Friday, October 26, 2007

Syndrome of the week

Takotsubo cardiomyopathy, also known as transient apical ballooning and stress-induced cardiomyopathy, is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the myocardium (the muscle of the heart). Because this weakening can be triggered by emotional stress, such as the death of a loved one, the condition is also known as broken heart syndrome .

The typical presentation of someone with takotsubo cardiomyopathy is a sudden onset of congestive heart failure or chest pain associated with EKG changes suggestive of an anterior wall heart attack. During the course of evaluation of the patient, a bulging out of the left ventricular apex with a hypercontractile base of the left ventricle is often noted. It is the hallmark bulging out of the apex of the heart with preserved function of the base that earned the syndrome its name "tako tsubo", or octopus trap in Japan, where it was first described.

Evaluation of individuals with takotsubo cardiomyopathy typically include a coronary angiogram, which will not reveal any significant blockages that would cause the left ventricular dysfunction. Provided that the individual survives their initial presentation, the left ventricular function improves within 2 months. Takotsubo cardiomyopathy is more commonly seen in post-menopausal women.Often there is a history of a recent severe emotional or physical stress.

Baby Whale

Crowd butcher stranded baby whale
By Olukayode Thomas and Kayode Ogunbunmi

A BABY whale measuring about 12 metres beached around 3.30 a.m. Wednesday on the Nigerian side of the Seme border town along the Nigeria-Benin Republic international corridor.
While some of the crowd that thronged the scene went with nothing more exciting than a camera, others went armed with knives, axes and bags.

It was all a little too much for security officers stationed at the area. So, around noon yesterday, the carcass of the whale was doused in fuel and burnt.
According to eyewitnesses, residents near the beach, including security officials and locals, became aware of the trapped animal in the early hours of Wednesday. This attracted a crowd who trooped to the area to behold the mighty creature, which was flopped belly-up on the Beach and had a large part of its tail buried in the sand.
This continued until yesterday, although by then, most of the whale's tail and a large chunk of its body had been cut and carried away - possibly by those who would eat it.
Initial efforts by the security officials, including Customs, Police, National Drug Law Enforcement Agency (NDLEA) and Quarantine officers to rescue the animal were unsuccessful as their collective effort could not shift it. Twice they tied almost five inches thick ropes around the animal to tug at it. Twice the rope snapped.

When the animal eventually died, all efforts to move it also proved futile. "We tried to bury it or push it back into the ocean but we could not do it," said one of the security officers.
But the officers succeeded in fencing the area of the beach away from would-be butchers by yesterday morning, around the time when part of the animal had started decaying, oozing of oil onto the beach.

"We don't want them to continue cutting the fish because they might start selling its meat," a customs officer said. "It is too bad some people decided to eat the fish. We don't want them to sell this to others so that we don't have an epidemic here."
In 2001, a blue whale that beached on the Bar Beach also attracted a large crowd of visitors, and many people also made away with large parts of its meat.

Thursday, October 11, 2007

2nd Amendment

Innocent people again battle for dear lives after a crazed shooting rampage reported in a downtown cleveland high school yesterday.Initial reports suggest a reason as trivial as a 14 year old's suspension from school.
No matter what side of the aisle you are on the debate on gun control and the 2nd amendment,one thing is crystal clear:this thing is now reaching epidemic proportions,and we need to stop playing the ostrich and face the real issues.
Every parent should be able to drop off their kids at school without having to worry constantly at work about their safety.These days,you never know which deranged minor has brought his dad's gun to school....and he may well be sitting next to your daughter!
As an "alien",i am neither qualified nor able to challenge the wisdom of the founding fathers in enacting the 2nd amendment.What i am dead sure about though,is that several of the assumptions and precautionary premises upon which this amendment was predicated are now irrelevant and obsolete.Even Britain whose experience during the elizabethan era inspired this amendment currently maintains a largely unharmed police force and exercises stringent gun control measures.Whether this has led to lower crime rates in the UK compared to the US or not is self evident and does not even lend itself to any sort of intellectual debate(no matter what the NRA tells you).....I have lived in both countries and should know what i am talking about.
Every time a sanctimonious ultraconservative babbles on the sanctity of the constitution and its enshrined amendments in relation to gun control,i like to refer them to the equally sacred provisions of the 9th amendment.

Syndrome of the week

The Uhthoff Phenomenon
Uhthoff's Symptom also referred to as Uhthoff's Phenomenon does not display solely in MS patients, however, it was the principal diagnostic test for multiple sclerosis until the 1980's when more accurate test methods became available.
The patient will show a worsening of symptoms with an increase in body temperature. The temperature rise may be the result of exercise, a hot bath, or the prevailing climatic conditions. Most associated with
Optic Neuritis this may demonstrate with or without multiple sclerosis. In one study, patients exhibiting Uhthoff's phenomenon without multiple sclerosis were found to be more likely to develop MS than patients with Optic Neuritis who didn't display Uhthoff's Symptom.
An increase in heat can worsen many MS symptoms and cause new ones to appear. As well as Optic Neuritis it is most often seen to exacerbate MS fatigue.
It is thought, and these are just theories, that heat may affect serum calcium, circulatory change, heat shock proteins, and the most popular theory is the blockade of ion channels.
I prefer the explanation that demyelinated nerves suffer a performance drop when used a lot and the associated heat probably worsens this degradation.

Friday, October 5, 2007

Premiership update

Family matters had precluded my comments at the height of the chaos on stamford bridge in the past 3weeks.
The special one is no more around in west London to steer the ship and some near capsizing scares have so far been endured by the pensioneers.
I have read diverse views on different mediums concerning where chelsea goes from here.It certainly will be tough going forwards,but i expect things to settle before xmas.We got some kind of reprieve midweek at the mestalla thanks to the drogs.I definitely expect chelsea to win our group,our dismal opening draw with rosenborg notwithstanding.
What must be more worrying to not only chelsea fans,but also man-utd and liverpool fans is the superb form of the young gunners against all expectations this season.If they continue in this vein of form(which i doubt),many pollsters would have to reset their bets for the season.
I have however no doubt in my mind that this year's contest will be determined by several non-football factors like injuries to key players,dubious referee decisions and the african nations cup!
For the last mentioned factor,man-utd can be said to have the edge....i can't name one african player in the man-utd 1st team.I will not be surprised at all if arsenal surrenders a big lead in february!
At this time,i can only hope that lampard returns soon,JT's cheekbone heals and the drogs stays out of trouble!I think Schevchenko should be sold in january or offered as part exchange for ronaldinho(if barca would fall for the bait and acquire a liability!)
Man city is still 2nd, guys....dont be fooled by their humility....remember i told you so several weeks ago....watch out for sven's matadors.
....was that really liverpool getting spanked by marseille in midweek??...i mean marseille can't beat anyone in league1 at the moment.The kop faithfuls must be wondering what benitez is doing with this rotation policy.

omc

Syndrome of the week

Lennox-Gastaut syndrome (LGS), also known as Lennox syndrome, is a difficult-to-treat form of childhood-onset epilepsy that most often appears between the second and sixth year of life, and is characterized by frequent seizures and different seizure types; it is often accompanied by mental retardation and behavior problems.
As a general rule, the age of seizure onset in LGS patients is between the ages of two and six; however, this does not exclude the possibility that seizures can begin before age two, or after age eight. The syndrome shows clear parallels to West syndrome, enough to suggest a connection.
Daily multiple seizures are typical in LGS. Also typical is the broad range of seizures that can occur, larger than that of any other epileptic syndrome. The most frequently occurring seizure types are: tonic, which are often nocturnal (90%); the second most frequent are myoclonic seizures, which often occur when the patient is over-tired.
Atonic, atypical absence, complex partial, focalized and tonic-clonic seizures are also common. Additionally, about half of patients will suffer from status epilepticus, usually the nonconvulsive type, which is characterized by dizziness, apathy, and unresponsiveness. The seizures can cause sudden falling (or spasms in tonic, atonic and myoclonic episodes) and/or loss of balance, which is why patients often wear a helmet to prevent head injury.
In addition to daily multiple seizures of various types, children with LGS frequently have arrested/slowed psychomotor development and behavior disorders.
The syndrome is also characterized by an interictal (between-seizures) EEG featuring slow spike-wave complexes.
LGS seizures are often treatment resistant, but this does not mean that treatment is futile. Options include anticonvulsants, anesthetics, steroids such as prednisone, immunoglobulins, and various other pharmacological agents that have been reported to work in individual patients.

Polygamy and governance

Nyako: God punish the press (?)By Reuben Abati

GOVERNOR Murtala Nyako of Adamawa state keeps showing up in the news for the wrong reasons. He needs to pull himself together and begin to focus on the urgent task of providing leadership. For eight years, Adamawa state was a centre of acrimonious politics. This was particularly so in the last four years of the Obasanjo administration, largely on account of the feud between President Obasanjo and his Vice President Atiku Abubakar. At a point, Adamawa, the latter's home-state was described as one of the hot spots of Nigerian politics. The then Governor, Bonnie Haruna was quick to announce that he was "Atiku's boy" and he diverted so much energy that should have gone into the business of governance to the protection of Atiku's interest on the home-front. Expectedly, the people of Adamawa were short-changed.
When Nyako showed up as Governor in 2007 many progressives across the nation heaved a sigh of relief. Nyako was generally regarded by the public as an officer and a gentleman: polite, urbane and well-behaved. A former Naval officer, he rose to the rank of a Rear Admiral. He had also served previously as Governor of Niger State and Chief of Naval Staff. Unlike many of his contemporaries, there was no whiff of scandal around him. In retirement, he had shown much capacity for continued hardwork with his public-spiritedness and investments in farming. Nyako in the last few weeks, unfortunately has been burning his bridges and squandering his goodwill.
While other state Governors have been busy showcasing their achievements in 100 days, and their plans for the future, Nyako has been caught up in a sordid drama of his own making. It is best described as an unwanted distraction from which he should extricate himself. It is the drama of his four wives - Binta, Halima, Zainab and Asamau. The press had reported that Nyako in an attempt to treat his wives equally had chosen to democratise the office of the First Lady by parcelling out the office to his four wives, with assigned responsibilities: (a) Political Affairs and Social Mobilisation (b) Abuja Affairs; (c) Health, and (d) Home Front. In its September 12, 2007 edition, The Guardian published a story: "Nyako's wives at war over office", indicating that Nyako's method of managing possible conflict over the First Lady office was in fact, now, a source of friction among his competing wives and their supporters.
The politics of First Ladyship, and its history as a source of wastage and undue self-promotion has been a vexed issue among Nigerians. The media immediately began to feast on the story with the notorious refrain that Nyako should call his wives to order. Thus, Nyako and his four wives became the main news from Adamawa state. The Governor and his team had tried to do some damage control. They used public funds to place full-page advertorials in the press specifically to accuse The Guardian of "immoral calumny" - being their response to the newspaper's editorial: "Nyako and his four wives" (September 17, 2007). The rejoinder contained more fog than light. In the future, Nyako should pay for such advertorials from his own purse, using public funds to fight his private battles is indecent.
Obviously unhappy, Nyako was also reported as having defended himself as follows: "I want to clear the air. I am a Muslim and as such, all wives have equal status and so far I have not declared any one of them as First Lady. You know during my tenure as a former governor, my wife was never referred to as a First Lady, even though she was the only one then. So as far as I am concerned, there is no such thing as a single first lady. You know that they are very talented, they have doctorate degrees, one in medicine, one in education, one in law, and even the fourth one is highly educated too. So, in the programme of government, any one of them who shows interest will be entitled to contribute."
Nyako had obviously missed the point. Nobody has questioned his right to have four wives. If he so wishes, he could have 50 wives. Nobody is also against the idea of his "well-educated and very talented" wives being encouraged to express themselves and make useful contributions. But the point is that the people of Adamawa should not be made to maintain four First Ladies, either directly or by default. And that the rivalry among the four women should not become a source of hardship to government.
In fact, my position is that since Nyako has a four-year tenure and he has four wives, he should consider the option of rotational First Ladyship with the wives serving a term of one year each in their order of seniority! The "Nyako and his four wives" debate nonetheless served the useful purpose of drawing public attention afresh to the First Lady syndrome and the challenges of polygamy. No one should overlook the simple truth that in this matter, Nyako had to find a way of maintaining peace in his home!. Every other argument is mere spin..
Matters such as this tend to have a short life-span, once the themes have been analysed and indeed, the media was beginning to focus on other issues. But last weekend, Nyako poured petrol into the furnace when he allegedly chose to call on God to punish Nigerian journalists. The report which Nyako is yet to deny, appeared in The Vanguard newspaper of October 2, at page 5, written by Umar Yusuf. It is worth quoting at some length: "Governor Murtala Nyako of Adamawa State weekend rained curses on the media over what he considered unfair reports on the activities of his wives and the jostle among them over who should be the first lady."
We are told that the Governor through his media team had invited journalists in the state to his residence to join him during the breaking of the Ramadan fast in the evening. The Governor and the journalists prayed and ate together. Then, the Master of Ceremony, Chief of Staff to the Governor and former Deputy Governor in the state, Alhaji Bello Tukur invited the journalists to "nominate one of them to speak on their behalf." The lot fell on one Comrade David Molomo, Secretary of the local branch of the Nigerian Union of journalists (NUJ), who apparently swooning over whatever he had been given to eat "apologised to the Governor for publications concerning his wives. The Secretary (He) appealed to the Governor to use the period of the Ramadan fast to put behind him the issue of his wives and the First Lady's position."
Molomo has the right to express a personal opinion but he was obviously talking nonsense. He is not in a position to apologise on behalf of the media. And why apologise? Is it not true that Nyako has four wives? Is it not true that these four wives have shared among themselves the First Lady portfolio as if they are sharing the family heirloom? Nyako does not need to put anything behind him; he should have been told to learn the right lessons from the media drubbing that he has received. Molomo spoke as if he could offer any guarantees. When journalists go to Government House to eat free food, they should watch their tongues. And of course, Molomo and his colleagues got what they did not expect. The Vanguard report states that Nyako was enraged. His aides had to appeal to him; eventually he was persuaded to say a word or two. When he obliged, he chose to speak in Hausa: "Allah Yai Sa! Allah Yar Sa! Allah!" which the newspaper translates as meaning "God punish the press, God punish the press, God punish the press." If he added other expletives, the Vanguard reporter, Umar Yusuf did not indicate. But we are told: "He then stood up and headed to his inner rooms to the surprise of the journalists and other top government functionaries present."
It serves those journalists in attendance right. If Nyako had been a military Governor, he could have ordered all the journalists arrested and direct that they should be caned. This was how intolerant military administrators responded to criticisms in the past. Nyako's conduct, even in its present form, is deplorable. The high office that he occupies requires maturity and self-control. Throwing tantrums, swearing and cursing and staging a walk-out like an aggrieved baby is unbecoming of his high office. Are his wives putting him under pressure?
Is he having problems dealing with the negative exposure that his four wives have now brought him? Is he helpless, angry and frustrated? He should learn to control his emotions. Why should God punish journalists? For doing their job? Those who have chosen to take up public positions must learn not to complain when the media focusses attention on them. It is the least price that they can possibly pay for the privilege of their pre-eminence. If they feel that they have been maligned, they can write rejoinders or go to court.
Nyako had earlier described himself as a true Muslim. What kind of Muslim is he, swearing and cursing in the Holy month of Ramadan, and walking out on his fellow men, rather contemptuously? During this month, Moslems are enjoined to be in their best behaviour, to eschew all vices - greed, use of intemperate language, violence, alcholism and to remain chaste. Ramadan is the month when Moslems are reminded of their duty to fellow human beings: to show love and understanding, to assist the needy, and to seek the Grace of God. Nyako pushed all this aside when he chose to swear and curse. If this were not the month of Ramadan, how else would he have treated his guests?
His conduct is however not peculiar. It illustrates the gap in our society between private and public morality. Most Nigerians are very religious. They can quote the Holy Books correctly, and make a passionate show of piety. But in their relationship with other human beings, they do not obey the commandments of the faith that they profess. Nyako had just finished breaking his fast before he called on God to "punish" his fellow human beings. He does not owe those journalists an apology, but he owes God an explanation. Let him atone for his sins by chanting "God bless journalists", a hundred times. And hopefully, when next Nyako invites journalists to dinner, they would learn to stand by the truth, even after eating... God bless Nyako.