Tag: medicine

Posted in Psychology & Medicine

Korsakoff’s Syndrome

Posted on by Jinavie

It is a well-known fact that excessive drinking leads to a so-called “blackout”. This form of memory loss is common in normal people and cannot be seen as a major illness. However, there is another disease that can be caused by excessive drinking called Korsakoff’s syndrome. Strictly speaking, this is not caused by alcohol but due to a thiamine (vitamin B1) deficiency and is commonly found in alcoholics and malnourished patients (it has also been reported to be caused by mercury poisoning and after centipede bites in Japan).

The six characteristic symptoms of this syndrome are: anterograde (cannot form new memories) and retrograde (cannot remember old memories) amnesia, confabulation, lack of detail in conversation, lack of insight and apathy.

Korsakoff’s syndrome patients show a very peculiar behaviour. As stated before they suffer from both anterograde and retrograde amnesia so not only can they not remember the past but they cannot make new memories either. Ergo, the brain uses information from its surroundings and attempts to recreate the lost memories, the result being confabulation. Confabulation is essentially what happens when the brain tries to fill in blanks in memories with false information. Confabulation is seen in everyday life too with healthy people but in the case of Korsakoff’s patients the effects are significantly more profound. For example, if you ask a patient what she did yesterday, she may look at your horse-print tie and claim she was horse-riding. If you ask the same question an hour later without your tie and instead holding a book with a photo of a Ferris wheel on the cover, she’ll state that she was at the amusement park. As one of the leading causes of amnesia and confabulation, Korsakoff’s should be suspected in any alcoholic or very underweight patient who keeps changing their stories around. 

As previously explained, the disease is caused by thiamine deficiency – therefore, the treatment is administering thiamine. But if the syndrome has persisted for a long time, the brain injury may be permanent. Also, treating the underlying alcoholism and malnutrition is important. 

If the thiamine deficiency is prolonged, it may lead to another disease called Wernicke’s encephalopathy. This is known as Wernicke-Korsakoff’s syndrome and in addition to the above symptoms, the patient may also experience confusion, tremors, nystagmus, paralysis of eye muscles, ataxia, coma and can eventually lead to death. All because of a deficiency of a single vitamin.

Who said nutrition is not important?

image

(NB: Dory from Finding Nemo is one of the most accurate portrayals of amnesia in films)

Posted in Psychology & Medicine

Zombie

Posted on by Jinavie

Clairvius Narcisse died in Haiti on May 2, 1962. In 1980, he returned to his hometown. Alive.
How did a man who was dead and buried come back to life?

According to Clairvius, he was cursed by a bokor (sorcerer) to become a zombie but returned home after the curse was undone. The sorcerer had enslaved him in a sugar plantation for 16 years and many others were working as “zombie slaves” until they revolted, killed the sorcerer then ran away.
Harvard ethnobotanist Wade Davis studied and investigated this case extensively. According to his research, most “zombies” were placed in suspended animation to fake death and were then (often after being buried) put under psychosis by the sorcerer. Many Haitians believe in the ancient African religion of voodoo, where one legend says that when a sorcerer curses a person, they are revived after death to become the sorcerer’s slave. Thus, Haitians strongly believe in the legend of zombies. In reality, the sorcerer was using drugs to zombify people and Davis used his expert knowledge in botany to deduce what the chemicals were.

The so-called zombie powder was a combination of tetrodotoxin (TTX, blowfish poison) and datura (from the poisonous plant Datura stramonium). The TTX simulates death due to its paralytic effect and datura is a powerful hallucinogenic that causes the person to confuse reality and fantasy (dissociation). Also, it may cause memory loss which allows the sorcerer to easily manipulate the victim. Long-term maintenance of the datura dose could allow the sorcerer to enslave someone for a long period of time. However, the zombification is not the same as perfect mind control and more like a strong hallucination or hypnosis (as seen as the above mentioned revolution).

As it involves the handling of poisons, only an experienced sorcerer could give the right mixture of doses while avoiding the lethal dose. Although science has advanced greatly, there are still many things we can learn from magic and sorcery. The reason being, magic and sorcery are simply undiscovered science.

Posted in Psychology & Medicine

Broken Heart Syndrome

Posted on by Jinavie

Countless novels and films depict a character, heartbroken from the loss of a loved one or due to a break-up, suddenly clutch their chest and collapse. Although this may seem like a dramatic plot device, it is actually possible to die from stress.

The condition, colloquially termed broken heart syndrome for obvious reasons, is known as takotsubo cardiomyopathy or stress-induced cardiomyopathy. As the name suggests, the heart suddenly goes into congestive heart failure after sudden emotional stress. In simpler words, the heart’s ability to pump blood is sharply reduced due to muscle weakness and blood is not circulated properly. This causes blood to dam up and cause symptoms such as chest pain, breathlessness, fluid overload and much more.

The characteristics of this disease is that the heart temporarily enlarges so that the tip (apex) bulges out while the function of the base (upper part of the heart) is normal. The muscles in the apex is thinned while the base has hypertrophied and thickened. This gives the appearance of a thin pocket with a thick entrance, thus giving the name takotsubo cardiomyopathy, which means “octopus trap” in Japanese.
Given the patient survives the initial heart failure, their condition improves over the course of two months. The patient may also need psychiatric help or antidepressants and sedatives to ease the stress that led to the heart failure. 

As the presentation is very similar to a normal myocardial infarction (“heart attack”), the diagnosis may be difficult. The cause has not been identified yet, but researchers believe it to be due to a combination of blood vessel spasms disrupting blood supply to the heart and high levels of catecholamines. As catecholamines (adrenaline/noradrenaline) are released in great quantities in times of stress, this theory has some plausibility. A similar thing happens when patients with heart problems are exposed to significant levels of fear – their heart goes into overdrive and develop cardiac arrest due to an exacerbation of their condition.

The concept of dying from intense emotions such as anger and stress is found in almost every culture, where a person collapses and falls deathly ill after shocking news or a particularly stressful experience. But modern medicine has only just begun to understand the scientific reasoning behind this strange phenomenon.

It has also been noted that takotsubo cardiomyopathy tends to affect post-menopausal women, especially widows. Interestingly, most of these patients are not considered “at risk” for a heart attack and generally healthy. 
Thus, stress alone can be enough to “break” someone’s heart and cause sudden death.

(Source: http://sndr.deviantart.com/art/Broken-Heart-7445432?q=boost%3Apopular%20broken%20heart&qo=0)

Posted in Psychology & Medicine, Special Long Essays

Lie Detection

Posted on by Jinavie

In developmental psychology, a child’s ability to successfully lie is considered a milestone achievement. This goes to show how lying is one of the characteristic behaviours of human beings. Even a three-year old knows that by lying, they can avoid punishment and gain much more.

There are many signs of deception. Becoming an expert in observing these signs and knowing what they mean can grant the ability to see through lies. The following is a description of some of the changes – both non-verbal and verbal – that people exhibit when lying. Note that these signs are not always definitive and should be used as a reference only. One must carefully deduce whether the signs are there because the person is lying, or whether it is a simple physiological process with no meaning. Here is a simplified list of the signs that will be discussed:

  • faster blinking, avoiding/too much eye contact, dilated pupils, looking up and right
  • sweaty face and palms, fast pulse and blood pressure, flushed face
  • dry mouth/lips, constant licking or pursing lips, swallowing loudly and often
  • looking away or down, tics and twitches in face (eyes, cheeks, mouth)
  • placing hand near mouth (rubbing nose/chin, scratching face etc.)
  • touching neck, pulling at collar, rubbing forearms or hands
  • shoulder shrug, crossed arms/legs, fidgeting, hiding of hands
  • holding hands or clenched fists, unusual movements
  • tucking feet below seat, tapping of feet
  • short, general descriptions (or overly detailed), inconsistencies in detail
  • talking faster and at a higher pitch, emphasising the “truth”

Non-verbal signs are essentially body language – a mean of subconscious communication through which the person signals to another person about their emotions and thoughts. These can be behavioural (avoiding eye contact), physiological (faster heart rate) or cognitive (exaggerating that they are “truthful”). As non-verbal communication makes up 90% of a conversation, it is extremely useful to know what signs to look for and know what they mean. Let us start with the face.

The eyes are considered the window to the soul. This is because the eyes give off so many clues about what the person is thinking, usually subconsciously. A key sign to look for is the frequency of blinking. If the person is blinking much more than usual, it suggests that they are nervous (causing their eyes to dry out faster). Another famous example is eye contact – people avoid eye contact when lying as they are subconsciously “ashamed” of being immoral. However, they may consciously compensate this and make too much eye contact, another sign they are hiding something. Looking up and to the right has been associated with the brain imagining something, as opposed to down and left which is related to recalling true memories. Lastly, the pupils may dilate from the excitement and nervousness.

When a person lies, they tend to be nervous, stressed and excited. This activates the sympathetic nervous system, colloquially known as the fight or flight mode (rapid blinking is related to this). This causes other signs such as sweating, dry mouth, fast heartbeat and blood pressure. Therefore, a liar may be seen licking or pursing their lips to moisten them. Frequent, loud swallowing is also a clear sign of dry mouth. The face may be slightly flushed as well.

As stated above, the person is also subconsciously ashamed of their lying. This causes the person to face away from the person or look down (think of a child who is lying – their innocence makes signs of deception flare up like Christmas lights). Many people place their hand near their mouth (e.g. rubbing their nose or chin, touching their lips), as if the brain is telling the hands to stop the lie from coming out. They also tend to rub their neck or adjust their collar as touching the neck comforts people. Note that scratching the nose is another sign of lying but not the same as rubbing the nose. Scratching is to relieve the itchiness caused by the raised blood pressure irritating the soft tissue of the nose (Pinocchio effect).

Obviously the facial expression would change also, expressing nervousness and mild stress. This may be concealed with a fake smile (when the “eyes don’t smile”) or anger. It is well-known that people exhibit microexpressions – a flicker of emotion expressed in the face – that only shows for a fraction of a second. Although it is hard to spot, it is a direct display of their true emotion. Fascinatingly, the right face tends to react more as it is controlled by the left brain – responsible for the logical and complex thinking required in telling a lie. This may show as a tic or twitch in the eyes, cheek or mouth.

Moving down the body, a classic sign of deception is the shoulder shrug. Shrugging the shoulders is a message they are “unsure” if what they said is true and is seen (subtly) in many cases of lies. The arms may be crossed (a closed position), which shows they are being defensive (a sign of guilt or discomfort). Similarly, the person may be leaning away from the other person.

The hands are just as important as the face when it comes to lie detection. As mentioned before liars tend to touch various parts of their face and neck while telling a lie. Women tend to rub their hands together or their forearm instead of the neck to comfort themselves. Fidgeting is also very important to notice as this is a comforting act too and exaggerating movements are seen also (reinforcing the “validity” of their lie). Usually, people are aware of this fact and attempt to hide their hands in their pockets, behind their back or behind a bag. They may hold the hands together to prevent fidgeting, or tightly clench their fists. Basically, look for unnecessary (or lack thereof) movements as this almost certainly indicates that something is abnormal.
Similarly, the person may cross their legs (defensive), tuck their feet below the seat (distancing from the other person) or tap their feet (nervousness and excitement).

To finish off, here are some verbal cues for deception. People have a tendency to give short replies when lying. They also talk at a faster pace and higher pitch. These are all due to the subconscious want for the conversation to be over as soon as possible (often accompanied by an awkward or angry attempt at changing the topic). On a similar note, they are more hesitant and less fluent in talking, adding many “umm”s and “uhh”s as they try conjure a lie. Words such as “somebody” “somewhere” “everywhere” that encompass a non-specific or broad target are used to try dilute the details of the lie.

Conversely, the more experienced liar tries to make their lie believable by adding excessive detail to their story. For example, asking a specific detail (that they normally wouldn’t notice) would prompt an answer as opposed to an “I don’t remember”. It is also useful to ask the same question again and check for any inconsistencies.
Lastly, if the more the person affirms that they are telling the truth (e.g. “honestly”, “believe me”, “swear to god”), the more likely they are lying.

This list is not exhaustive and there are many tiny details that can be used to help you decide whether someone is trying to deceive you or not. Again, as the signs are not definitive (e.g. they may be thirsty or just nervous talking to you) it should be considered within the context along with other information. However, it is still an extremely useful tool for finding the truth as everybody lies.

Posted in Psychology & Medicine

Superbug

Posted on by Jinavie

Frequently on the media, the word “superbug” is used as if it were the new Black Death or the coming apocalypse. What is a superbug and why is it so feared?
Superbug is the colloquial nickname for drug-resistant bacteria. For example, one of the most famous superbugs is MRSA (methicillin-resistant Staphylococcus aureus). This strain S. aureus, a common bacteria found on skin and inside the nose, is resistant to a powerful antibiotic called methicillin and thus very hard to treat. Unfortunately, MRSA is most commonly contracted in hospital settings as patients are vulnerable to infections (e.g. after surgery) and hospitals are perfect breeding grounds for superbugs.

The cause of a “normal” bacteria turning into a superbug is due to the incorrect use of antibiotics. When antibiotics are used, they wipe out a significant portion of the bacterial population but fail to kill all of them in the first attack. The surviving bacteria are the more adapted ones that are able to withstand the harsh environment for a little longer. If the patient stops taking the antibiotics and the bacteria remains, these “drug-resistant” bacteria multiply to create a second infection that is resistant to the drug that was used previously. In fact, this is a classic example of natural selection in motion, except that the environmental change is man-made.
This is the reason why doctors are reluctant to prescribe antibiotics for diseases such as the common cold or viral diseases, as the risk of developing superbugs is greater than the benefit (which is zero in viral diseases as they do nothing) of the treatment. It is also why a course of antibiotics must be finished even if the patient is feeling well, so that even the surviving bacteria are eventually killed.

To show the potential risk of superbugs, the case of VRSA can be taken into consideration. When MRSA was first discovered, doctors found it very difficult to treat but luckily they had a secret weapon – vancomycin, one of the most powerful antibiotics known to mankind. However, they soon found that S. aureus and natural selection easily overcame this through a new strain called VRSA – vancomycin-resistant S. aureus. Here was a bacteria that could overcome the greatest weapon man had against bacteria, all because people were taking more antibiotics than needed and not taking the full course prescribed.

Thus, one of the growing problems of modern medicine is the development of new drugs so that we can make a comeback in the arms race against bacteria.

Posted in Psychology & Medicine

Hysteria

Posted on by Jinavie

Hysteria is a disease that was believed until the late 19th century to be a disease unique to women due to a pathology of the uterus (hystera is Greek for uterus). The most common symptom was mental disturbance (such as extreme moods) accompanied by shortness of breath, vaginal dryness, nervousness, insomnia, oedema, faintness and many more. The treatment back then was for a physician to massage or stimulate the patient’s vagina to induce an orgasm. By the 19th century, the treatment evolved and involved vibrators and water massage machines.

This disease was first noted by Hippocrates, the father of modern medicine. Galen, another famous physician in the 2nd century, believed it to be caused by sexual deprivation. Thus, sexual intercourse was prescribed as treatment in the Middle Ages.

Modern medicine no longer recognises hysteria as a medical condition and is now referred to as sexual dysfunction (the sexual treatments described above are no longer used either). However, there is a condition called mass hysteria that indeed exists.
This is a psychological phenomenon rather than a disease, commonly occurring in closed spaces such as planes or in crowds in a state of panic. When a high tension situation arises, people easily become delusional and believe that they are suffering from a disease. The body reacts to this with actual symptoms such as a psychosomatic rash. These symptoms can be as severe as fevers, vomiting and even paralysis.

If many people are all complaining of similar symptoms and infectious disease seems unlikely, there is an easy way of diagnosing mass hysteria. Tell the patients that they have a rare disease and begin listing the symptoms they complain of. At the end, make up a false symptom (e.g. “shaking of the left hand”). If the patients all suddenly start to shake their left hands (which causes them to panic more), it is likely that their panicking brain is causing the symptoms rather than some pathogen. Symptoms subside after the patients relax.

Interestingly, mass hysteria affects women much more than men.

Posted in Science & Nature

Piquance

Posted on by Jinavie

When the word taste is mentioned, people often think of sweet, sour, bitter, salty, savoury and spicy. But among these, only the first five are officially “tastes”. Spiciness is technically not a taste; it is rather a type of pain.
Due to the confusion between the words hot (which could mean temperature) and spicy (suggesting there are spice, but not specifying what type), scientists devised a new word called piquance to correctly name the sensation.
Piquance is caused by chemicals such as capsaicin stimulating the densely packed nerve fibres in mucous membranes in the mouth, causing pain. This sensation can be sensed anywhere covered by thin skin or membrane such as the eye. Tear gas and pepper spray exploit this by attacking the eyes, disabling sight, and the respiratory system, crippling breathing by inducing cough reflexes, to nullify the target.

Being a sensation, piquance can be seen as a subjective measure. Is there an objective way of measuring the piquance of a food?
In 1912, an American pharmacist called Wilbur Scoville utilised the fact that piquance is due to capsaicin to create something called the Scoville Scale. This scale’s unit is 1 Scoville Heat Unit (SHU) and is proportionate to the level of capsaicin.
The following is a list of many types of chilli and their SHU:

  • Paprika: 0
  • Peperoncini: 100-150
  • Jalapeño pepper/Tabasco sauce: 2,500-8,000
  • Chungyang red pepper: 10,000-23,000
  • Habanero chilli: 100,000-350,000
  • Red Savina habanero: 350,000-58,0000
  • Naga Jolokia: 1,067,286
  • Naga Viper: 1,382,118
  • Trinidad Scorpion Butch T pepper: 1,463,700 (currently the world’s hottest pepper)
  • Tear gas/pepper spray: 5,300,000
  • Pure capsaicin: 16,000,000

Posted in Science & Nature

Bleach

Posted on by Jinavie

The most potent and frequently used household cleaning product is bleach. Bleach is a diluted solution of sodium hypochlorite (NaClO), which has powerful antimicrobial properties thanks to the element chlorine. This is also the reason chlorine is used to treat tap water and disinfect pools.

Although it is an extremely useful chemical, chlorine also has a very dark side. Chlorine gas is a highly toxic gas, which forms hydrochloric acid when breathed in and seriously burns the respiratory tract. Due to its toxicity, chlorine gas was used as a weapon of mass destruction in World War I. However, this terrifying gas can be made very simply at home. Unfortunately, this is often done accidentally (but sometimes on purpose) and causes significant damage.

The key warning for using bleach is that it must never be mixed with other cleaning products. If mixed with an acid cleaner, it causes a chemical reaction that produces chlorine gas, while mixing it with ammonia creates chloramine, another deadly gas (although dangerous in itself, chloramine can sublimate into chlorine gas too). Therefore, many people suffer a loss of smell, consciousness or their lives by accidentally mixing two cleaning products or cleaning up urine with bleach. A major problem is that these victims tend to be children who unknowingly mix the chemicals, creating a horrible accident. What is more unfortunate is that some people choose to end their lives using this method.
If you do find a person rendered unconscious by chlorine, it is imperative to quickly move them to a well-ventilated area, while not endangering yourself. An ambulance should be called right away.

As seen from above, simple chemicals found easily at home can produce toxic gases, which can cause irreversible damage. Thus, one must never mix bleach and cleaning products and should educate their children on the dangers of chlorine gas.

Posted in Psychology & Medicine

ICU Syndrome

Posted on by Jinavie

ICU stands for intensive care unit and is the place where patients are sent after an operation to stabilise and recover under supervision. ICU patients commonly have a very unique and strange post-operative experience.

ICU syndrome is a type of delirium where the patient experiences severe anxiety, fear, hallucinations or delusions. Although the cause has not been determined, it is likely related to post-op stress, the segregation and loneliness in the ICU room and confusion from coming out of anaesthesia. This is especially the case if an emergency situation led to the surgery being longer than expected or resulted in additional surgery, causing extreme confusion in the patient.

A patient suffering from ICU syndrome tends to be extremely excited and unstable. They may develop intense paranoia or distrust (especially against medical professionals), which can lead to fits or dangerous acts such as pulling out cannulas and lines. A friend or loved one talking calmly to the patient has a great effect in helping the patient overcome the delirium. Therefore, allowing the family to visit to keep the patient company and calm is an effective way to prevent ICU syndrome. However, if the situation spirals out of control, a sedative or anti-psychotic may need to be administered.

A study states that about 25% of patients admitted to the ICU suffer from ICU syndrome. It is one of the most common causes of delirium and any patient can get it (elderly patients are more likely to). Interestingly, there is a theory that medical professionals are more likely to suffer ICU syndrome after an operation.
Nowadays, the term ICU syndrome or ICU psychosis is discouraged and is instead grouped under delirium (which is an actual psychiatric disorder, not just a general term).

Posted in Science & Nature

Caffeine

Posted on by Jinavie

Coffee is a magical drink that can make a busy person’s morning. Coffee’s stimulant effect is due to the substance called caffeine. Caffeine can make the mind more alert and drives away sleepiness for about 3~4 hours. This is why students studying for an exam or people working late love to drink coffee.
There are many students who say they do not like coffee and drink energy drinks instead. These drinks tend to advertise that the substances guarana and taurine give energy, but an interesting fact is that guarana is just a plant where caffeine is extracted from. Taurine has many beneficial actions in the body, but has no effect as a stimulant. Therefore, an energy drink is simply made of caffeine and sugar and holds no advantage over coffee.

Although caffeine is beneficial in moderate amounts, excessive consumption leads to adverse effects. A normal adult can handle up to about 400mg of caffeine. Any more and they could suffer from anxiety, insomnia, headaches, dehydration, increased urination, fever, rising heart rate, stomach pain, nausea and many other symptoms. As everyone’s rate of caffeine metabolism is different, only they know how much caffeine they can consume. Furthermore, the more coffee or tea you drink, you build a tolerance towards caffeine and can consume much more without adverse effects.

The following is a list of the caffeine content in common drinks and foods:

  • Drip coffee(200ml): 150mg
  • Espresso(50ml): 100mg (this is because the cups are small, the concentration is about 3 times that of drip coffee)
  • Caffeine tablet: 100mg
  • Energy drink(250ml): 80mg
  • Coca-cola(600ml): 60mg
  • Chocolate(250g): 60mg
  • Black tea(170ml): 50mg
  • Green tea(170ml): 30mg
  • Decaffeinated coffee(200ml): 10mg

However, the best method to drive away sleepiness is by sleeping. If you are tired, the only way to recover is by taking a 30 minute to 2 hour nap, especially if you will be driving or have a night shift.