Why do we sleep and how much sleep do we need?

Sleep is probably the most underrated health habit. Did you know, we spend one-third of our lives asleep!

Being a student, I’ve pulled of many all-nighters – whether it was to finish homework, finish writing an essay or finish cramming for an exam – I’ve experience it all; however, one only understands the value of sleep – when waking up (or in some cases not even falling asleep) the next morning.

We are told on average that we need 7-9 hours of sleep, but how much sleep do we actually need? Sleeping more or less than our average recommended hours could prove to be detrimental to our health. The amount of sleep we need varies on our age, lifestyle and overall health. Sleep has many health benefits: boosting immunity and mental well-being, increasing fertility and sex drive and there are also studies indicating that it can prevent diabetes!

The longest a human has intentionally gone without sleep not using stimulants or drugs of any kind is 11 days and 25 minutes (264.4 hours).

Scientists and researches have been trying for years to find an ultimate answer to – why human beings sleep, however experiments such as the group led by Prof Maiken Nedergaard at the University of Rochester Medical centre in New York discovered a network of fluid-filled chemicals in rats that clears waste chemicals from the brain, suggesting that the brain has a unique method of waste removal, also researchers found that during sleep the brain’s cells reduce in size making it more effective to lose waste.

 

 

The past year…

Hello!

So it’s been a while since I’ve posted on my blog – various things have happened since my last post, from volunteering abroad at various orphanages and refugee camps, becoming a parish and media volunteer for Cafod, working in the NHS for a year, working as a tutor, having a family member being diagnosed with cancer and watching them fight the battle to passing my first year at UNI. It’s been a crazy couple of years – but I’m back!

Most people say that medicine is such an optimistic job – it’s about saving lives, but the past year has reinforced not only the importance of medicine, but also the tougher side of medicine: from witnessing the diagnosis of terminal illnesses, the effects lack of medication can have on the residents of rural towns to watching the emotions, mental strength and physical strength fluctuate in patients – the past year has been such a lesson for me, not only have I grown stronger as a person – but my interest and passion for medicine has intensified; as the cruciality of medicine becomes more apparent.

I cannot wait to write more blog posts – I have a few ideas in my mind and few topics that I’ve been wanting to research. It’s great to be back, and I can’t wait to see what the future holds for my blog. Until then here are a few pictures of my recent trips abroad:

Praying with the children

Resident – she loves to draw

One of the children at the home

Helping out with the cooking

Kadcyla

I was surfing on the internet when I stumbled upon this article: “Kadcyla breast cancer drug ‘too expensive’ for NHS says NICE”. The title surprised me as there were around 50,800 cases of breast cancer in 2012, approximately 140 women every day; so I began researching about the drug, here’s a few key details I gathered:

Kadcyla is an approved drug used to treat HER2-positive breast cancer, after previous treatment with trastuzumab and a taxane.

HER2-positive breast cancer, is a type of breast cancer that tests positive for a protein called human epidermal growth factor receptor 2, which promotes the growth of cancer cells.

Trastuzumab is a monoclonal antibody that interferes with the HER2 receptor.

kadcyla

Kadcyla is a different type of treatment it is a combination of two cancer fighting drugs: the monoclonal antibody and a chemotherapy drug. Kadcyla is designed to bring chemotherapy inside HER2 positive cancer cells and kill them, it is thought to cause less harm to normal cells.

The most common side effects of kadcyla are:

  • Tiredness
  • Nausea
  • Bleeding
  • Liver problems
  • Headaches
  • Constipation

Scientific investigations and research illustrate that women taking Kadcyla lived six months longer, that women taking different medication. It was also recorded that women taking Kadcyla lived without their cancer spreading and growing for longer compared to women taking other medication.

 http://www.bbc.co.uk/news/health-35103033 – Link to the article

 

Suicide Gene Therapy

Suicide gene therapy is a technique used to genetically modify prostate cancer cells, so that the immune system is able to easily identify these cells and attack them. Cancer cells are evolved from healthy cells – and are caused by uncontrolled cell division, the genetic modification of these cells makes it easier for our body to kill the cancerous cells.

Firstly, a genetically modified virus is injected into the tumour site, the E-coli bacterium is quite common, the virus then deposits a gene into the cancer cells which in turn causes them to produce an enzyme. Secondly the patient is injected with prodrug (type of chemotherapy drug – most prodrugs are non-toxic, hence they cause no harm to healthy cells). When the prodrug comes in contact with the enzyme, it becomes highly toxic; this stimulates the beginning of programmed cell death, which causes cells to suicide. As the virus is not present in any of the body’s healthy cells, the prodrug only destroys cancer cells that were altered genetically by the virus.

 

suicide gene therapy

Various research has taken place over the years, there is also experimental evidence on laboratory mice to demonstrate the benefits of suicide gene therapy for mesothelioma treatment. An animal trial demonstrated that suicide gene therapy shrank tumours and extended survival by 144 days.

The discovery of this technique is substantial to cancer researchers, however more research is required, such as the comparison of suicide gene therapy to radiotherapy.

 

Work experience day two

My second day at the hospital captivated my interest greatly. I attended an orthopedic clinic; there were a vast number of patients each orthopedic doctor had to consult. There majority of the patients had shoulder pain, which restricted movement in their arms; a key hole operation was recommended, however it didn’t have a 100% success rate, and any clinical operation has risks, hence it was at times discarded as an option by patients. MRI scans were taken for these patients to see if there was any internal tissue damage.

MRI scanner

 

There was a patient with a lump in the groin, which was hardening of mass; this patient had pain the side of the groin. This was due to a bad external bruise which bled causing a lump. The patient was offered the option of an operation, however there was a risk of infection also as it is in near proximity to the groin, it may be extremely painful for the patient. Also there was no confirmation of the lump being permanently removed, as there was a chance for it to reappear, moreover as he is a horse-rider, a scar in the groin could be extremely uncomfortable for daily life.

The next patient had a car crash several months ago, and was still suffering from a condition called whiplash. Whiplash is a common injury that occurs to a person’s neck following a sudden extreme acceleration or deceleration force; it is damage done to both the bone structures and soft tissues. This mostly occurs in car accidents due to the vigorous movement of the head affecting the ligaments and tendons in the neck. The patient had both shoulder and upper arm pain, however whilst reviewing the patient’s x-rays it illustrated that there were no structural abnormalities and no nerve problems. A physical assessment which included testing movement in shoulder, elbows and hands ensured that movement in the neck is fine, and the symptoms were gradually improving, and there were no abnormal neurological findings during the appointment. The patient was then referred to physiotherapy to ensure that her muscles would get back to normal state.

Furthermore the next patient had pain in her right arm and shoulder which restricted her movement, she complained of constant ache and difficulty in everyday activities such as: sleeping, cooking and writing. She had to adjust her daily routine due to the lack of movement in her shoulder. Her shoulder tendon was swollen, causing inflammatory causing her bone to swell. An anaesthetic followed by a drug was injected to ease her pain in the short-term, and a key-hoe operation was offered for the long-term. The necessary information was discussed, such as the risks and success percentages.

Throughout the entire day, an orthopaedic doctor consults an average of 40 patients.

Work Experience Day One

Work Experience has made a tremendous impact on me; it has reinforced my ambition and passion to become a paediatrician greatly. During the course of my experience I learnt numerous facts and rules regarding medicine. One the first day I worked in the orthopaedic department. An orthopaedic doctor is a surgeon who specialises in the diagnosis and treatment of bone and skeleton-related problems. This varies from broken fingers to knee replacements. Firstly I attended a trauma meeting which was non-clinical. A trauma meeting is where orthopaedic doctors review and discuss x-rays to determine the state of injury and what appropriate medical action is required. I viewed a variety of CT scans, MRI scans and x-rays. I learnt how to determine whether there is a fracture or internal tissue damage by viewing a scan, I also learnt that you either treat a fracture in an operative or non-operative manner.

Xray

We viewed an x-ray of an 8 year old who was bouncing on a trampoline and had broken either side of her lower growth plate in her leg. The growth plate, also known as the epiphyseal plate is the area of growing tissue near the ends of long bones in children and adolescents. The growth plate determines the future length and shape of the mature bone, when growth is complete, the growth plate closes and is replaced by solid bone. Also as the growth plates are the weakest areas of the growing skeleton, they are vulnerable to injury. This case required a CT scan, however there was a major risk of excessive radiation exposure which is highly dangerous for children with growing cells, as it can affect their growth tremendously. We also viewed another patient and this man, was arm-wrestling with his friends for a social event and had broken his arm and had damaged his radial nerve. He required an operation, which greatly risked his life as he was a carpenter and there were risks associated with the operation, hence it could permanently affect his life.

I also learnt a few rules: the first rule I learnt was that patient confidentiality is crucial and information about patients should not be publically discussed, also your upper clothing should not be below your elbow, whilst you are in wards due to risk of infection. During my day at the hospital learnt more about medicine, there are two types of doctors:

  • Some work in community such as GP’s

And

  • Some work in hospital such as surgeons, paediatrician, orthopaedic doctors, neurologist etc…

Furthermore by interacting with different doctors, some who were in the profession for over twenty years, some who had just started and some who were on their training I began to understand and comprehend the extremely long path it is to become a doctor, and how magnificent it is to reach the goal of becoming one.

The effects of alcohol

How does alcohol affect you?

  • Your eyesight begins to double, your speech begins to slur, and you lose your sense of distance.
  • Alcohol loosens your inhibitions; you begin to make vital judgements that can result in car accidents, violence, unwanted pregnancy etc…

The physical effects of alcohol

Alcohol irritates the stomach; therefore excessive consumption of alcohol can cause sickness and nausea and sometimes diarrhoea. Moreover alcohol has a dehydrating effect, hence why excessive drinking can lead to a thumping headache the morning after.

How does alcohol effect your appearance

Alcohol can be devastating, it causes bloating. Research from the Department of Health reveals that a man drinking five pints a week is consuming the same number of calories as someone getting through 221 doughnuts a year. Additionally alcohol also has effects on the skin. Alcohol causes dark circles under your eyes, also alcohol dries out your skin and leads to wrinkles and premature aging. Heavy drinking, and excessive drinking can develop acne rosacea, this is a skin disorder which starts with a tendency to blush and flush easily and can progress to facial disfiguration, a condition known as rhinophyma.

Alcohol poisoning

Statistics state that between 2007 and 2008 more than 30,000 people were admitted to hospital with alcohol poisoning, in the worst possible cases, alcohol poisoning can also cause lung damage ( because you are swallowing your own vomit) and can even lead to heart attack.

The signs and symptoms of alcohol poisoning contains:

  • Vomiting
  • Slow breathing
  • Seizures (fits)
  • Confusion
  • Cold, clammy, pale-bluish skin (caused by a dangerous drop in body temperature)

Diseases and cancers

Liver disease

Experts have estimated that alcohol is responsible for at least 33,000 deaths in the UK each year. In 2006 a Lancet study shows that liver cirrhosis death rates are already around twice as high in Scotland as they are in the European countries. Alcohol liver disease does not usually cause any symptoms, until the liver has been extensively damage. When this happens, the symptoms include:

  • Nausea
  • Weight loss
  • Loss of appetite
  • Yellowing of the eyes and skin
  • Confusing and drowsiness
  • Swelling in the ankles

With the exception of the brain the liver is the most important organ. The liver has many functions these include:

  • Filtering toxins from the body
  • Helping to fight infections and diseases
  • Regulating cholesterol levels in the body

 

My trip to Sri-Lanka (Colombo) 2012

A few weeks ago, I made a trip to my parents’ home land Sri-Lanka. It was an exotic trip, and the country is defined as the tropical teardrop at the toe of India. Sri Lanka is one of the world’s most beautiful islands, with miles of palm-fringed beaches, a unique culture, thick jungles, mystical ancient cities and many more. The trip only lasted two weeks, however this was enough time to allow myself to indulge the beautiful sun sets, and savour the gourmet dining that was provided.

Whilst I was there I made a trip to the local orphanage, this was one of the most emotional and sensitive moments of my entire life, when I encountered how it would feel to be restricted in a limited place. These children were not only orphans, they were also disabled. This day definitely demonstrated how lucky I was compared to them.

This orphanage sustained many children, with a few adults to company them. Deafness was one of the common disabilities that occurred in the orphanage, another was Muscular Dystrophy, and this is a disability known to weaken muscles. Duchene muscular dystrophy and Becker muscular dystrophy are perhaps the best-known.        Most of these children could be cured easily, if they had the substantial amount of money, for the required treatment.

This was one of the most unforgettable moments of my trip to Sri-Lanka, and that precise day precisely teaches that “Life is not a matter of milestones, but of moments.” I know that world peace is something that cannot be created in a day, or overnight. However I believe and I trust that someday in the future I would be able to go back to Sri-Lanka, as a Paediatrician and with the medication to treat children at orphanages, definitely not all of them, but definitely some.  

What is a migraine?

A migraine is a severe, painful headache that is often preceded or accompanied by sensory warning signs such as flashes of light, blind spots, nausea, vomiting and sensitivity to light and sound. The excruciating pain that migraines bring, could last up to hours or even days. The headache is mainly focused on one particular side of the head.  

There is not an exact cause for migraines, however many believe that a migraine is caused because of the abnormal changes in levels of substances that are naturally produced in the brain. When the levels of these substances increase, they can cause inflammation; this inflammation then causes blood vessels to swell and press on nearby nerves, causing immense pain. Genes may also contribute to migraines; those who have migraines may have abnormal genes that control the function of certain brain cells.

Many people with migraines tend to have attacks triggered by:

  • Lack of sleep/ Or excessive sleep
  • Skipped meals
  • Stress/anxiety
  • Excessive caffeine
  • Foods that contain nitrates (hot dogs)
  • Foods that contain tyramine (aged cheese, soy products)

Those who have constant migraines, on a daily basis, keep a migraine diary. So in your diary you would include, what day you have the migraine, the time when your migraine started, where you were and what you were doing when the migraine started, whether you’re having your period at that time. This information helps the doctor to advise you about what sets off your headache, and to help find the right solution for you.

There are two types of migraines, migraines with aura, and migraines without aura. When you have a migraine with aura might have these sensory symptoms:

  • Flashing lights
  • Numbness or tingling in your hands
  • Feeling mentally “weird or fuzzy”

However only one in five people who get migraine experience an aura, women have this form of aura more than men. Migraines have no cure, but migraines can be managed by a doctor’s help. Producing a migraine diary you and your doctor could work together to find ways to treat migraine symptoms when they occur, as well as ways to help make your migraines less frequent and severe. Drugs such as aspirin, acetaminophen, and ibuprofen relieve mild migraine pain for some people. If these drugs do not work your doctor might want you to try a prescription drug. Two classes of drugs that doctors often try first are:

  • Triptans
  • Ergot derivatives (this drug works in a similar way as triptans, however they should not be used if you have heart disease or a high blood pressure

There are also some lifestyle changes you could do to reduce the number of migraine attacks, such as:

  • Avoid or limit triggers
  • Eat healthy food and do not skip meals
  • Engage in regular physical activities
  • Limit alcohol and caffeine intake
  • Learn various ways to reduce and limit stress

 

 

What is cancer and how is it caused?

Cancer is a disease caused by out-of-control cell growth. There is an immense amount of different types of cancer. There are many charities regarding cancer, however Cancer Research UK is the world’s leading independent charity dedicated to cancer research. Cancer statistics show that cancer is more popular in men than women, however the deaths per year has overall decreased in both genders. Each year in the EU nearly two million people are diagnosed with cancer, and there are over a one million deaths from this disease. It is also estimated that nearly three million people alive in the EU who have received a diagnosis of cancer in the last five years. Cancer is issued as a worldwide disease, with no actual medication that can cure it.

Cancer affects the body, when the damaged cells divide uncontrollably and form lumps or masses of tissues called tumours. These tumours can grow and interfere with the digestive, nervous and circulatory systems. They can also release hormones that alter body function.

There are about 200 different types; cancer can start in any type of body tissue. However environmental can also contribute to cancer, this could include:

  • Tobacco smoke
  • The sun
  • Natural and man-made radiation
  • Work place hazards
  • Exposure to asbestos (a group of minerals found in housing and industrial buildings)
  • Studies have also shown that those who are exposed to high amount of benzene are at risk for cancer

 There is no guaranteed cure for cancer, due to the fact that there are different types of cancer, therefore there is a problem of finding a cure as cancer is not just one disease, but an umbrella term for over 200 diseases.