tag:blogger.com,1999:blog-63977042024-03-13T18:41:36.039+08:00.PARALLEL UNIVERSES.Ninety percent about health and medicine.Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comBlogger992125tag:blogger.com,1999:blog-6397704.post-19997764724527622402013-03-04T09:03:00.001+08:002013-03-04T09:03:49.883+08:00Universal Health Care and No Smoking<p dir=ltr>Both in place as far as policies and laws are concerned, but still far from being achieved with regards to their true objectives. </p>
<div style='clear: both; text-align: center; font-size: xx-small;'>Published with Blogger-droid v2.0.10</div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-38583457998868955312011-10-01T09:30:00.000+08:002011-10-10T09:47:49.494+08:00Blogging Misses Me<div>
Hello there! I am back. For good? I hope so.....</div>
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Why the long absence?</div>
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I would like to describe it as a period of hibernation tempered with varying degrees of experimentation. I have always wondered what would happen if a blogger stops writing after coughing out more than 1,000 posts.<br />
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Well, it was life-changing. It energized me. I also learned a lot from the brief pause. I learned I can get away from blogging if I wanted to. A busy schedule helps. It eats my time, and before I know it, more than a year has passed since my last post. </div>
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But I miss it. You would know what I mean if you're a blogger, too. There are moments when there is an urge to write, but the interest will then fizzle. Thoughts and ideas run inside my mind, but the consummation of the final act is lost after a short moment of interest. Sometimes, I still wonder myself why I did not find time to write. Maybe simply because it was really difficult. There were always so many pressing engagements. And at night, minutes before sleep sets in, there is that regret that gnaws and castigates why I am not writing anymore.</div>
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Today, I could not really describe my schedule as less hectic. But I have decided to write again. For sure, it will be irregular until I get my balance again.</div>
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I feel a bit happier thinking I can write again.</div>
Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-36502081293751955482011-09-30T01:15:00.001+08:002011-12-21T01:17:49.505+08:00Cheaper Medicine in Canada<div align="justify"><a href="http://www.canadadrugcenter.com/why-are-meds-cheaper-in-canada.asp"><img src="http://www.canadadrugcenter.com/images/why-are-meds-cheaper-in-canada.jpg"/></a><br />
Via: <a href="http://www.canadadrugcenter.com">Canada Drug Center</a><br />
</div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-85085640018339741902010-08-15T06:33:00.055+08:002010-08-21T12:34:37.341+08:00Painkillers and Stroke Risk<div align="justify">Common painkillers include two groups of mostly over-the-counter (OTCs) medications like NSAIDs and COX-2 inhibitors. <br />
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Non-steroidal anti-inflammatory drugs (NSAIDs) examples are mefenamic acid, ketorolac, ibuprofen, and naproxen, which are frequently advertised by famous personalities as effective in relieving muscular and joint pains. <br />
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A COX-2 inhibitor example is celecoxib (Celebrex), which is still in the market today, after other COX-2 inhibitors like rofecoxib (Vioxx) and valdecoxib (Bextra) were removed from the market in 2004 and 2005 because of their reported association with increased risk of heart attacks.<br />
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Now comes a <a href="http://stroke.ahajournals.org/cgi/content/abstract/STROKEAHA.110.585828v1">recent study</a> among more than 30,000 Taiwanese stroke patients showing an association between the use of NSAIDs and the risk of both hemorrhagic and ischemic stroke episodes.<br />
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The study found that for ischemic stroke, there was a modest increased risk evident for all oral NSAIDs ranging from 20 percent to 90 percent. For hemorrhagic stroke, oral ketorolac had been shown to be associated with a significantly higher risk.<br />
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Pointers to remember:<br />
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<ul><li>Limit the use of painkillers, especially in the elderly and those with identified stroke risk factors like hypertension, diabetes, and smoking.</li>
<li>If it cannot really be avoided, initially try taking paracetamol or acetaminophen using a low dose of 325mg before proceeding with 500mg, if pains still persists.</li>
<li>Always consult a doctor before self-medicating. It is tempting to buy over-the-counter medications, but long-term side effects will also prove to be a problem later on, if proper professional advice is not taken. </li>
</ul></div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-51422598453625741022010-04-29T10:42:00.002+08:002011-03-30T07:58:48.245+08:00Heat Exhaustion Kills Diabetic Hypertensives in the Philippines<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S9jZG9dDDtI/AAAAAAAAAg4/WGfID8ET26M/s1600/hottest.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S9jZG9dDDtI/AAAAAAAAAg4/WGfID8ET26M/s320/hottest.jpg" /></a></div><div align="justify"><div style="font-family: Arial,Helvetica,sans-serif;">Yesterday was <b>another hot day</b>. They say it's the hottest since January this year. This may not also be the last in the 'hottest' series, as the temperature can still get hotter.</div><div style="font-family: Arial,Helvetica,sans-serif;"><br />
</div><div style="font-family: Arial,Helvetica,sans-serif;">What really matters here is not only the recorded temperature, but <b>how it really feels like</b> out there with this kind of temperature.</div><br />
<a href="http://accuweather.com/">AccuWeather.com</a> calls it the <a href="http://www.blogger.com/post-create.g?blogID=6397704"><span style="font-family: helvetica,arial,sans-serif; font-size: small;"></span></a><span style="font-family: helvetica,arial,sans-serif; font-size: small;"><a href="http://www.accuweather.com/iwxpage/adc/help/pr_realfeel_pr.htm"><b>RealFeel Temperature</b></a> and it takes into account the effects of multiple parameters, including ambient temperature, wind speed, solar intensity, humidity, precipitation intensity/type, elevation and atmospheric pressure.</span><br />
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<span style="font-family: helvetica,arial,sans-serif; font-size: small;">In the case yesterday, for example, that <b>37.3°C</b> really felt like <i><span style="font-size: large;">40°C</span></i> or a scorching <i><span style="font-size: large;">104°F</span></i>.</span><br />
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<span style="font-family: helvetica,arial,sans-serif; font-size: small;">Why so? Because of humidity and because heat can't really be dissipated in an environment like Metro Manila. The concrete roads and cemented surroundings absorb heat and stores it long after the sun has set.</span><br />
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<div class="separator" style="clear: both; text-align: center;"><span style="font-family: helvetica,arial,sans-serif; font-size: small;">Why is this important? What happens when it becomes hotter?</span><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S9jhsadGp_I/AAAAAAAAAhA/PL0XrqEsQAQ/s1600/armandsanchez.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S9jhsadGp_I/AAAAAAAAAhA/PL0XrqEsQAQ/s640/armandsanchez.jpg" width="475" /></a></div><div style="text-align: center;"><b><span style="font-size: x-small;"> <a href="http://inquirer.net/">Inquirer.net</a>, 27 April 2010</span></b></div><br />
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<span style="font-family: helvetica,arial,sans-serif; font-size: small;"><a href="http://www.gmanews.tv/story/189515/ex-batangas-gov-dies-a-day-after-heat-stroke">News</a> <a href="http://www.abs-cbnnews.com/nation/regions/04/26/10/vilmas-rival-batangas-collapses-heat-stroke">reports</a> previously attributed the death of the former governor above due to heat stroke. I think it's a misnomer. Here's another case reported yesterday:</span><br />
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<div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S9jnBc_9BnI/AAAAAAAAAhI/TkzZsdoSKj4/s1600/hottest2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="175" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S9jnBc_9BnI/AAAAAAAAAhI/TkzZsdoSKj4/s400/hottest2.jpg" width="400" /></a></div><div style="text-align: center;"><span style="font-family: helvetica,arial,sans-serif; font-size: small;"><span style="font-size: x-small;"><b><a href="http://www.mb.com.ph/articles/255071/heat-stroke-claims-cavite-cop">Manila Bulletin</a>, 28 April 2010</b></span></span></div><br />
<span style="font-family: helvetica,arial,sans-serif; font-size: small;">Anyone who collapses here amidst a hot weather is termed a 'heat stroke,' but a heat stroke means having a temperature of <b>more than 40°C</b> due to heat exposure and abnormal thermoregulation. I strongly doubt both the governor and the cop's temperatures were taken at the time of their respective fainting spells.</span><br />
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<span style="font-family: helvetica,arial,sans-serif; font-size: small;">What probably happens is simply <b>heat exhaustion</b>.</span><br />
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<span style="font-family: helvetica,arial,sans-serif; font-size: small;">What ultimately kills them is a <b>myriad of other factors</b>.</span><br />
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<span style="font-family: helvetica,arial,sans-serif; font-size: small;">In the <b>governor's case</b>, there was a confluence of diabetes, hypertension, and exhaustion from campaign activities. This was a fatal cocktail that led to a <b>cerebrovascular stroke</b>, and as reported, the governor was semi-comatose after his brain surgery. </span><br />
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<span style="font-family: helvetica,arial,sans-serif; font-size: small;">In the <b>cop's case</b>, it was clearly <b>heat exhaustion</b> complicated by head trauma when he fainted and hit his head on the cemented floor.</span><br />
<blockquote style="font-family: "Trebuchet MS",sans-serif;">"A CPPO report said that Alivio fainted as he and his colleagues were having tae bo at the camp’s open basketball court at 4:30 p.m. Tuesday. Tae bo is an exercise program combining elements of boxing, dance and tae kown do, a Korean martial art. </blockquote><blockquote><span style="font-family: 'Trebuchet MS',sans-serif;">Alivio sustained bruises on the forehead when he collapsed on the cemented court. "</span> ~ <span style="font-family: helvetica,arial,sans-serif; font-size: small;"><span style="font-size: x-small;"><b><a href="http://www.mb.com.ph/articles/255071/heat-stroke-claims-cavite-cop">Manila Bulletin</a>, 28 April 2010</b></span></span></blockquote><span style="font-size: small;"><span class="Apple-style-span" style="font-family: Arial,Helvetica,sans-serif;">Too much heat can certainly cause blood pressures and tempers to rise. </span></span><span class="Apple-style-span" style="font-family: Arial,Helvetica,sans-serif;">Drinking plenty of water and staying in air-conditioned places might help. But ultimately, what determines survival is the </span><b><span class="Apple-style-span" style="font-family: Arial,Helvetica,sans-serif;">presence or absence of complicating ailments</span></b><span class="Apple-style-span" style="font-family: Arial,Helvetica,sans-serif;"> like diabetes and hypertension.</span><br />
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<span style="font-family: helvetica,arial,sans-serif; font-size: small;">There are plenty of diabetic hypertensives Filipinos out there. These people should be <b>more cautious</b> of their health conditions during these hot months. The risk of having <b>cerebrovascular stroke increases</b> in direct proportion to the increase in environmental temperature. </span></div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-21036647398841906172010-04-17T14:03:00.002+08:002010-05-03T03:00:34.404+08:00Things I Learned at the First Philippine Health Financing Summit<div align="justify">'Better late than never.<br />
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Finally, after so many years, the Philippines had its <b style="color: #ffe599;"><i><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">first Health Financing Summit</span></span></i></b> last April 14, 2010 at the GT-Toyota Asian Center Auditorium inside the UP Diliman Campus.<br />
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<b>It was very low-key.</b> I don't think the media covered it. Most of the people who attended were from the academe. There were lots of familiar faces from UP Manila, Ateneo Graduate School of Business, De La Salle University, and the Asian Institute of Management.<br />
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<ul><li>The likelihood of having <b>appendicitis</b> in a lifetime is 7 percent. At present, if one undergoes appendectomy, the total expense from the operation and hospitalization is around <b><span style="font-family: "Trebuchet MS",sans-serif;">Php 70,000.00</span></b> or US$ 1,574.00 (1 US$ = Php 44.48) <i><b><sup>1</sup></b></i>.</li>
</ul><ul><li>For Filipino women, the likelihood of having <b>breast cancer</b> in a lifetime is 12 percent. After being diagnosed, expenses will most likely run in the range of <b><span style="font-family: "Trebuchet MS",sans-serif;">Php 1.5 million</span></b> or US$ 33,760.97 for the first year, and around <b><span style="font-family: "Trebuchet MS",sans-serif;">Php 120,000.00</span></b> or US$ 2,700.88 per year for the next four years, <b>excluding</b> doctors' professional fees <i><b><sup>1</sup></b></i>.</li>
</ul><ul><li>Latest available national health account data available is 2005. It shows a per capita health spending of <b><span style="font-family: "Trebuchet MS",sans-serif;">P1,978 or US$ 44.52 in 2004</span></b> to <b><span style="font-family: "Trebuchet MS",sans-serif;">P2,120 or US$ 47.72 in 2005</span></b> or a measly 7.2 percent increase <sup>2</sup>. </li>
</ul><ul><li>Health spending in the Philippines is mostly private or out-of-pocket. <b>Nearly 60 percent of all health spending here is <span style="font-size: large;">out-of-pocket</span> </b><i><sup>2</sup></i><b>. </b></li>
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<ul><li><b>WHO</b> defines <b style="font-family: "Trebuchet MS",sans-serif;">catastrophic health spending</b> as any of the following: <b>[a] </b>it happens when households reduce their basic expenditures in order to cope with paying the medical bills of one or two of their family members, <b>[b]</b> it may be equal or above 40% of the household's capacity to pay, and <b>[c]</b> there is no consensus on what the catastrophic threshold is. </li>
</ul><ul><li><b>Poor families</b> define catastrophic health spending in very simple terms: it is a choice between <b><span style="font-family: "Trebuchet MS",sans-serif;">being unhealthy or being poorer</span></b>. </li>
</ul><ul><li>The government response made thru the <b><span style="font-family: "Trebuchet MS",sans-serif;">Department of Health (DOH)</span></b> to counteract out-of-pocket health spending is to <b>increase social insurance coverage</b> <i><b><sup>3</sup></b></i>. It presents the framework below as for health sector reform:</li>
</ul><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8ky-CRFZ8I/AAAAAAAAAgM/swT9gfqbmwY/s1600/doh.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8ky-CRFZ8I/AAAAAAAAAgM/swT9gfqbmwY/s320/doh.jpg" /></a></div><ul><li>In terms of health indicators like infant and maternal mortality rates, the <b>Philippines</b> has shown improvement from <b>1950 to 2009</b>, but <b>lags behind</b> when the same figures are compared with its Asian neighbors like Thailand, Malaysia, Singapore, Vietnam, Korea and Japan. <b>It only fares better than Indonesia</b> <i><b><sup>4</sup></b></i>.</li>
</ul><ul><li><b>Professor Phua Kai Hong</b> of Singapore acknowledges that while there is substantial growth of social insurance in the Asia-Pacific region, the <b><span style="font-family: "Trebuchet MS",sans-serif;">current predominate health spending method is still out-of-pocket</span></b>. In <b>China</b>, for example, 50 - 60 percent of the total health budget is spent on drugs and diagnostics.</li>
</ul><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8k2v0r_JjI/AAAAAAAAAgU/bU0ZVSMrKuA/s1600/comphltspnd.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="292" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8k2v0r_JjI/AAAAAAAAAgU/bU0ZVSMrKuA/s400/comphltspnd.jpg" width="400" /></a> </div><div class="separator" style="clear: both; text-align: center;"><span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Slide from <b>Prof. Phua Kai Hong</b>, NUS</span></span></div><div class="separator" style="clear: both; text-align: center;"><i><span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Health Systems Financing: </span></span></i></div><div class="separator" style="clear: both; text-align: center;"><i><span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Examples from the Asian Region </span></span></i></div><div class="separator" style="clear: both; text-align: center;"><br />
</div><ul><li> Prof. Hong also said showed the health expenditures as percentage of GDP of developed countries. <i><b><span style="font-family: "Trebuchet MS",sans-serif;">"But don't be misled,"</span></b></i> he said. <i><b><span style="font-family: "Trebuchet MS",sans-serif;">"It's not how much countries spend that's really important, it's about getting the expected results. The questions to ask are if people get well or if they die in spite of all the health spending."</span></b></i></li>
</ul><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8k4oMblFSI/AAAAAAAAAgc/u_VkaGTwtyM/s1600/comphltspnd2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="298" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8k4oMblFSI/AAAAAAAAAgc/u_VkaGTwtyM/s400/comphltspnd2.jpg" width="400" /></a> </div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"><span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Slide from <b>Prof. Phua Kai Hong</b>, NUS</span></span></div><div class="separator" style="clear: both; text-align: center;"><i><span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Health Systems Financing: </span></span></i></div><div style="text-align: center;"><i><span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Examples from the Asian Region </span></span></i></div><div class="separator" style="clear: both; text-align: center;"></div><ul><li> <b><span style="font-family: "Trebuchet MS",sans-serif;">What we can learn from the Singapore experience</span></b> ---In the figure above, Prof. Hong gave reasons for Singapore's high health performance ranking in spite of its low per capita health expenditure: <b>[a]</b> their relatively high GNP, <b>[b]</b> their lower consumption due to their age structure, <b>[c]</b> their strong budgetary controls on public spending, <b>[d]</b> the absence of a comprehensive health insurance, and <b>[e] </b>government subsidies for public health and differential pricing for personal consumption.</li>
</ul><ul><li><b>UK Ambassador Stephen Lille</b> gave a picture of what the <b>UK National Health Service (NHS)</b> is. Founded in 1948, it has these 3 magnificent core principles: <b>[a]</b> it meets the needs of everyone, <b>[b]</b> it is free at the point of delivery, and last, but most important I think is, <b> [c]</b> <b><span style="font-family: "Trebuchet MS",sans-serif;">it is based on clinical need, and not the ability to pay</span></b>. </li>
</ul><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8k_9bUYnZI/AAAAAAAAAgk/YIl4IgFr4OM/s1600/nhs.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="323" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8k_9bUYnZI/AAAAAAAAAgk/YIl4IgFr4OM/s400/nhs.jpg" width="400" /></a> </div><div class="separator" style="clear: both; font-family: Arial,Helvetica,sans-serif; text-align: center;"><span style="font-size: x-small;">Slide from H.E. <b>UK Ambassador Stephen Lille,</b></span></div><div class="separator" style="clear: both; font-family: Arial,Helvetica,sans-serif; text-align: center;"><i><span style="font-size: x-small;">The UK National Health Service </span></i></div><div class="separator" style="clear: both; text-align: center;"></div><ul><li>The UK Ambassador ended his talk with this quote from <b>Aneunn Bevan</b>, the NHS architect: <i><b><span style="font-family: "Trebuchet MS",sans-serif;">"No society can call itself civilized if a sick person is denied medical aid because of lack of means."</span></b></i> Ouch! There's the rub. </li>
</ul><ul><li>To many Filipinos, <b>good health</b> has always been associated with the a<b>vailability of medicines</b> and the <b>capacity to pay</b> for their respective prescribed dosages made by physicians. This is sad as this shows that <b><span style="font-family: "Trebuchet MS",sans-serif;">the current mindset still remains to be curative and not preventive</span></b>. </li>
</ul><ul><li>Because <b>good health = availability of medicines</b>, the drive is to make the government <b><span style="font-family: "Trebuchet MS",sans-serif;">go beyond</span></b> the Cheaper and Quality Medicines Law, <b><span style="font-family: "Trebuchet MS",sans-serif;">go beyond</span></b> the Maximum Drug Retail Price (MDRP) Executive Order, <b><span style="font-family: "Trebuchet MS",sans-serif;">go beyond</span></b> the Food and Drug Authority Law, and <b><span style="font-family: "Trebuchet MS",sans-serif;">go beyond</span></b> the Generic Act of 1988. <b>MDRP should have expanded coverage</b> and include all essential medications. This remains to be a great challenge for the next President of the Philippines.</li>
</ul><ul><li>There must also be a <b>bridge between health financing and quality of care</b> delivered. Poor quality generates additional costs and current financing arrangements may impede health improvements. </li>
</ul><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/_cApfbkC20Fs/S8lHLhLRTVI/AAAAAAAAAgs/e70QGTc7QsQ/s1600/qual.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="304" src="http://3.bp.blogspot.com/_cApfbkC20Fs/S8lHLhLRTVI/AAAAAAAAAgs/e70QGTc7QsQ/s320/qual.jpg" width="320" /></a></div><div style="font-family: Arial,Helvetica,sans-serif; text-align: center;"><span style="font-size: x-small;">Slide from <b>Dr. Madeleine de Rosas-Valera</b>, WHO-WPRO</span></div><div style="font-family: Arial,Helvetica,sans-serif; text-align: center;"><span style="font-size: x-small;"><i>Patient Quality and Safety: </i></span></div><div style="text-align: center;"><span style="font-size: x-small;"><i style="font-family: Arial,Helvetica,sans-serif;">A Requirement for Successful Health Financing</i></span></div><div style="text-align: center;"><br />
</div><ul><li> <b>Mayor Sonia Lorenzo of San Isidro, Nueva Ecija</b>, a small town in Northern Philippines, gave a talk on how a local government unit is able to cope on health expenditure problems. She cites the value of volunteerism among citizens, the importance of integrating health in schools, allotting 16 percent of municipal funding to health concerns, and having at least 10,000 families enrolled in social insurance with member co-sharing.</li>
</ul><br />
Overall, my verdict on this summit is <b>more than satisfactory</b>. Presentations were able to identify the problems and suggest possible solutions. My <b>only criticism</b> is that it tried to cover so many topics in such a short time, to the detriment of the audience missing out taking their lunch. Next time, organizers should make this at least a two-day affair.<br />
<br />
In summary, I think <b><span style="font-family: "Trebuchet MS",sans-serif;">the main problems</span></b> in health financing in the Philippines are:<br />
<ol><li><b><span style="font-family: "Trebuchet MS",sans-serif;">Not enough money available</span></b> - holds true for both the citizens, who spend mostly out-of-pocket for their health expenditures, and the government, which is tasked to address all health need problems.</li>
<li> <b><span style="font-family: "Trebuchet MS",sans-serif;">Weak Political wil</span>l</b> - the next President should have a stronger will to make health a priority in his administration programs. The next Health secretary should also have strong public health leadership skills.</li>
<li><b><span style="font-family: "Trebuchet MS",sans-serif;">Corruption</span></b> - needs to be stopped so lost money can be channeled to number 1 where it is mostly needed.</li>
<li><b><span style="font-family: "Trebuchet MS",sans-serif;">Preventive, Not Curative</span></b> - Filipinos need to learn that in the long run, an ounce of prevention is cheaper and goes a long way than the more expensive pound of cure.</li>
</ol>_______________<br />
Sources: <span style="font-size: x-small;">1 - <b>Dr. Alvin Caballes</b>, Social Medicine Unit, UP Manila</span><br />
<span style="font-size: x-small;"> 2 - NCSB 2005, <a href="http://www.nscb.gov.ph/stats/pnha/2005/exsum.asp">Philippine National Health Accounts PNHA</a></span><br />
<span style="font-size: x-small;"> 3 -<b> Dr. Liezel Lagrada</b>, DOH</span><br />
<span style="font-size: x-small;"> 4 - <b>Dr. Eduardo Banzon</b>, World Bank</span><br />
<br />
<ul></ul></div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-35616617942058632752010-04-13T21:11:00.010+08:002010-04-15T23:37:41.956+08:00GRAND ROUNDS Volume 6, No. 29<div align="justify">After a hiatus of almost a year from hosting Grand Rounds, I am back today to welcome you all to <b><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">GRAND ROUNDS, Volume 6, No. 29</span></span></b>. This is my <b>6th time</b> to host this weekly round-up of the best in med- and health blogs. If one is passionate about it, hosting can be a taxing experience. More often than not, it eats precious time one should allocate for sleeping. Thank God I live on the other side of the planet, and most of those who submitted are on the opposite side --- I can still rest tonight. 'Kidding! I am always proud to host. I thank <a href="http://blogborygmi.blogspot.com/2004/09/grand-rounds-archive-upcoming-schedule.html"><b>Nick</b></a> for the invitation this week. Thank you also for all those who joined.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/_cApfbkC20Fs/S8Sm11vJXNI/AAAAAAAAAf8/1Bod8uE0GpE/s1600/GR-logo.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" src="http://3.bp.blogspot.com/_cApfbkC20Fs/S8Sm11vJXNI/AAAAAAAAAf8/1Bod8uE0GpE/s320/GR-logo.jpg" width="320" /></a></div><br />
Those who are familiar with me know I do not require themes. I think requiring bloggers to create posts revolving on a certain theme asphyxiates creativity, and makes the job easy for the assigned host only. In my case, I arrange submitted posts as they arrive, and I try my best to include everyone. I also visit and read each post submitted.<br />
<br />
Let's begin:<br />
<br />
<div style="text-align: center;"><i><b style="color: #ffe599;"><span style="font-size: large;">CHOICE CUTS</span></b></i> - these are the best of the best,<br />
and as such, are must-reads.<br />
<div style="text-align: left;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8Q5fSGJRKI/AAAAAAAAAcc/SGn1Vja5Dcc/s1600/24a-the+truth.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8Q5fSGJRKI/AAAAAAAAAcc/SGn1Vja5Dcc/s320/24a-the+truth.jpg" /></a></div><div style="text-align: left;"><div style="text-align: justify;">As Oscar Wilde said, the truth is rarely pure and never simple.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Such was the problem of the <b>#1 Dinosaur</b> when faced with the difficulty of telling a patient the truth about the death of his wife. It was a moving experience and you can almost palpate the emotions involved.</div><br />
<a href="http://dinosaurmusings.blogspot.com/2010/03/truth.html"><span style="font-family: "Trebuchet MS",sans-serif;">How does a doctor encourage a patient to tell the Truth?</span></a> <br />
<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8Q8NvZVOSI/AAAAAAAAAcs/eClaSXvsAFU/s1600/14a-compassionF.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8Q8NvZVOSI/AAAAAAAAAcs/eClaSXvsAFU/s320/14a-compassionF.jpg" /></a></div><div style="text-align: justify;">Ah, compassion fatigue. It happens to all of us. Even to doctors and general surgeons like <b>Bongi</b>. It is difficult to admit at times because no one wants to look bad in front of people and patients. But ignoring it does not make it disappear. In the place where I practice, physical exhaustion matched with loss of idealism remain to be its top cause. <a href="http://other-things-amanzi.blogspot.com/2010/04/compassion-fatigue.html" style="font-family: "Trebuchet MS",sans-serif;">Read Bongi's reasons on why doctors succumb to it. </a></div><br />
<br />
<a href="http://4.bp.blogspot.com/_cApfbkC20Fs/S8Q_Pb9ge9I/AAAAAAAAAc0/Hq-_BF2rNCI/s1600/26a-scar.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/_cApfbkC20Fs/S8Q_Pb9ge9I/AAAAAAAAAc0/Hq-_BF2rNCI/s320/26a-scar.jpg" /></a>This is a very short post by my friend <b>Ramona Bates, M.D</b>., who is a plastic surgeon in Little Rock, Arkansas.<br />
<br />
Short. Sweet. Very profound.<br />
<br />
<a href="http://rlbatesmd.blogspot.com/2010/04/her-scars-story.html"><span style="font-family: "Trebuchet MS",sans-serif;">What is the story behind your scar? </span></a><br />
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<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RFmAFeqLI/AAAAAAAAAc8/UrxDXCGX18c/s1600/22a-pallimed.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RFmAFeqLI/AAAAAAAAAc8/UrxDXCGX18c/s320/22a-pallimed.jpg" /></a></div><div style="text-align: justify;">Death comes to us all, doctors and patients alike. But doctors always try to put up either a brave front or feign a deep connection with a patient to prepare themselves.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Inspired by an article from the New York Times, <b>Pallimed</b> explores how a <a href="http://www.pallimed.org/2010/04/nyt-on-death-of-palliative-care.html"><span style="font-family: "Trebuchet MS",sans-serif;">palliative care physician and her relatives cope with death</span></a>.</div><br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/_cApfbkC20Fs/S8RHVWmXV3I/AAAAAAAAAdE/pjdeJr-nZ50/s1600/23a-cushings.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/_cApfbkC20Fs/S8RHVWmXV3I/AAAAAAAAAdE/pjdeJr-nZ50/s320/23a-cushings.jpg" /></a></div><div style="text-align: justify;">I have a few patients with Cushing's Disease, and because it is not a common disease here, it becomes quite a challenge when explaining the nature of the ailment to both the patient and the relatives. A doctor is a healer and a teacher most of the time. It comes as whiff of fresh air to me then, when librarian <b>Laika</b> makes a complex condition sound so simple and easy to understand.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><a href="http://laikaspoetnik.wordpress.com/2010/04/10/irreversible-effects-of-previous-cortisol-excess-on-cognitive-functions-in-cushings-disease/"><span style="font-family: "Trebuchet MS",sans-serif;">Cushing's Disease explained in simple terms</span></a>. </div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div><div style="text-align: center;"><b style="color: #ffe599; font-family: inherit;"><i><span style="font-size: large;">USEFUL TIPS and HOW-TOs</span></i></b> -<br />
bloggers offer the steps on some interesting topics.<br />
<br />
<div class="separator" style="clear: both; text-align: justify;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RMsTkV32I/AAAAAAAAAdM/TUITAgXHbqg/s1600/19-osler.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RMsTkV32I/AAAAAAAAAdM/TUITAgXHbqg/s320/19-osler.jpg" /></a></div><div style="text-align: justify;"><b>Chris Nickson</b> points us to the great William Osler as we learn <a href="http://lifeinthefastlane.com/2010/04/lessons-from-osler-003/"><span style="font-family: "Trebuchet MS",sans-serif;">how to be a better observer</span></a>. Very valuable in Medicine as doctors are also constant investigators.</div><div style="text-align: justify;"><br />
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</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RO1-IQOtI/AAAAAAAAAdU/ItxOwagBohM/s1600/2-howt2copewpain.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RO1-IQOtI/AAAAAAAAAdU/ItxOwagBohM/s320/2-howt2copewpain.jpg" /></a></div><div style="text-align: justify;">A Board-certified Orthopedic surgeon guest blogs in <b>How To Cope With Pain</b>, and highlights the merits and details of <a href="http://www.howtocopewithpain.org/blog/1957/self-hypnosis-for-surgery/">s<span style="font-family: "Trebuchet MS",sans-serif;">elf-hypnosis in surgery</span></a>.</div><div style="text-align: justify;"></div><div style="text-align: justify;">This is bad news for Anaesthesiologists. </div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RPxRVZAsI/AAAAAAAAAdc/lJPvrZQN2tE/s1600/16-JILLemerkit.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RPxRVZAsI/AAAAAAAAAdc/lJPvrZQN2tE/s320/16-JILLemerkit.jpg" /></a></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">In this time of frequent earthquakes and other unexpected disasters, <b>Jill of All Trades, MD</b> urges us to <a href="http://jillofalltradesmd.blogspot.com/2010/04/be-prepared-for-disasters-learn-how-to.html"><span style="font-family: "Trebuchet MS",sans-serif;">prepare our respective emergency kits</span></a>. </div><div style="text-align: justify;"></div><div style="text-align: justify;"></div><div style="text-align: justify;"></div><div style="text-align: justify;"></div><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RQ1JMr6FI/AAAAAAAAAdk/W_2OFNrPXcM/s1600/15-JILLnarco.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RQ1JMr6FI/AAAAAAAAAdk/W_2OFNrPXcM/s320/15-JILLnarco.jpg" /></a></div><div style="text-align: justify;">It is difficult to avoid patients who consult because they want narcotic prescriptions. What to do and how to get rid of them?</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">For the second time, <b>Jill of All Trades, MD </b>carefully explains to us the steps on <a href="http://jillofalltradesmd.blogspot.com/2010/04/how-to-gracefully-sing-beat-it-to-your.html"><span style="font-family: "Trebuchet MS",sans-serif;">how to 'dance' gracefully with narcotic seekers</span></a>.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"></div><div style="text-align: justify;"></div><div style="text-align: justify;"></div><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/_cApfbkC20Fs/S8RSCwdW9xI/AAAAAAAAAds/JQhefZ53D7Q/s1600/4-lockupdoc.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/_cApfbkC20Fs/S8RSCwdW9xI/AAAAAAAAAds/JQhefZ53D7Q/s320/4-lockupdoc.jpg" /></a></div><div style="text-align: justify;">Finally, here's a very useful tip for medbloggers who lead double lives of being simultaneous health professionals and bloggers.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Lockup Doc</b> teaches us <a href="http://lockupdoc.com/2010/04/how-to-fit-many-medical-blogs-into-your-busy-life/"><span style="font-family: "Trebuchet MS",sans-serif;">how to handle medical blogs and a busy life</span></a>.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div><br />
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<i style="color: #ffe599;"><b><span style="font-size: large;">POINTS TO PONDER</span></b></i> - strong opinions on select topics <br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RUq54896I/AAAAAAAAAd0/LorhN6LLJxA/s1600/1-jolie.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RUq54896I/AAAAAAAAAd0/LorhN6LLJxA/s320/1-jolie.jpg" /></a></div><div style="text-align: justify;"><b><br />
</b></div><div style="text-align: justify;"><b>Dr. Jolie Bookspan</b> offers a comprehensive discussion on <a href="http://www.healthline.com/blogs/exercise_fitness/2010/03/surgery-for-achilles-tendon-may-not.html"><span style="font-family: "Trebuchet MS",sans-serif;">Achilles tendon surgery</span></a>, weighing on important issues like whether ligament tears can heal without surgery and whether surgery plus physical rehab, or physical rehab alone is the favorable approach.</div></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RYbUQJEOI/AAAAAAAAAd8/-RNxnp4B_Kg/s1600/20-navratilova.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RYbUQJEOI/AAAAAAAAAd8/-RNxnp4B_Kg/s320/20-navratilova.jpg" /></a></div><br />
</div>A double fault for <a href="http://eve-harris.blogspot.com/2010/04/martinas-breast-cancer-double-faults.html"><span style="font-family: "Trebuchet MS",sans-serif;">Martina Navratilova on her recent breast cancer</span></a> diagnosis. Know if you agree with <b>Eve Harris</b> or not.<br />
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<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/_cApfbkC20Fs/S8RZT8I60RI/AAAAAAAAAeE/RDrJDoMDwCU/s1600/7-sexualaddictn.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/_cApfbkC20Fs/S8RZT8I60RI/AAAAAAAAAeE/RDrJDoMDwCU/s320/7-sexualaddictn.jpg" /></a></div><br />
<b>EverythingHealth</b> has second (and third) thoughts on <a href="http://healthwise-everythinghealth.blogspot.com/2010/04/is-sexual-addiction-real.html"><span style="font-family: "Trebuchet MS",sans-serif;">whether sexual addiction is real or not</span></a>.<br />
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Tiger would? Tiger wouldn't? Take your pick.<br />
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<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RaFwijsMI/AAAAAAAAAeM/q0Az0gwR7as/s1600/27-medoverNC.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RaFwijsMI/AAAAAAAAAeM/q0Az0gwR7as/s320/27-medoverNC.jpg" /></a></div><br />
<br />
<div style="text-align: justify;">Here's a lengthy, lengthy, lengthy post on <a href="http://drjshousecalls.blogspot.com/2010/04/lesson-on-medical-oversight-in-north.html"><span style="font-family: "Trebuchet MS",sans-serif;">a medical oversight case in North Carolina</span></a>. Did I say it's a long post? <b>Dr. Mary Johnson</b> also gives us a fair warning, but do not let that discourage you. It is a strongly assertive post on the clash of medicine and the law.</div><br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RbyGbPaZI/AAAAAAAAAeU/WtQPk3wCBh0/s1600/12-HAIRestoration.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RbyGbPaZI/AAAAAAAAAeU/WtQPk3wCBh0/s320/12-HAIRestoration.jpg" /></a></div><br />
<div style="text-align: justify;"><b>Happy Hospitalist</b> dissects the many alternatives <a href="http://thehappyhospitalist.blogspot.com/2010/04/hair-restoration-for-women-5-dollar.html"><span style="font-family: "Trebuchet MS",sans-serif;">on female hair restoration</span></a>. I would have considered this a good post if only Happy removed all those subtle links to Amazon, which offers several hair restoration products. </div><br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8ReatLBCCI/AAAAAAAAAec/i1Uc_W5z14Y/s1600/3-schizo.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8ReatLBCCI/AAAAAAAAAec/i1Uc_W5z14Y/s320/3-schizo.jpg" /></a></div><b><br />
</b><br />
<b><br />
</b><br />
<div style="text-align: justify;"><b>Philip Hickey, PhD</b> offers a number of points to prove that <a href="http://behaviorismandmentalhealth.com/2010/03/20/schizophrenia-is-not-an-illness-part-3/"><span style="font-family: "Trebuchet MS",sans-serif;">schizophrenia is not an illness</span></a>.</div><br />
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<div style="text-align: center;"><i style="color: #ffe599;"><b><span style="font-size: large;">NICE TO KNOW</span></b></i> - improves your conventional wisdom</div><div style="text-align: center;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RgKWlhDII/AAAAAAAAAek/uFN7tQMNZF8/s1600/8-peaceofmind.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RgKWlhDII/AAAAAAAAAek/uFN7tQMNZF8/s320/8-peaceofmind.jpg" /></a></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div></div></div><div style="text-align: justify;"><b>ACP Internist</b> tells us <a href="http://blog.acpinternist.org/2010/04/why-peace-of-mind-is-so-expensive-in.html"><span style="font-family: "Trebuchet MS",sans-serif;">why peace of mind is so expensive in health care</span></a>.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/_cApfbkC20Fs/S8Rg6uKrZTI/AAAAAAAAAes/zvGaLXJhCds/s1600/5-vasectomy.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/_cApfbkC20Fs/S8Rg6uKrZTI/AAAAAAAAAes/zvGaLXJhCds/s320/5-vasectomy.jpg" /></a></div><br />
Most males dread vasectomy. Who doesn't?<br />
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<b>Unbounded Medicine</b> weighs in on both the effectiveness and failures of <a href="http://www.unboundedmedicine.com/2010/03/24/effectivenes-of-vasectomy/"><span style="font-family: "Trebuchet MS",sans-serif;">vasectomy procedures</span></a>. <br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8Rh3JFSS9I/AAAAAAAAAe0/q8v1FFxWex8/s1600/17-PG13violence.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8Rh3JFSS9I/AAAAAAAAAe0/q8v1FFxWex8/s320/17-PG13violence.jpg" /></a></div><br />
<div style="font-family: "Trebuchet MS",sans-serif;"><a href="http://www.healthline.com/blogs/teen_health/2010/04/more-violence-in-pg-13-movies.html">MPAA has faulty classification standards?</a></div><br />
Find out with <b>Nancy Brown, PhD</b>, as she explores a probable reason why adolescents today are becoming more likely to commit violent crimes. <br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/_cApfbkC20Fs/S8RixXivBUI/AAAAAAAAAe8/tJJzn01TsmQ/s1600/18-mdmba.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/_cApfbkC20Fs/S8RixXivBUI/AAAAAAAAAe8/tJJzn01TsmQ/s320/18-mdmba.jpg" /></a></div><br />
As a physician with an MBA degree, I found this post written by <b>Dr. Joseph Kim</b> useful.<br />
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<a href="http://www.nonclinicaljobs.com/2010/04/mdmba-careers-in-financial-services.html"><span style="font-family: "Trebuchet MS",sans-serif;">MD/MBA career paths in the financial services?</span></a> Would you consider this as an option? <br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RkGbJy-RI/AAAAAAAAAfE/0GbKdMe7MQc/s1600/9-todrinkornot.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8RkGbJy-RI/AAAAAAAAAfE/0GbKdMe7MQc/s320/9-todrinkornot.jpg" /></a></div><br />
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<b>ACP Hospitalist</b> has good advice to give those who go out <a href="http://blog.acphospitalist.org/search/label/medical%20news%20of%20the%20obvious"><span style="font-family: "Trebuchet MS",sans-serif;">drinking alcohol with friends</span></a>.<br />
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<div style="text-align: center;"><i style="color: #ffe599;"><b><span style="font-size: large;">HEALTH CARE POLICIES</span></b></i> - most of these posts discussed </div><div style="text-align: center;">different aspects of the Obama Health Care Reform</div><div style="text-align: center;"><br />
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</div></div><div class="separator" style="clear: both; text-align: center;"></div><div style="text-align: justify;"><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8Rlz8ggEBI/AAAAAAAAAfM/sdOJ6QmJElI/s1600/10-obamaNHS.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8Rlz8ggEBI/AAAAAAAAAfM/sdOJ6QmJElI/s320/10-obamaNHS.jpg" /></a></div><br />
</div>Can health insurers "cherry-pick" patients?<br />
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Read the <b>Cockroach Catcher</b>'s <a href="http://cockroachcatcher.blogspot.com/2010/03/obama-health-nhs-patients-trading.html"><span style="font-family: "Trebuchet MS",sans-serif;">Obama and the NHS: Patients Trading</span></a>.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/_cApfbkC20Fs/S8RzGwY2BkI/AAAAAAAAAf0/el1WJkYJOeg/s1600/13-costcontrol.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/_cApfbkC20Fs/S8RzGwY2BkI/AAAAAAAAAf0/el1WJkYJOeg/s320/13-costcontrol.jpg" /></a></div><br />
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The <b>Health Business Blog</b> tackles one of the main criticisms of Obama's health care reform law --- <a href="http://www.healthbusinessblog.com/?p=3283"><span style="font-family: "Trebuchet MS",sans-serif;">cost control</span></a>. <br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_cApfbkC20Fs/S8Rm52rc-8I/AAAAAAAAAfU/dC6YO_X8Dzc/s1600/6-docobamacare.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S8Rm52rc-8I/AAAAAAAAAfU/dC6YO_X8Dzc/s320/6-docobamacare.jpg" /></a></div><b><br />
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<b>InsureBlog</b> says <a href="http://insureblog.blogspot.com/2010/04/docs-on-record.html"><span style="font-family: "Trebuchet MS",sans-serif;">insurance rates might rise</span></a> and there might be a potential shortage of physicians in the future.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/_cApfbkC20Fs/S8RoSCcsIpI/AAAAAAAAAfc/WSDmmT_YsCg/s1600/11-halfempty.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/_cApfbkC20Fs/S8RoSCcsIpI/AAAAAAAAAfc/WSDmmT_YsCg/s320/11-halfempty.jpg" /></a></div><br />
<b>Chris Langston</b> the majority of today’s health care providers are still fundamentally incompetent in caring for older patients.<br />
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<a href="http://www.jhartfound.org/blog/?p=1503"><span style="font-family: "Trebuchet MS",sans-serif;">Is the glass half-full? </span></a><br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/_cApfbkC20Fs/S8RpFP0YrGI/AAAAAAAAAfk/6xqqsoUwFlY/s1600/21-covercolorado.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/_cApfbkC20Fs/S8RpFP0YrGI/AAAAAAAAAfk/6xqqsoUwFlY/s320/21-covercolorado.jpg" /></a></div><br />
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The <b>Health Insurance Insider</b> ponders on <a href="http://www.healthinsurancecolorado.net/blog1/2010/04/08/expanding-coverage-for-people-with-health-conditions/"><span style="font-family: "Trebuchet MS",sans-serif;">expanding coverage for people with health conditions</span></a>.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RpzsmMHPI/AAAAAAAAAfs/zZKfXG-9LVM/s1600/25-healthreformgalax.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S8RpzsmMHPI/AAAAAAAAAfs/zZKfXG-9LVM/s320/25-healthreformgalax.jpg" /></a></div><br />
<b>Catherine Hess</b>, Senior Program Director at the National Academy for State Health Policy (NASHP), writes in Health Reform Galaxy Blog about her desire to push for <a href="http://rwjfblogs.typepad.com/healthreform/2010/03/todays-post-comes-to-us-from-catherine-hess-senior-program-director-at-the-national-academy-for-state-health-policy-nash.html#more"><span style="font-family: "Trebuchet MS",sans-serif;">kid's enrollment in public insurance programs</span></a>.<br />
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That's all folks. I now bid you good night from Manila, in the Philippines. Happy reading!<br />
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Tune in at the <a href="http://sterileeye.com/"><b>Sterile Eye</b></a> (over in far, far Norway) next week for the next edition of Grand Rounds. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-15405585538987219102010-04-07T11:23:00.000+08:002010-04-07T11:23:09.701+08:00Hosting Grand Rounds Again...<div align="justify"><b style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Medical Grand Rounds</b> will be hosted again here at <i><b>Parallel Universes</b></i> next week, <b>April 13, 2010.</b><br />
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<b>Grand Rounds</b> is a weekly collection of the best health and medical posts made by doctors, nurses, students, patients, and others in the health-related profession.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/_cApfbkC20Fs/S7v6fjC50NI/AAAAAAAAAcM/9M5gWRjRw40/s1600/gr_logo-new.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/_cApfbkC20Fs/S7v6fjC50NI/AAAAAAAAAcM/9M5gWRjRw40/s320/gr_logo-new.jpg" /></a></div>Please submit your post links to <b><span style="font-size: small;"><i style="font-family: Arial,Helvetica,sans-serif;">doc.emer at gmail [dot] com</i></span></b> on or before <b>11:59pm EST of April 12, 2010. </b><br />
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Don't forget to include a <b style="color: #f1c232; font-family: Verdana,sans-serif;"><span style="font-size: large;">brief description</span></b> of what your post is all about. <br />
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Like the veteran <b style="font-family: "Trebuchet MS",sans-serif;"><a href="http://gruntdoc.com/">GruntDoc</a></b>, this edition will have <b style="font-family: "Trebuchet MS",sans-serif;">NO theme</b>. I'd like to think I'm creative, but creativity will show itself once I collate all your submissions and decide how to arrange them. <br />
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Meanwhile, go and visit this week's awesome host, Dave's <b><a href="http://dailymonthly.com/?p=368"><i><span style="font-size: large;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">THE DAILY MONTHLY</span></span></i></a></b>, which hosts <a href="http://dailymonthly.com/?p=368">this week's Grand Rounds</a> and has an excellent collection of health posts relating to nutrition and fitness. I promise you will learn a lot there!</div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-82300914876790747642010-04-06T12:00:00.002+08:002010-04-07T00:12:04.092+08:00What Poor Filipinos Are Eating<div align="justify">Last January 2010, the Social Weather Station (SWS) published the results of a <a href="http://www.sws.org.ph/ind-pov.htm">poll</a> undertaken on the last quarter of 2009. This poll said that the number of Filipino families that claimed to be hungry reached 4.4 million, with 24 percent as the hunger measure. This figure was more than five points higher than at the end of September and worse than the previous record of 23.7 percent in December 2008. <br />
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Government statistics reveal that <a href="http://www.census.gov.ph/data/sectordata/2000/ie00pftx.html">nearly 40 percent</a> of the Philippine population can be considered poor. Additional data say that an average Filipino family composed of 6 members (father, mother, and four children) can survive using only an income of P38.00 a day. That's not even equivalent to 1 US dollar using today's foreign exchange rates. <br />
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What can <b>P38.00</b> buy and what do poor Filipino families really eat?<br />
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Based on my own observations, the poor among us survive by:<br />
<ul><li>eating only ONCE a day; a worse case scenario means eating ONCE every OTHER day</li>
<li> eating rice with salt alone</li>
<li>eating rice with soy sauce alone</li>
<li>eating rice with coffee alone</li>
<li>the 'lucky ones' eat rice with instant noodles which sell around P5.00 - P9.00 per pack, and cooked diluted with plenty of water</li>
<li>the so-called 'clever group' NEVER eats and opts to <a href="http://www.philstar.com/ArticlePrinterFriendly.aspx?articleId=468421">sniff rugby instead</a></li>
</ul>If you analyze it, the poor families get a carbohydrate and salt-riddled diet which is very unhealthy and can result in chronic malnutrition in the long run.<br />
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<center><img src="http://1.bp.blogspot.com/_cApfbkC20Fs/S7q8B58ZWrI/AAAAAAAAAbw/qNW62_ADm3w/s400/nudelabel.jpg" /></center><br />
<div style="text-align: center;"><span style="font-size: x-small;"><b>NUTRITION FACTS on a Noodle Pack</b></span></div><br />
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Those mothers who care for babies are also known to give their babies not the usual pediatric milk formulas (which are very expensive), but cheaper milk brands which are either powdered or in the condensed form and like the cooked noodles diluted to a final product that is wanting in the needed vitamins and minerals a growing baby needs.<br />
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<center><img height="400" src="http://2.bp.blogspot.com/_cApfbkC20Fs/S7rGk-DO-_I/AAAAAAAAAb4/KHXipfBoRag/s400/nudels-a.jpg" width="267" /></center><br />
<div style="text-align: center;"><span style="font-size: x-small;"><b>Feeding the baby: ONE NOODLE at a time</b></span></div></div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-20905481418580810832010-03-18T18:12:00.004+08:002010-03-26T02:52:36.986+08:00Overweight Gordon and Quite Possibly, Gallstone Teodoro<div align="justify"><span style="font-family: arial; font-size: large; font-weight: bold;">Health is never a priority in this country</span><span style="font-size: large;">.</span><br />
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Only <span style="font-weight: bold;">2 out of the 9</span> presidential candidates running for the May 10, 2010 election showed up at the much-publicized health forum sponsored by the Philippine College of Physicians (PCP) last Tuesday evening inside the Medical City hospital.<br />
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<center><img src="http://4.bp.blogspot.com/_cApfbkC20Fs/S6HwvmYyHyI/AAAAAAAAAa4/Wf_Hq47WKh0/s400/gt.jpg" /></center><br />
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Who showed up? <a href="http://en.wikipedia.org/wiki/Richard_Gordon_%28politician%29"><span style="font-weight: bold;">Richard Gordon</span></a> and <a href="http://en.wikipedia.org/wiki/Gilberto_Teodoro"><span style="font-weight: bold;">Gilberto Teodoro</span></a>.<br />
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Doctors were in the audience, and so, it was expected that they will ask about the two candidates' ailments and how fit they are for the top post of the land.<br />
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Gordon complained of <span style="font-weight: bold;">sore throat</span> that time. He said he is <span style="font-weight: bold;">overweight</span> from eating too much food, but had normal blood pressure.<span style="border-bottom: 3px solid rgb(0, 0, 0); border-top: 3px solid rgb(0, 0, 0); float: left; margin: 4px 0pt 4px 4px; padding: 10px; text-align: center; width: 180px;"><span style="color: #fff2cc; font-weight: bold;"><i><span style="font-family: trebuchet ms;">"<span style="font-size: 130%;"><span style="font-size: small;">I’m</span> not worried</span> about anything right now. I’m a little <span style="font-size: 130%;">overweight</span> because of all the eating. When you’re campaigning they feed you everything." Gordon said. He added that his <span style="font-size: 130%;">blood pressure <span style="font-size: 100%;">was</span> normal</span> and that his only problem was his weight.</span></i></span> - <span style="font-size: 85%; font-style: italic;"><a href="http://ph.beta.promo.yahoo.com/purple-thumb/editors-log-article?blogid=editors_log&postid=94&viewPost=1" style="font-family: arial;">Yahoo! News</a></span></span> I do not know if he got away with that kind of reasoning, but doctors know that the relationship between being overweight and blood pressure is linear, and exists throughout even the non-overweight range. An added threat of diabetes also looms around.<br />
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In my opinion, <span style="font-weight: bold;">Gordon should be worried</span> about being overweight.<br />
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Also, to begin with, he did not become overweight because of campaigning. <span style="font-weight: bold;">Even years ago, he looked overweight.</span> He should stop blaming people from overfeeding him during campaign sorties. One can always say 'no' to people. But it seems delicious food is Gordon's waterloo.<br />
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Doctors should have followed up that question to Gordon --- "<span style="font-size: 85%; font-style: italic;">How overweight are you, Senator? What is your present weight?</span>" That way, they would have found out if he was overweight or obese already.<br />
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It is already known that risk estimates from medical reviews suggest that approximately 75 and 65 percent of hypertension in men and women, respectively, are directly attributable to an overweight condition and obesity.<br />
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Teodoro, on the other hand, was <span style="font-weight: bold;">more honest</span> about his health condition. <span style="border-bottom: 3px solid rgb(0, 0, 0); border-top: 3px solid rgb(0, 0, 0); float: left; margin: 4px 0pt 4px 4px; padding: 10px; text-align: center; width: 180px;"><span style="color: #fff2cc; font-weight: bold;"><i><span style="font-family: trebuchet ms;">"<span style="font-size: 130%;"><span style="font-size: 100%;"><span style="font-size: small;">For his part, Teodoro said, "I had the good fortune of inheriting a lot of things from my parents, to include </span><span style="font-size: small;"><span style="font-size: large;">hypertension</span>, and </span><span style="font-size: large;">high blood sugar <span style="font-size: small;">for which I take maintenance medicine every day. Aside from that, aside from a</span> </span><span style="font-size: large;">gall bladder</span> <span style="font-size: small;">that needs to be taken out as soon I have time</span>, I’m okay.</span>"</span></span></i></span><span style="color: #fff2cc;"> </span>- <span style="font-size: 85%; font-style: italic;"><a href="http://ph.beta.promo.yahoo.com/purple-thumb/editors-log-article?blogid=editors_log&postid=94&viewPost=1" style="font-family: arial;">Yahoo! News</a></span></span> He readily admitted that he had inherited familial health problems like <span style="font-weight: bold;">hypertension</span> and <span style="font-weight: bold;">diabetes</span>. He said he was under maintenance medication, and he was doing this religiously.<br />
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Gilberto Teodoro was honest enough. But wait! He downplayed his gallbladder problem.<br />
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He said clearly that he had "<span style="font-size: 85%; font-weight: bold;"><span style="font-style: italic;">a gallbladder that needs to be taken out</span></span>," as soon as he had time for it.<br />
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I bet it was his doctor who suggested that. And it is an advice not heeded well. He said he'll do it once he had time for it. What is this?!? He makes it sound like it was some trivial appointment that can be postponed.<br />
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The most common reason for gallbladder removal or <a href="http://en.wikipedia.org/wiki/Cholecystectomy">cholecystectomy</a>, as surgeons call it, is gallstones. This operation is done when attempts to treat gallstones with ultrasound to shatter them, or medications to dissolve them have all proved to be unsuccessful.<br />
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If his doctor advised it, then <span style="font-weight: bold;">it must be urgent</span>. He could postpone it alright, but he is putting himself at risk. He is probably waiting for that 'gallbladder attack' when he will experience intense and excruciating upper abdominal pains before he has it removed. This campaign is, therefore, harmful to his health.<br />
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On the issue of <span style="font-weight: bold;">curbing overpopulation</span> and the use of <span style="font-weight: bold;">condoms</span>, Teodoro said yes, in addition to providing "<span style="font-size: small;"><i>funding for all modern and natural family planning methods, except abortion</i></span>." Gordon said no, and insisted that "<span style="font-size: small;"><i>not a single peso from the national coffers will be spent to procure condoms and other birth control devices</i></span>." Gordon will instead promote a limit on the number of children a family can have. Preferably only two, according to him. How he will be able to accomplish that without using birth control devices is still puzzling me.<br />
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It would have been a better discussion if the other candidates showed up, especially front runners like <a href="http://en.wikipedia.org/wiki/Noynoy_Aquino"><span style="font-weight: bold;">Aquino</span></a> and <a href="http://en.wikipedia.org/wiki/Manny_Villar"><span style="font-weight: bold;">Villar</span></a>. But they were too busy, I guess. And as I said, health is never a priority in this country. Health becomes important only when they get sick, or a national epidemic is happening. Otherwise, there are far more important things they consider important.</div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-41423816450512410332010-03-16T16:02:00.003+08:002010-03-16T17:01:35.529+08:00No To Magic Sugar<div align="justify">What is magic sugar? Not too many people know what it is.<br /><br /><center><img src="http://1.bp.blogspot.com/_cApfbkC20Fs/S58_y4Jo4MI/AAAAAAAAAaw/760CRrDIU3Y/s400/magicsugar.jpg" /></center><br /><br />What you need to know about it:<br /><ol><li><span style="font-weight: bold;">Magic Sugar is sodium cyclamate</span>. Depending on the concentration, it is an artificial sweetener that is 30 to 50 times sweeter than sugar.</li><li>It is <span style="font-weight: bold;">banned for use</span> in the United States since 1969. It is, however, still used in Europe, and approved as sweetener in more than 55 countries<br /></li><li>Studies have implicated cyclamate in increasing the incidence of <span style="font-weight: bold;">bladder cancer</span> in rats, and a council report has found that it <span style="font-weight: bold;">accelerates the formation of tumors and cancer</span>.</li><li>In dogs, a study has found that it causes <span style="font-weight: bold;">testicular atrophy</span> and <span style="font-weight: bold;">infertility</span>.</li><li>According to Wikipedia, "the <span style="font-weight: bold;">Coca-Cola Company</span> has began using it again for soft drinks such as Coca-Cola Zero or Nestea Light sold in countries where it isn't banned (large parts of South America, Asia, Africa and Europe)."</li><li>In the <span style="font-weight: bold;">Philippines</span>, because it is cheaper and many times sweeter than cane sugar, it is used by sidewalk vendors to sweeten their juice and snack products. Today, Dept. of Health Secretary Esperanza Cabral reiterated calls not to use this artificial sweetener.</li></ol><span style="font-weight: bold;">Sources:</span><span style="font-family: arial;"> </span><span style="font-size:85%;"><span style="font-style: italic; font-family: arial;">Wikipedia</span><span style="font-family: arial;"> -</span><a style="font-family: arial;" href="http://en.wikipedia.org/wiki/Sodium_cyclamate"> Sodium Cyclamate</a><br /><span style="font-family: arial;"> </span><span style="font-style: italic; font-family: arial;">Inquirer.net</span><span style="font-family: arial;"> - </span><a style="font-family: arial;" href="http://newsinfo.inquirer.net/breakingnews/regions/view/20100316-259028/Dont-use-magic-sugarhealth-chief">Don't Use Magic Sugar -- Health Chief</a></span><br /></div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-31301024998259806942010-03-15T00:41:00.002+08:002010-03-15T01:19:07.176+08:00New Clopidogrel (Plavix™) Warning<img src="http://1.bp.blogspot.com/_cApfbkC20Fs/S50Q6dagG-I/AAAAAAAAAao/OzUEK5Sf458/s400/plavix1.jpg" align="left" /><div align="justify">In the US, the FDA has added a warning to those patients taking <a href="http://en.wikipedia.org/wiki/Clopidogrel"><span style="font-weight: bold;">clopidogrel</span></a>, a widely-prescribed anti-blood clotting medication.<br /><br />There is a subset of patients who are <span style="font-weight: bold;">poor metabolizers</span> of the drug. Because of this, these patients are not getting the full benefits of the medication. This particular group of patients have <span style="font-weight: bold;">low CYP2C19 enzyme activity</span> in their livers, which is necessary to convert clopidogrel into an active form which can prevent blood clotting.<br /><br />In the US, there is <span style="font-weight: bold;">a test available</span> to detect if a patient has low or sufficient CYP2C19 enzyme activity. In the Philippines, however, I am not to sure. Even if it were available, I am certain it would be expensive.<br /><br />The possible solution of dosage adjustment is met with the obstacle of identifying first this subset of patients who are poor metabolizers of clopidogrel. Also, an appropriate dose regimen for poor metabolizers <span style="font-weight: bold;">has not been established yet</span> in any clinical outcome trials.<br /><br />The <span style="font-weight: bold;">best option</span> patients have is still to consult with their respective physicians. A possible shift to other anti-blood clotting medications maybe necessary.<br /><br />More information can be found <a href="http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm203888.htm"><span style="font-weight: bold;">here</span></a>. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-19881069726512239322010-03-10T14:41:00.004+08:002010-03-10T15:01:18.241+08:00Wine, Women, Weight<div align="justify"><img src="http://4.bp.blogspot.com/_cApfbkC20Fs/S5dAXDMyHuI/AAAAAAAAAag/cU_tm4P_bVI/s320/wine.jpg" align="left" />A <a href="http://archinte.ama-assn.org/cgi/content/short/170/5/453?home">prospective study</a> published in this week's <span style="font-style: italic;">Archives of Internal Medicine</span> involving nearly 20,000 women showed the opposite of what might be expected from drinking wine.<br /><br />The researchers concluded that, "compared with nondrinkers, initially normal-weight women who consumed a <span style="font-weight: bold;">light to moderate amount of alcohol</span> gained less weight and had a l<span style="font-weight: bold;">ower risk</span> of becoming overweight and/or obese during 12.9 years of follow-up."<br /><br />The key words there might be "<span style="font-weight: bold;">light-to-moderate amount of alcohol</span>."<br /><br />A half-filled wine-glass before going to bed might fall into that classification. Red wine is the preferred choice, but beer, white wine, and other spirits were also shown to provide the same result.<br /><br />I can also add the added perk of a good night sleep after drinking that shot of red wine at night. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-35946606082210390502010-01-20T16:40:00.001+08:002010-01-22T01:32:40.195+08:00SDS + NaOH = Effective Disinfectant<div align="justify">'Definitely many times better than rubbing alcohol.<br /><br />Researchers in Berlin, Germany have come up with a simple disinfectant that is effective against bacteria (including the tuberculosis-causing mycobacteria), fungal spores, non-enveloped viruses (includes the common cold, wart, and hepatitis A viruses) and prions.<br /><br />The effective formulation is a mixture of <span style="font-size:130%;"><span style="font-weight: bold;font-family:trebuchet ms;" >0.2% SDS and 0.3% NaOH in 20% n-propanol</span></span>.<br /><br /><span style="font-weight: bold;font-size:130%;" >SDS</span> is <a href="http://en.wikipedia.org/wiki/Sodium_lauryl_sulfate">sodium dodecyl sulfate</a>, a known surfactant already used in cleaning and hygiene products.<br /><br /><span style="font-weight: bold;font-size:130%;" >NaOH</span> is <a href="http://en.wikipedia.org/wiki/Sodium_hydroxide">sodium hydroxide</a>, a chemical most science students know about in their chemistry experiments. It is also known as lye or caustic soda.<br /><br /><span style="font-weight: bold;font-size:130%;" >n-Propanol</span> is an <a href="http://en.wikipedia.org/wiki/Propan-1-ol">alcohol</a> commonly used as a solvent in the pharmaceutical industry.<br /><br />According to the researchers, these chemicals are inexpensive, simple to prepare, and were found to be effective in eliminating infectious agents in 20 minutes or less of exposure. With the never-ending onslaught of infections in our daily lives, this is certainly a welcome development.<br /><br /><span style="font-family: trebuchet ms; font-weight: bold;font-size:85%;" >SOURCE: Journal of General Virology 91 (2010), <a href="http://vir.sgmjournals.org/cgi/content/full/91/2/580">580-589</a> </span></div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-33911272210297003052009-09-11T12:56:00.002+08:002009-09-11T13:41:23.993+08:00Gardasil HPV Vaccine For Boys?<div align="justify">The drug company manufacturing <a href="http://en.wikipedia.org/wiki/Gardasil">Gardasil</a>, the popular vaccine known to prevent cervical cancer in women, has recently presented a study that Gardasil has also been shown to prevent genital warts in boys.<br /><br />Thus, the idea of vaccinating boys with Gardasil is now being suggested. CBS' morning newscast carried the story below:<br /><br /><center><object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/1vugiwXXzpQ&color1=0xb1b1b1&color2=0xcfcfcf&feature=player_embedded&fs=1"></param><param name="allowFullScreen" value="true"></param><param name="allowScriptAccess" value="always"></param><embed src="http://www.youtube.com/v/1vugiwXXzpQ&color1=0xb1b1b1&color2=0xcfcfcf&feature=player_embedded&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" allowScriptAccess="always" width="425" height="344"></embed></object></center><br /><br />In the US, 3 doses of Gardasil cost US $390 or about P18,877.06 in Philippine pesos using current exchange rates. Because it is expensive, only the well-to-do can afford it here. <br /><br />But is that a good idea?<br /><br />I think so. Vaccinating both boys and girls might be the key to bring down overall incidence rates of cervical cancer in the future. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-63957841659556738992009-08-06T11:50:00.002+08:002009-08-06T12:17:15.625+08:00Men With Healthy Sperms Live Longer<div align="justify"> <img src="http://s213.photobucket.com/albums/cc99/bmeets/sperm.jpg" align="left" />You might doubt if there's a connection between healthy sperms and longer life spans among men, but a study among Danish men suggests a link.<br /><br />"No matter what you look at, the risk of dying is decreased if you have a good semen quality compared to low; the poorer the semen quality, the higher the risk of dying."<br /><br />That is what one of the researchers involved in the study said.<br /><blockquote><br /><br /><br /><span style="font-size:130%;"><span style="font-family: trebuchet ms;">To test the hypothesis that semen quality might therefore be related to illness and death, the researchers looked at men who had been referred to the <span style="font-weight: bold;">Copenhagen Sperm Analysis Laboratory</span> between 1963 and 2001, following them through the end of 2001 or until they died. They restricted their analysis to <span style="font-weight: bold;">43,277 men with viable sperm </span>in their semen.</span><br /><br /><span style="font-family: trebuchet ms;">As the concentration of sperm in the men's semen increased, so did their lifespan, the researchers found. Men whose sperm concentration was 40 million per milliliter were <span style="font-weight: bold;">40% less likely to die</span> during the course of the study than men with sperm concentrations below 10 million per milliliter.</span><br /><br /><span style="font-family: trebuchet ms;">Longevity also rose steadily with the percentage of a man's sperm that were "<span style="font-weight: bold;">motile</span>," meaning they moved around normally; and the percentage of normally formed sperm. For example, <span style="font-weight: bold;">men with 75% or more normal sperm had a 54% lower risk of dying</span> than men who had less than 25% normal sperm. <span style="font-size:85%;"><span style="font-family: arial;">~ </span></span></span><span style="font-size:85%;"><a style="font-family: arial;" href="http://www.reuters.com/article/healthNews/idUSTRE5746LR20090806"><span style="font-weight: bold;">Reuters</span></a><span style="font-family: arial;">, 5 Aug 2009</span></span><br /></span></blockquote><br />Another 0bservation made in the same study is that men "who had fathered children <span style="font-weight:bold;">lived longer</span> than childless men." Fertility has its rewards.<br /><br />This seems to be true. In the Philippines, famous personalities like <a href="http://en.wikipedia.org/wiki/Dolphy">Dolphy</a>, <a href="http://en.wikipedia.org/wiki/Ramon_Revilla,_Sr.">Ramon Revilla, Sr.</a>, and even former <a href="http://en.wikipedia.org/wiki/Joseph_Estrada">President Joseph Estrada</a>, who are all known to have fathered several children outside of their respective marital relations, are all still alive and kicking today. They might have been sick or suffered from stroke attacks in the past, but their recovery periods are commendable compared to men belonging to similar age brackets.<br /><br />But this new finding shouldn't be misconstrued as evidence to support men's hidden desires to father children out of their marriages. No, sir. I think men can still have more children with their wives, and well within the context of a monogamous relationship. Besides, I still think the mindset to have more children outside of marriage is culture-driven. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-47604753391343330102009-08-06T01:25:00.003+08:002009-08-06T02:00:38.074+08:00Dementia and High Cholesterol Levels<div align="justify">What is your current cholesterol level? Did you ever bother to find out?<br /><br />A recent study suggests that cholesterol may not only play a role in cardiovascular diseases and hypertension, but also in developing dementia.<br /><blockquote><span style="font-size:130%;"><span style="font-weight: bold;font-family:trebuchet ms;" >High cholesterol levels in midlife</span><span style="font-family:trebuchet ms;"> --- even cholesterol levels considered only borderline elevated --- significantly increases the risk of A<span style="font-weight: bold;">lzheimer's disease</span> 30 years later, results of a large study indicate.</span><br /><br /><span style="font-family:trebuchet ms;">"This is the first study, to our knowledge, to show that not only high cholesterol, but also <span style="font-weight: bold;">borderline high cholesterol</span>, is associated with dementia," Dr. Rachel Whitmer, the study's senior author, noted in a telephone interview with Reuters Health.</span><br /><br /><span style="font-family:trebuchet ms;">Compared to people with "desirable" cholesterol levels below 200 milligrams per deciliter of blood (mg/dL) in midlife, the risk of Alzheimer's disease three decades later was <span style="font-weight: bold;">57 percent higher</span> in people with high midlife cholesterol levels of 240 mg/dL and above.</span></span> ~ <span style="font-size:85%;"><a style="font-family: arial;" href="http://www.reuters.com/article/healthNews/idUSTRE57447520090805"><span style="font-weight: bold;">Reuters</span></a><span style="font-family:arial;">, 5 August 2009</span></span></blockquote><br />Most of my patients have borderline to high cholesterol levels. There are only a few who manage to keep their cholesterol levels below 200mg/dL, and this, I think, is not only because of diet restrictions but due to their statin medications.<br /><br />The same study also stated that "<span style="font-style: italic;">midlife borderline high cholesterol increased the risk of vascular dementia by 50 percent</span>." I think that is a clear warning and a definite eye-opener. Fifty percent is a high number.<br /><br />To my knowledge, I think this is the first study to link dementia with dietary considerations. Dementia is said to be both a degenerative and genetic consequence. If it can also be influenced by lifestyle modifications, then, this must be <span style="font-weight: bold;">good news</span> on the preventive aspect. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-54404991879334394202009-07-28T13:03:00.000+08:002009-07-28T15:20:25.572+08:00Cheaper Philippine Meds: EO 821 Signed!<center><img src="http://s213.photobucket.com/albums/cc99/bmeets/eo821.jpg" /></center><div style="text-align: center;"><a href="http://newsinfo.inquirer.net/breakingnews/nation/view/20090728-217615/Arroyo-cuts-cost-of-essential-meds-by-50"><span style="font-size:78%;"><span style="font-family: arial;">Inquirer.net, 28 July 2009</span></span></a><br /></div><br /><div align="justify">Some questions linger:<br /><ol><li><span style="font-weight: bold; font-family: arial; color: rgb(204, 0, 0);">Why are only 5 essential medicines included when the original recommendation by the Department of Health (DOH) was more than 20?</span> Only these 5 medicines are included --- "the anti-hypertensive <span style="font-style: italic;">amlodipine</span> (including its S-isomer and all salt form); the anti-cholesterol <span style="font-style: italic;">atorvastatin</span>; the antibiotic/antibacterial <span style="font-style: italic;">azithromycin</span> (and all its salt form); and the anti-neoplastics/anti-cancer <span style="font-style: italic;">cytarabine</span> and <span style="font-style: italic;">doxorubicin</span> (and all its salt form)."</li><li><span style="font-family: arial; font-weight: bold; color: rgb(204, 0, 0);">Why still wait this long ?</span> Executive Order 821 takes effect on August 15, 2009. Meanwhile, chronically-ill patients whose survival depend on these medicines will bear the unnecessary risk of becoming worse or dying.<br /></li></ol></div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-36941712798877580252009-07-21T12:44:00.002+08:002009-07-21T18:03:22.875+08:00Mothers Who Spank Their Children<div align="justify"><blockquote><span style="font-size:130%;">Moms who suffered physical abuse or other violent experiences in childhood are much more likely to spank their infants than moms who did not suffer these adverse childhood experiences, results of a new study indicate.<br /><br />This study provides more evidence that a mother's past experiences in her own childhood have a "huge impact on how she approaches her own children," Dr. Esther K. Chung from Jefferson Pediatrics/duPont Children's Health Program in Philadelphia told Reuters Health.<br /><br />Among a group of 1265 mostly black, single, low-income mothers of infants up to 11 months old, Chung and colleagues discovered that 19% said they "valued" corporal punishment as a means of discipline and 14% reported spanking their infants.<br /><br />"We were pretty surprised, actually, to find the high prevalence of infant spanking because, on average, the children were about 9 months old and to think that children that young are being hit is disturbing," Chung said.<br /><span style="font-size:85%;">~</span> <span style="font-size:85%;"><a style="font-family: arial;" href="http://www.reuters.com/article/healthNews/idUSTRE56J5GD20090720"><span style="font-weight: bold;">Reuters</span></a><span style="font-family: arial;">, 20 July 2009</span></span></span></blockquote><br />In the Philippines, spanking of children is still practiced, not only by parents, but some school teachers, especially in rural areas. They believe that a child that has been spanked will grow up to be a more disciplined person.<br /><br />Yes, it is true that most of these mothers were also spanked when they were kids. Spanking of children has a deep cultural history here.<br /><br />The reasoning is that if it worked for the parents, then it must work for the kids also.<br /><br />Kids who grow up with little corporal punishment are somewhat frowned upon by the elders, especially if they end up as bad adults. 'Bad adults' is a subjective description, of course. In this day and age of child abuse, however, the mindset is gradually changing. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-26663162509187899752009-07-18T10:46:00.007+08:002009-07-18T11:31:30.296+08:00Why Medicines in the Philippines are Expensive<div align="justify">A doctor-congressman has another insightful explanation on why prescription drugs in the Philippines remain unaffordable.<br /><br />He pinpoints <a href="https://www.mercurydrug.com/index.html"><span style="font-size:130%;">Mercury Drug</span></a>, the country's biggest pharmacy, as the culprit.<br /><br /><center><img src="http://s213.photobucket.com/albums/cc99/bmeets/mdrug.jpg" /></center><div style="text-align: center;"><span style="font-size:85%;"><span style="font-weight: bold;font-family:arial;" >SOURCE:</span></span><span><span style="font-size:85%;"><span style="font-weight: bold;font-family:arial;" > </span></span><a href="http://newsinfo.inquirer.net/inquirerheadlines/nation/view/20090718-216043/No-compromise-on-price-cap-of-21-drugsPalace"><span style="font-size:85%;"><span style="font-weight: bold;font-family:arial;" >I</span></span></a></span><a href="http://newsinfo.inquirer.net/inquirerheadlines/nation/view/20090718-216043/No-compromise-on-price-cap-of-21-drugsPalace"><span style="font-size:85%;"><span style="font-weight: bold;font-family:arial;" >nquirer.net, 18 July 2009</span></span><br /></a></div><br />With profits of <span style="font-weight: bold;">over a billion pesos</span> every year, it is not difficult to see that Biron has a point to isolate Mercury Drug as a major factor in this perennial problem. Can they cut their profit margins to the levels of Thailand and India?<br /><br />Mercury Drug offers weekly discounts on select products, none of which have been in the prescriptive category. And, even if they did offer discounts, these are <span style="font-weight: bold;">piecemeal</span> only.<br /><br />The pharmacy giant even has a rewards program in the form of "<span style="font-style: italic;">Suki cards</span>," which hardly benefit majority of its customers. Mercury's only claim to public service rests in its age-old marketing tagline that states, "<span style="font-style: italic; font-weight: bold;">nakakasiguro, gamot ay laging bago</span> [<span style="font-style: italic;">Translation</span> - we assure everyone that our medicines are always new!]<br /><br />Maybe it is time the lawmakers also look at the possibility of drafting laws to address the pricing policies of Mercury Drug Corporation.<br /><br />Meanwhile, <a href="http://newsinfo.inquirer.net/inquirerheadlines/nation/view/20090718-216043/No-compromise-on-price-cap-of-21-drugsPalace"><span style="font-weight: bold;">today</span></a> is the deadline the President gave drug companies to voluntarily cut their prices by 50 percent. If not, she will sign an Executive Order forcing them to do so.<br /><br />Will Arroyo sign such an instrument? With the State of the Nation Address a mere number of days away, there is strong possibility she will.<br /><br />The days of cheaper medicines are coming?<br /><br />Let's hope so.</div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-37085574136585783742009-07-14T17:14:00.003+08:002009-07-14T17:26:53.084+08:00Wanted: (A)H1N1 Vaccine<div align="justify">Even the World Health Organization is pleading that an (A)H1N1 flu vaccine be developed at the soonest possible time, possibly before autumn or winter begins this year.<br /><br />WHO also said that nurses, doctors, and health workers should be vaccinated first. Then, all the rest of the people in all countries should get it.<br /><br /><center><a href="http://www.reuters.com/article/healthNews/idUSTRE56C60820090714"><img src="http://s213.photobucket.com/albums/cc99/bmeets/h1ni-unstp.jpg"></a></center><br /><br />I also think developing countries should get a discount from drug companies who will develop the said vaccine. Not everyone can afford this vaccine for sure.<br /><br />Vaccine developers need not worry about their profit margins when giving a discount. With the whole planet as customer, this vaccine will certainly be a bestseller. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-36753287982630986962009-07-13T06:08:00.001+08:002009-07-13T07:16:09.548+08:00Swearing is Therapeutic<div align="justify">Swearing, cussing, cursing, or saying the unutterables makes you feel good. It appears it is a potent psychological analgesic.<br /><br /><center><img src="http://s213.photobucket.com/albums/cc99/bmeets/fukc.jpg"></center><br /><br />So, when you feel like doing it, go!!! @%$*&#!!!!<br /><br />Better to blaspheme and let the expletives explode that than die of a heart attack later on. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-11600466091683981282009-07-11T06:02:00.000+08:002009-07-11T09:02:13.684+08:00Obesity + (A)H1N1 = Probable ICU Confinement<div align="justify">Obesity is developing to be a risk for poor prognosis for patients with (A)H1N1.<br /><br /><center><img src="http://s213.photobucket.com/albums/cc99/bmeets/h1n1-obese.jpg"></center><br /><br />More fat means more work for the respiratory muscles, and with (A)H1N1, respiration has to be efficient in order to survive. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-43408557880948306352009-07-08T14:22:00.003+08:002009-07-08T17:45:44.319+08:00Reduce Colon Cancer Risk<div align="justify">Colon cancer is a disease of lifestyle.<br /><br /><center><img src="http://s213.photobucket.com/albums/cc99/bmeets/colon.jpg"></center><br /><br />Consume less or stop eating red and processed meats --- hams, hotdogs, bacon, even those <a href="http://en.wikipedia.org/wiki/Tocino"><span style="font-style:italic;">tocinos</span></a> you love to eat for breakfast.<br /><br />Stop smoking. I have emphasized that over and over.<br /><br />Exercise more. Movement has many benefits. It also decreases both your diabetes and obesity risks. <br /><br />Former President <a href="http://en.wikipedia.org/wiki/Corazon_Aquino"><span style="font-weight:bold;">Corazon Aquino</span></a> is now battling colon cancer. The health tips above are a bit too late for her, but not for most people reading this.<br /><br />Reduce your colon cancer risk; lifestyle modification is still the best cure. </div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.comtag:blogger.com,1999:blog-6397704.post-12274494098054667742009-07-03T13:53:00.002+08:002009-07-06T22:21:51.688+08:00Gloria Arroyo's Self-Quarantine?<div align="justify">Truly, everything is not what it seems.<br /><br />It is just a cover for pending <span style="font-weight: bold;">cosmetic</span> and <span style="font-weight: bold;">gynecologic</span> medical concerns. President Gloria Arroyo is probably making good use of her self-imposed quarantine. I wonder if other members of her delegation are also doing the same.<br /><br /><center><img src="http://s213.photobucket.com/albums/cc99/bmeets/gma-h1n1.jpg" /></center><br /><br />Currently, the Philippines has <span style="font-weight: bold;">nearly 2,000</span> (A)H1N1 cases, majority of whom have recovered (the good news).<br /><br />___________________<br /><br /><span style="font-weight: bold;font-family:arial;font-size:180%;" >UPDATE on 06 July 2009:</span> The problem with telling lies is that later on, you might have to tell the truth. "Chief talker" is Cerge Remonde, the president's spokesperson.<br /><br /><center><img src="http://s213.photobucket.com/albums/cc99/bmeets/gma-q3.jpg" /> </center></div>Dr. Emerhttp://www.blogger.com/profile/02407128557937763280noreply@blogger.com