other groups mentioned and therefore the number of doctors struck off or suspended from is far fewer in proportion to many other nations. 

There are indeed several issues with overseas doctors coming from a foreign land and culture to practice medicine here in the UK or for that matter anywhere else in the world.

The prevalent and persistent colonial culture of Britain does make these issues more pronounced to say the least.

These overseas doctors are indeed trained medically in systems akin to that of Britain. I for one was educated in India and most if not all our textbooks were written by British medics and scholars. From Cunningham for  Anatomy Dissection to Davidson’s for Medicine and everything in between. So its not the medicine that is at fault – but rather something larger and murkier than it all.

One cannot say that these overseas graduates are of poorer intelligence or social skills as well – for most if not all of them needs to master a foreign language in addition to their own mother tongue to even gain entry to sit the PLAB. The IELTS that tests for English language proficiency tests written, verbal, listening and reading skills and one is required to achieve at least a score of 7 in the academic module. This is followed by the PLAB theory and the PLAB practical OSCE’s. So after all these tests and rigours these overseas doctors begin their career in the UK under a vast and varied environment that has no standardised training pathways across schemes.

And again when they claim that 3 in 4 danger doctors are trained abroad they are referring to the 4 1/2 -5 1/2 years of undergraduate training. These doctors  have since then been entirely 'trained' in supposedly equal roles in the nations NHS for several years thereafter. Some of those referred have probably done double the amount of training in the UK as compared to their overseas training prior to being referred. 

So in actual fact the newspaper cannot be referring to their training background (as many would have trained for an equal length of time abroad and in the UK and most possibly longer within the UK than abroad). So then are they subtly alluding to their ethnic background?

That notwithstanding lets explore what it may be that fails these doctors and what is the real reason behind these referrals.  My surmise is that there are bad apples and poor apples as in any other given population and that these will account for some of the referrals. But then what about the rest? A few may fall out because even after all these testing  and years of training they fail to grasp regional colloquialism and conventions and fail to match up to patient expectations. There is also an amount of patient expectations differing when they see a foreign doctor as opposed when they see a doctor of their own kind –as in they may be able to give more leeway for failings from a doctor they like as opposed to a doctor they tolerate out of necessity.

The other more important factor is referrals from those in power and authority. The potential of potential whistle blowers being referred to the GMC for trumped up issues or for minor issues blown out of proportion should never be underestimated as there are plenty of anecdotal evidence to support this. This potential is more so if the doctor in question happens to be coloured. Outside of whistle blowing there are other referrals made without even a preliminary investigation or fact finding from the powers that be. I am a first hand witness to such a frivolous GMC referral where the deputy dean who referred  the trainee doctor didn't even bother to have a chat or elicit the facts about the issue from the trainee  before he referred him to the GMC. The first time the trainee doctor heard about it was after the referral. Had the deputy dean showed the common courtesy that he may have shown a local grad then such a frivolous complaint would not have been lodged.
But that is beside the point –these people give the GMC work to justify the fees they take from its members.

So to sum up –Overseas doctors in the UK beware – up your act if you are trailing, smarten up if you are smarting and jump the ship before they sink you if you have the wherewithal!

That the medical environment in the UK is becoming increasingly hostile to International Medical Graduates is no secret. The only question is how worse can it get?

ADaMMs - Awesome DAds Medical (Mango) Milkshake

Last night my dearest husband ventured into the kitchen. Each 'venture' is akin to a hair raising adventure for the rest of the family. OH loves to help - but when it comes to dishes I end up with less clean ones than the number of dirty ones that went into the sink --crick, clang, crash! One day it's a bowl, next day a glass may be and the day after a plate.
Luckily last night was Mango milkshake night so I was a little less apprehensive about the venture. But I quickly realised that not everyone shared my optimism as you can soon see.

I'm inviting a few guests over on News Day and have planned on giving them a nice cool welcoming drink. Since I'm the hostess I'll obviously be too busy with the 'really important' stuff you know! So my Dearest has been entrusted with the lofty job of creating an awesome mango milkshake to serve them.

Like everything in the medical world (OH was a surgeon before he changed his spots) preparation is paramount. OH decided that he would like to make a test batch of milkshake just to be sure that everything would be just right on the day. So after we put Lil DS to sleep OH declares to DD and DS1 -- " I'm off to the kitchen to make some Awesome Dads Mango Milkshake -- who would like to volunteer?"
"Sorry Daddy I don't want to 'vomiteer' "  quips  7 year old DS1 immediately, delivering an 'awesome' blow to Dads ego. Anyways he has us all in stitches laughing at his well timed play of words.

Long story short the kids didn't 'vomiteer' and Awesome Dad made his very own milkshake without any further mishap (or so I think as I didn't hear any of the usual sounds of clink, clank, clatter)!

Oh No! First post a scandal?

I dearly wish my first post didn't have to be bad news---but bad it is neehow!

Our beloved Royal College of General Practitioners (RCGP), the esteemed College  with the Royal Charter is now being accused of certain unsavoury goings on. Its all hush hush and behind closed doors at the college but the medical media is reeling under the onslaught of tales of woe and discrimination being rife within the RCGP.

Pulse, an esteemed GP online magazine in the UK has been reporting about potential bias in the Clinical Skills Assessment (CSA) conducted by the RCGP and which International Medical Graduates(IMGs) are failing left right and center  The first inkling that something was amiss started being reported in early November when Pulse said here that the RCGP could face legal action due to the huge differential in pass rates between local 'white' candidates and IMG's though both went through the same selection process and identical three year training rotations.
This article brought forth an unprecedented number of comments from local and IMG medical doctors alike. On its pages are a never before heard tale of woe and perceived discrimination of GP trainees who feel they are in a rut out of which an exit is impossible.

Over the past several months it had become blatantly obvious to any cursory observer that something was amiss - especially when doctors with excellent feedback from patients during their GP years and excellent scores at the Applied Knowledge test started failing the CSA in droves. This became excruciatingly painful when they were later booted out of their training schemes, thousands of pounds out of pocket and jobless. The only common factor in all these cases were that these candidates were IMG's and predominantly male.

Background investigation and hear say point to the fact that the bar for CSA was raised again in 2010. The candidate now had to pass in all 13 stations which were marked by a single examiner with no videoing or appeals process. The stations were simulated surgeries with professional actors role playing patients.

From the comments on Pulse it is obvious that some of the actors are far from fair in divulging information to the doctor and some examiners may fail terribly under closer scrutiny.

But the key reason for this mass failure seems to stem from the fact that the Clinical Skills Assessment is anything but. It has been designed to enable only high  end English communicators to pass the exam. And as such the trainers are woefully under equipped to help the failing trainee as this fact has probably not been divulged to them.

Recently the BAPIO (British Association of Physicians of Indian Origin) has decided to take up the issue on behalf of all the suffering IMG's irrespective of ethnic origin. We wish them all success in their pursuit for justice.


Good to read : theriskyshift.com - Black and Minority Ethnic Doctors within the British National Health Service: What can History tell us?


Add on:  It has just come to my notice that Pulse had apparently raised this issue here as early as in January 2011. And here we are one year later still reeling from its after effects.