Tag: medicine

Posted in Psychology & Medicine

Couvade Syndrome

Posted on by Jinavie

A patient comes to a doctor complaining of the following symptoms: “I can’t sleep because my teeth have been aching for the past few weeks. My head is killing me and whenever I wake up in the morning my stomach hurts and I feel nauseous and want to vomit. Sometimes I have no appetite and sometimes I crave a certain food. My breasts have gotten bigger and my stomach is bulging quite a bit.”
The patient has been married for three years and in a few months will have a beautiful daughter.
What is the diagnosis?

Most people would immediately say “Pregnancy!”. But there is one small detail that was left out: the patient is a man.
It is common sense that men cannot be pregnant. So what is this man suffering from?

Couvade syndrome is also known as sympathetic pregnancy. In other words, the husband subconsciously copies his wife’s pregnancy and suffer the same symptoms. This syndrome can be severe enough to cause labour pains, nosebleeds and even post-partum depression.
The cause has not been established, but it is likely to be psychosomatic, where psychological symptoms are expressed through physical symptoms, or due to changes in hormone levels.

Posted in Psychology & Medicine

Insulin

Posted on by Jinavie

Diabetes is a common and serious disease that is caused by the body being unable to control the blood sugar (glucose) level, leading to severe organ damage. For example, blood vessel damage can lead to blindness, renal failure, heart attacks or strokes. Diabetes is divided into Type 1, caused by the destruction of pancreatic β-cells (that produces insulin) leading to insulin deficiency, and Type 2 diabetes, where insulin resistance renders the hormone useless. Thus, diabetes is a disease related to insulin. So what is insulin?

Insulin is a hormone that lowers blood glucose. It has the important function of controlling blood glucose levels after a meal. Therefore, a diabetes patient has high blood glucose, which has a toxic effect.
As type 1 diabetics cannot produce insulin, they require daily insulin injections. Some type 2 patients also need insulin. But this hormone that saves the lives of diabetics also has a deadly dark side.

Too much insulin leads to hypoglycaemia due to its blood glucose lowering properties. This is the opposite of what happens in diabetes, but is even more dangerous. Although there are in-built autonomic defence mechanisms to prevent this from happening, a high level of insulin can overcome this to cause blood glucose to plummet. 
A hypoglycaemic patient initially suffers cognitive dysfunction, then sweating and tremors. As blood glucose falls further, the patient begins to convulse, until they fall into a coma and eventually die. This is because the brain heavily relies on glucose for its functions, and a disruption of glucose supply causes it to shut down.
Because blood glucose fluctuates much like blood pressure, it is hard to control. This leads to many diabetics accidentally falling into hypoglycaemia, or even losing their lives. Furthermore, insulin is sometimes used by people to cause hypoglycaemia as a means of suicide.

If you see a person convulsing, check around for any hypodermic needles or bottles of insulin. A diabetic patient would have a medic alert bracelet, and if it is a suicide attempt they would have recently injected themselves with insulin. If you think it is hypoglycaemia, you must immediately treat the patient as severe complications can occur in a very short time. The emergency treatment is quite simple – raise the blood glucose. For example, dissolving a spoon of white sugar in the patient’s mouth or making them drink a sugary drink such as apple juice can cause a spike in blood glucose, causing the symptoms to disappear. If their consciousness does not return, you may need to repeat the process until their blood glucose is high enough.

Knowing even a little about insulin and hypoglycaemia may lead to you saving a person’s life someday.

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Posted in Psychology & Medicine

Toxoplasmosis

Posted on by Jinavie

There is a protozoan parasite called Toxoplasma gondii. This parasite infects many animals through an interesting route. 
The first victim is a mouse. An infected mouse loses its fear of cats, leading it to play fearlessly in front of one until it gets caught and eaten (was Jerry a mouse with toxoplasmosis?). It is unclear how it controls a more advanced animal’s brain, but thanks to this effect, Toxoplasma gondii can infect its intermediate host – a cat.
An infected cat starts excreting parasite eggs with its faeces. If a person forgets to wash their hands or eats food contaminated with cat faeces, they can be infected and become the final host for the parasite.

Usually, Toxoplasma gondii cannot overcome the healthy immune system, but it can infect those with a weaker immune system such as the elderly or pregnant women. Furthermore, it is part of the TORCH complex (toxoplasmosis, rubella, cytomegalovirus, herpes) – a group of infections that commonly cross over from the mother to the fetus in utero. Symptoms are normally flu-like, but if more severe it can cause dysfunction of the eyes, brain and other vital organs. Sometimes it lies dormant until the person’s immune system is weakened, whence it becomes active. Toxoplasmosis is also a possible cause of a miscarriage or infertility.

One fascinating symptom of toxoplasmosis is psychiatric disorders. Because Toxoplasma gondii can infiltrate the brain, it is known to cause depression or even schizophrenia. As cats are the most common intermediate host, cat owners are more susceptible to toxoplasmosis. Because of this, there is a theory that “crazy old cat ladies” are in fact toxoplasmosis patients.

Posted in Life & Happiness

Progressive Muscle Relaxation

Posted on by Jinavie

Everyone goes through a tough time at least once in their lives. As modern life is ideal for stress to build, it is easy to get weighed down by fatigue and negativity. Pent-up stress is the cause of all ill health and one cannot lead a healthy life without overcoming their stress.
Although everyone has a unique method of overcoming stress, there are some very effective generic methods of stress relief. Some examples include hobbies, laughter yoga and meditation, but the method that will be introduced here is progressive muscle relaxation, or PMR.
PMR is very simple and doesn’t take up much time, making it a useful way of relieving stress for busy people.

  1. Sit back comfortably, close your eyes and rid yourself of all thoughts.
  2. Breathe in slowly and deeply and then breathe out. Concentrate on your breathing.
  3. Relax all the muscles in your body into a jelly-like state.
  4. Squeeze both hands into a fist as hard as possible for 5 seconds, then release.
  5. Rest 5 seconds and then repeat twice more.
  6. After three cycles of contraction and relaxation, repeat with your arm muscles.
  7. Apply the same three cycles on your feet, legs, abdomen, chest, neck and head.

The key principle of PMR is achieving complete relaxation by concentrating all your energy into one spot then releasing it. Furthermore, concentrating on your slow breathing has a meditation effect, resting both your mind and body. Once you are relaxed from head to toe, you will feel all the fatigue in your body disappear.
There is no greater enemy than stress. Therefore, it is best to have your own defence mechanism against it, but it also very useful to know a few general methods.

Now, try the progressive muscle relaxation on yourself to resolve all the stress that accumulated over the day.

Posted in History & Literature

Darkness

Posted on by Jinavie

When you close your eyes, what do you see? When you look into the night sky, what do you see? Most people describe darkness as pitch black, but this is not quite true.
The colour that we see in perfect darkness is not black, but more of a dark grey colour. This colour has a special term called eigengrau, which is German for “intrinsic grey”. Similarly, when you look into the night sky the actual colour is a deep navy.

The reason for this is that the brain uses relative contrast to determine true black rather than the absolute brightness. So when you see darkness, the optic nerve still fires off some signals that the brain interprets as eigengrau. When you see a black object, the brain compares it to the surrounding to cancel this effect out to see true black.

The night sky is lit with stars and the moon, giving it a darker colour than eigengrau due to contrast, while retaining the blue hue produced by the dust diffracting light in a particular manner. Because of this, ninjas actually wore dark navy clothes instead of the black that we associate with them in the present.

An interesting point regarding darkness is that people often see it as a symbol of the negative side (e.g. The Dark Side). However, darkness is technically the opposite of light. It is in fact defined by the absence of light, which in other words suggests it is the default state.

The default state of the universe is nothing.

Posted in Psychology & Medicine

Gait

Posted on by Jinavie

In medicine, a person’s way of walking is termed gait. By analysing a person’s gait, a trained professional can gain insight into what pathologies the person may be suffering from. For example, just from the way the patient limps, the doctor may discover that the patient has an incurable degenerative brain disease.

The most common gait abnormality is the antalgic gait, or limping due to pain. Most people would have experienced the difficulty of walking with a sprained or broken ankle, muscle ache or knee problems. This is easy to spot as the patient quickly switches to the other feet when leaning on the affected leg due to the pain. Therefore, the side that stays on the ground less than the other is the affected leg.

Sometimes, you can see a person “waddling” along as they swing from one side to the other. This may be a waddling gait, also known as Trendelenburg’s gait, caused by a weakness in the hip muscles that support the pelvic girdle, either due to muscle or nerve damage. As the patient cannot support their weight on the affected side, their pelvis tilts towards the opposite side. To avoid falling over, the patient lurches their body towards the other side, causing them to waddle. Looking at the tilt and lurch gives insight into what side is affected.
Another rather common gait is the steppage gait, where the person lifts one leg higher than the other, while their foot drags on the ground. This is caused by nerve damage leading to the loss of ability to lift the foot up (termed foot drop).

As the brain controls the motor system, damage to the brain also leads to motor dysfunction. A common example is a stroke.
If the stroke damages a significant part of the motor cortex, the patient suffers from hemiparesis/hemiplegia, or weakness/paralysis of one half of the body. This causes the limbs on the affected side to stiffen, as seen by an extended leg pointing inwards and retracted arm. The patient has to swing the affected leg around while they walk as they cannot flex the hip, known as a hemiplegic gait.
If the cerebellum is damaged, balancing becomes an issue. This causes the patient to suffer from ataxia, where they cannot coordinate their movements and are prone to toppling over. These patients tend to sway violently from side to side as they try to walk in a straight line.

Lastly, degenerative brain diseases can also affect gait. There are two main examples.
In Parkinson’s disease, the patient suffers from what is called hypokinesia and bradykinesia – reduced and slow movement. This leads to a shuffling gait where the patient walks slowly by shuffling their feet in small steps. They are also stooped over and are often seen with a pill-rolling tremor of their hands – a cardinal symptom of the disease.
In Huntington’s chorea, the opposite (hyperkinesia) occurs. This causes flailing as the muscles contract in an uncoordinated manner, including both the arms and legs. Ergo, their gait is quite jerky and interrupted by bouts of flailing, termed choreiform gait, but their balance is fine so walking in a straight line is still possible.

Knowledge of these disorders may help one appreciate the suffering a patient walking along the street has to undergo everyday of their life.

(Video demonstrations: http://stanford25.wordpress.com/gait-abnormalities/)

Posted in Science & Nature

Taste Of Water

Posted on by Jinavie

It is a common chemical fact that water is flavourless and odourless. However, most people will know that water “tastes” subtly different each time.
Taste is composed of information from taste buds on the tongue, combined with the sense of smell from your nose. Although water itself has no flavour or smell, it has many things dissolved in it such as gases and minerals that can be tasted.
This is why tap water can taste bad due to the chlorine used to treat it, or metals such as copper that have come off the pipes. 

It is also well known that temperature affects the taste of water. The ideal temperature is between 10~17°C, where oxygen saturation is sufficient, giving the water a “refreshing” taste. Any hotter and the oxygen escapes, giving the water a flat taste, just like distilled water. Warm water also causes the brain to think it is saliva or mucus, sometimes producing an uncomfortable sensation. Any colder, the tongue is numbed and it loses its ability to taste.

When making tea, the ideal temperature is 70~80°C. A simple way to achieve this is by leaving a cup of boiled water for a minute or two before putting the teabag in. This is the temperature when the dissolving of the various chemicals in tea leaves is optimal. If it is too hot, bitter-tasting tannins and catechins are released in excess, whereas if it is too cool, not enough dissolving occurs.

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Posted in Life & Happiness

Blindness

Posted on by Jinavie

Cataracts, glaucoma, macular degeneration, corneal disease, diabetes, trauma, optic nerve disease; myopia, hypermetropia, astigmatism, colour blindness…
There are many causes and types of blindness, but by far the most powerful, debilitating and dangerous blindness is prejudice – the blindness to what is deep to the surface.

This disease affects 100% of the adult population and causes a severe impairment in judgement, leading the patient to make wrong assumptions. Much like colour blindness, prejudice robs the world of colour, transforming it into black-or-white. The patient’s visual acuity falls dramatically, not being able to see the beautiful scenery of the human soul, and instead seeing a distorted, superficial image.

Despite the devastating effects of the disease and extreme prevalence, the treatment is simple. Just as you would treat someone who claims that “the room is too dark” – take off your sunglasses and see the world for what it truly is.

(Source: http://www.deviantart.com/download/193661196/aph__color_by_lolitamyangel-d37atxo.jpg)

Posted in Psychology & Medicine

Post-mortem

Posted on by Jinavie

When a person dies, they leave a body. How does the body change after death? There are four main post-mortem events: algor mortis, livor mortis, rigor mortis and putrefaction. Forensic pathologists use these phenomena and an autopsy to determine the time of death, hearing out the final words of the deceased.

With death, all physiological functions cease. Therefore, the body produces no more heat and begins to cool (algor mortis), evident when touching the corpse. The rectal temperature is measured for an accurate reading. 
As blood is no longer flowing, red blood cells sink due to gravity. They sink to capillaries in the lowest point of the body, causing a purple-red rash on the skin of the area. This is known as livor mortis, or lividity. It appears first about 1~2 hours after death, and worsens with time. On the other hand, the other areas of skin become pale due to the lack of blood.
2~3 hours post-mortem, one can observe the jaw stiffening. This is called rigor mortis. It is caused as ATP is needed for muscle relaxation, and ATP production stops with death. This leads to the muscle becoming rigid, fixating on the position at the time of death. About 6~7 hours later, rigor mortis spreads to the entire body and completely fixes the body 10~12 hours later. After about 72 hours, rigor mortis dissipates and the corpse is limp again.

Putrefaction is the process of microbes decomposing the body – more commonly called rotting. After death, cells die from the lack of energy and are broken down by enzymes. As the immune system also ceases function, microbes easily infiltrate the body and begin converting organic material into inorganic material.
Microbes release gases as it digests the corpse, which collects and causes bloating. The main gases are carbon dioxide, methane and hydrogen sulphide, producing the rotting smell, attracting insects to the corpse.
The key insects studied by pathologists are arthropods and flies. They can estimate the time of death from observing what species are present on the body, and at what stage of the life cycle they are at. For example, 0.5~1 hour post-mortem, flies arrive and lay eggs, which hatch into maggots at 10~24 hours, which becomes cocoons after 8~12 days, which hatch into adult flies at 12~14 days post-mortem.

There is no dignity in death. The rich, the powerful, the kind, the happy – everyone rots away by nature after they die.

Posted in History & Literature

Black Death

Posted on by Jinavie

This disease, also known as Pest or the bubonic plague, was a vicious infectious disease that decimated medieval Europe. It is caused by the bacteria Yersinia pestis, usually transmitted by fleas. The symptoms vary from high fever, malaise, nausea and vomiting, headaches, muscle cramps, seizures, red rashes, coughing and swollen lymph nodes, and causes death within four or five days without treatment.
People did not know about the existence of bacteria back then (it would be 200 more years until Louis Pasteur would suggest germs as the cause of infections). Back then, they considered diseases to transmit through miasma, or bad air. Also, they believed that to prevent transmission, they required a stronger smell to counter it.

Plague doctors, who treated according to the miasma theory of disease, wore a special set of equipments that were known as beak doctor costumes. They wore an overcoat, hat, gloves and boots made from waxed leather, carried a cane to assess the patient and point things out, and a peculiar mask. The mask had a long beak like a bird’s, giving the doctors the nickname beak doctors. The masks had round, glass windows to see through, and two small nostrils at the end of the beak.

Why did they wear this strange mask? The beak was hollow and doctors filled it with flowers, herbs, vinegar and incense that produce a strong smell, so as to “purify” the air coming through the nostrils. 
Although the miasma theory has been falsified by germ theory, this gear was the first hazmat suit in history.

There is another fascinating fact regarding the Plague, miasma theory and beak doctors. It regards the nursery rhyme, Ring a Ring o’ Roses:

Ring-a-ring-a-roses,
A pocket full of posies; 
Atishoo! Atishoo! 
We all fall down. 

This nursery rhyme actually describes the Plague. The ring of roses refers to the red rashes and swelling of lymph nodes – a symptom of the Plague; the posies were herbs used to counter the miasma; coughing and sneezing were end-stage symptoms before death, which is shown in the final line.