The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 15 Oct 2011 08:03 PM PDT CONSIDERING that the majority of human beings have had Helicobacter pylori living in their stomachs most of their lives, it is hardly surprising that this spiral-shaped bacteria has been spotted by scientists long before Australian pathologist and Nobel laureate Prof Emeritus Dr Robin Warren first noticed them in gastric biopsies of patients with gastritis in 1979. Among the first to report seeing the bacteria in sections of the stomach was noted German-Swiss pathologist Edwin Klebs, who also identified the bacteria that causes diphtheria, and has the bacteria genus Klebsiella named after him. He reported seeing "bacilli-like organisms" in the lumen of the gastric glands, along with inflammation of the gastric mucosa, as far back as 1881. Eight years later, Polish gastroenterologist Prof Walery Jaworski isolated and described spiral-shaped bacteria in the sediment of washings from human stomach contents, which he called Vibrio rugula. More significantly, he speculated that these bacteria might be responsible for stomach ulcers, gastric cancer and achylia (the absence of gastric juices; the absence of hydrochloric acid from gastric juices is one of the signs of acute H. pylori infection). However, as these findings were published in a Polish book, the title of which translates as Handbook of Gastric Diseases, they went largely unnoticed by the wider scientific community. The spiral-shaped bacteria, or spirochaetes, were also spotted in the stomachs of dogs, cats and mice. The first scientist to report finding them in the stomach of dogs was Italian doctor Guilio Bizzozero, who published his findings in the German journal Archiv für mikroskopische Anatomie in 1893. Meanwhile, in 1906, German physician Dr Walter Krienitz published a paper in the journal Deutsche Medizinische Wochenschrift, describing a spiral-shaped bacteria in the stomach of a patient with gastric cancer. Following that, Japanese scientists Rokuzo Kobayashi and Katsuya Kasai concluded in their 1919 Journal of Parasitology paper that certain cases of haemorrhagic gastroenteritis were caused by the spirochaetes they, and others before them, had observed in certain mammals. Most significantly, they had also eliminated these bacteria with the antibiotic salsarvan, thereby being the first to prove the treatment of H. pylori with antibiotics. And in 1925, American Dr Albert Hoffmann managed to induce gastric and duodenal ulcers in a guinea pig, using a sample from a patient with peptic ulcer disease. He also described the organism in his paper in the American Journal of Medical Sciences. However, their work went little noticed among the scientific community. Then, in 1940, Harvard Medical School scientist Dr A. Stone Freedberg and his colleague Dr Louis Barron observed in a study looking at surgically-obtained gastric samples that spirochaetes were present in 53% of the samples with ulceration, but in only 14% without ulceration. But when other scientists could not confirm Dr Freedberg's suspicions that the spirochaetes were causing the ulcers, and he was unable to culture the bacteria, he was urged to give up on the line of enquiry and turn his attention to other research areas. In a 2005 interview in The New York Times, Nobel laureate Prof Dr Barry Marshall acknowledged that he and Prof Emeritus Warren would not have won the Nobel Prize for identifying H. pylori and proving its link to peptic ulcer disease if Dr Freedberg had continued his ulcer research. He was quoted as saying: "If Dr Freedberg's team had been able to culture H. pylori, they would have seen that bismuth kills the bacteria and they could have developed a treatment in a few years. "They would have won the Nobel Prize about 1951 as I was getting born. So it was just a bit of bad luck for a lot of people." In the book Helicobacter Pioneers, Prof Emeritus Warren wrote that Dr Freedberg had written to him and Prof Marshall in 1983 after they published their initial findings, thanking them for proving he had been right all along. There have also been many other scientists who have observed H. pylori since Klebs in 1881, but they either came to the wrong conclusions about the bacteria — for example, that they were contaminants or commensals, or could not link the bacteria to any disease process. Fortunately, treatments for peptic ulcer disease were discovered much earlier than the cause, even though no one knew why they were effective. For example, bismuth has been used as a treatment for gastritis and peptic ulcers since 1868. However, no one knew that the real reason it worked was because of its anti-bacterial properties, which were only discovered much later. Nowadays, peptic ulcer disease is usually treated with the first-line triple therapy regiment of two antibiotics and a proton-pump inhibitor to suppress acid production by the stomach. Related Story: |
| Posted: 15 Oct 2011 08:00 PM PDT The shift towards the policy of 'harm reduction' in controlling drug addiction problems may be more effective in curbing the drug problem. MALAYSIAN drug policy has been, and still is, predominantly enforcement-based, and is loosely related to the moral "social evils" model. This means that our approach so far has been to ostracise and incarcerate persons who use drugs. However, in the past 10 years, there has been a policy shift towards a concept called "harm reduction" due to high levels of HIV infections, predominantly among injecting drug users. Harm reduction is an ideology that seeks to mitigate the harm done to individuals who consume drugs, their families, and society at large. Via harm reduction, certain actions are taken to ensure that HIV does not spread, and drug users are given a chance to reintegrate into society without resorting to acquisitive crimes, and are not removed from positive influences in society. Harm reduction is the principle opposite of prohibition and punitive sanctions for drug use – more popularly known as the War on Drugs. In their 2002 book, Alex Wodak and Timothy Moore address the failure of prohibition and describe it as being an "expensive way of making a bad problem worse". They also say: " ... a modern drug policy for the 21st century requires that mood-altering drugs are considered to be primarily health and social issues rather than a problem to be solved predominantly by law enforcement". A colleague in Australia once told me that harm reduction is not a practice solely confined to drugs. Harm reduction is practised regularly throughout our lives, in relation to many things. That colleague told me of the day his son told him that he wanted to buy a motorcycle. "You can't stop the kid, Fifa, he's going to ride the motorbike anyway." Subsequently, my colleague knew he had to buy his son the very best protective gear to reduce the harm that could possibly be inflicted upon his son. So he bought the helmet, the leather riding suit, and the best protective boots. Sure enough, his son got into an accident, and because of the harm reduction measures practised by my colleague, his son was safe, and heartbreak to his family was avoided. Decades of punitive law enforcement has done nothing to reduce drug use, or the supply and demand of drugs. In fact, statistics from the Royal Malaysian Police show that arrests for consumption of drugs alone under Section 15(1)(a) of the Dangerous Drugs Act 1952 rose from 42,304 arrests in 2009 to 56,725 arrests in 2010. The time has come when we must accept that no matter how much we prohibit and jail people, the problem will probably persist, and it is prudent for us to take action to reduce as much harm as possible resulting from drug use. These harms may include HIV infection, co-morbid psychiatric and substance dependency, increase in petty crimes, broken families, and last but not least, broken hearts. One such specific harm reduction measure is the needle-and-syringe exchange programme (NSEP). Needle-and-syringe exchange programmes involve the drug user bringing his or her contaminated syringes to NSEP sites in exchange for sterile needles and syringes. As a result, when clean needles are available, the sharing of contaminated needles is greatly reduced, and this helps reduce HIV infection. Malaysia first introduced needle-and-syringe exchange programmes in 2006 as a response to high infection rates among intravenous drug users. In 2007, it was seen that there were 2,601 new cases of HIV infection, reduced from 3,127 infections in the previous year in the injecting drug user population. This reduction may also have been complemented by an increasing openness towards treatment-based solutions for drug users. "Gentler" measures have been proven to reduce HIV infection. In fact, drug policies in Portugal have been proven to reduce not only HIV infections, but also drug-related crimes, addiction and recidivism. This is because law enforcement officials make less arrests, and drug users come into increased contact with social workers, health professionals, and other positive influences. Portuguese drug policy understands that all incarceration does is increase the risk of transmission of HIV, remove positive influences from the drug user's social circle, increase the chances of the drug user getting a psychiatric co-morbidity, and stigmatises them by permanently branding them as criminals. As a result of this, persons who have been incarcerated as a result of their drug use find it difficult to get normal jobs once they leave prison. Eventually, these persons are forced to turn to petty crime. Furthermore, prison does not address the chemical dependency that the person has on drugs. Chemical dependency is something that MUST be solved via medical treatment and behavioural therapy, NOT incarceration. Next week, we will describe policies in Portugal, Germany, Switzerland and other countries, explore how they have reduced dangers associated with drug use, and also examine the viability of adopting such policies in Malaysia. The writers are from the Malaysian AIDS Council. The views expressed are those of the writer. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. Full content generated by Get Full RSS. |
| Posted: 15 Oct 2011 08:00 PM PDT The libido can be easily affected by various elements in our lives. IN the previous article for this column, I talked about several causes of low libido in women. I feel that it is important to give coverage to this issue, as women still find it difficult to openly confront this problem. The libido is a fragile, fickle thing, and can so easily be lost due to physical and psychological factors in our lives. If we do not identify the causes of low libido, we will be constantly wondering why we do not enjoy or desire sex, and may even heap blame on ourselves and damage our relationships. In this article, I will continue with the list of common sex drive killers in women, and ways to address these. Poor body image Beauty and attraction are intertwined with feelings of sexuality and desire. Yet, it is often not our looks or body that is the issue, but our perception of them. It is hard to feel comfortable with your body, or feel sexy when you have poor body image. Some women think that they are too fat, others think that they are not curvy enough. Some want bigger breasts, others want longer legs. These characteristics don't really have anything to do with sexual performance, yet some women obsess about it until they lose their desire to have sex because they feel ashamed to bare their bodies. This problem has to be first resolved within yourself – nobody can make you feel sexy until you feel good about yourself. You should also talk to your partner and ask him what he finds desirable about you. You might be surprised to learn that he has no issues with the parts of you that you so dislike! Do not let anyone make you feel bad about yourself. If you feel that you should lose weight, make sure that you do so healthily and properly. Do not crash diet or starve yourself. Follow a suitable exercise programme – working out will give you an energy boost, tones your body, and increases your sex drive. Menopause Sex after menopause? Why not? But first, women have to overcome the tendencies of menopause to reduce sexual desire. The hormonal changes brought on by menopause not only affect libido, but also some of the important sexual functions. As testosterone production drops, the sex drive becomes lower, the clitoris becomes less sensitive, and the body is less able to respond sexually. The low levels of oestrogen, meanwhile, cause vaginal dryness and makes penetration painful. While menopausal changes are inevitable, there are ways that you can overcome some of the symptoms. If you have vaginal dryness, your doctor can prescribe topical oestrogen therapy, or you can use a water-based lubricant. Besides these physical factors, menopausal women should also consider the state of their relationship (have they become too comfortable, entered a boring routine?), their body image, and self esteem (are they shy about their ageing bodies?), as well as their state of health (are they taking other medications or suffering from other conditions that could affect libido?). Monotony and routine Complacency can set in to any relationship. Sex is part of a package that includes intimacy, connection, communication and affection. If sex becomes routine in a relationship – on a fixed day, at a fixed time, with fixed moves – the fun and sizzle will quickly dry out. For women, in particular, intimacy and affection are very important. Your partner needs to understand that talking, snuggling and touching can do a lot to revive your sex drive. It's somewhat ironic that birth control pills not only stop you from getting pregnant, but they also stop you from wanting sex. Oral contraceptives work by stopping your ovaries from producing hormones, which affects your body's sexual functions. The Pill also causes your body to produce a protein called sex hormone binding globulin (SHBG), which binds itself to testosterone and renders it useless. If you feel that oral contraceptives are interfering with your sex drive, consider using an alternative form of contraception, with your doctor's advice. Medical conditions If you have health problems like thyroid disorders, high blood pressure, high cholesterol, diabetes or autoimmune disorders, you may find yourself losing interest in sex. This is because these conditions affect your hormone levels, blood flow and nerve signals in the body, all of which play a role in sexual desire. If these conditions are well-managed and under control, you should find your libido returning to normal. However, be aware that certain medications, such as high blood pressure drugs, can also affect libido, so discuss it with your doctor, if this is a concern. If you think that one or several of these libido killers relates to you, talk to your doctor about what you can do to change the situation. Sometimes, you will not even need drastic changes. You'd be surprised at how much good lifestyle changes can do – just exercising regularly, eating a healthy diet and taking time out to relax. If you take care of yourself, your libido will take care of itself too! Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). For further information, visit www.primanora.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. Full content generated by Get Full RSS. |
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