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Showing posts from January, 2014

Can the doctor really understand the patient's pain?

I have always wondered whether a physician can really understand the condition of the patient unless the doctor himself (or herself) has experienced it. I haven't had a headache, so I don't really know what it feels like to have a headache. Sometimes, I say it gives me a headache and I don't really mean that, it is just a matter of saying. Is the doctor's knowledge bookish? Different patients may have different levels of tolerance to the pain. How do you exactly quantify the level of pain? Shooting pain, stabbing pain, throbbing pain.. What do these things really mean? Health is of course much more than pain related. Blood pressure may be asymptomatic. You may not feel a thing but you could be sick. It looks like a doctor's job is enormously complicated.

If you get dengue fever once, are you protected from subsequent infection?

Not necessarily! There are several serotypes. The fifth serotype was discovered in 2013. " While they are all closely related to each other, infection with one serotype only offers limited and temporary immunity against other serotypes. In fact, multiple infections with different types of dengue increase the risk of severe dengue infections such as dengue hemorrhagic fever and dengue shock syndrome. - See more at: http://healthmap.org/site/diseasedaily/article/fifth-dengue-serotype-discovered-102513#sthash.2hf8yqoI.dpuf" If you had the first infection with DENV-1 and later got the second infection with DENV-2, the antibodies you generate will bind to the virus DENV-2 but cannot prevent infection. Dengue can be extremely debilitating. There is no vaccine or cure for dengue at this time.

Most damage in viral infections is caused by not the virus but by you!

There are very few viruses that cause tissue damage. These are called cytolytic viruses. Most viruses are non-cytolytic. Clinical symptoms of viral disease (fever, aches, pains, nausea, malaise) are caused by our immune system's response to infection. This is why immunopathoplogy is called too much of a good thing. An enteroviral infection, and in particular to coxsackievirus B3, can cause extensive heart tissue damage (myocarditis) requiring heart transplant.  The heart tissue damage is caused by CTLs in our immune system (CTL is CD8 T  lymphocytes ). Perforin is a cytolytic protein found in CTLs and NK cells (natural killer cells), Mice  that have perforin knockout gene show no heart damage when  infected with Coxsackie B3.  Herpes stromal keratitis most common cause of blindness in developed countries is also mediated by CD4+ Th1 cells. In this case virus replicates in corneal epithelium but that is not the cause of the disease. The disease is caused by CD4+ Th1 which

Don't hit too hard on the keyboard!

I cannot think of humans in the previous centuries (>1000 years ago) hitting something constantly like we do on computer keyboards. Evolutionary response takes tens of thousands of years, so obviously we are not equipped to pound the keyboard and not suffer the consequences. I have a bad habit of hitting the keyboard harder than it needs to be and occasionally my fingers hurt. I have to remind myself to make it soft and use switch fingers (I am not a typist). Whenever we do something that requires applying force or (really, impulse) on parts of body due to technological changes, ask yourself, did my ancestors in may be a different activity have similar force/impulse on the same part of the body? If the answer is no, most likely you are not properly equipped to continue practice. Anyway, even after another ten thousand years, we won't be equipped to hit the keyboards hard since that type of activity is not going to affect "fitness" (in terms of being able to reprod

Transgenerational Epigenetic Inheritance

Epigenetics is a sexy subject for those who are not doing research on epigenetics. One thing I learned in a recent MOOC course I took on Epigenetics is there is no clear evidence of epigenetic changes passed on to offspring through gametes in humans. Epigenome is completely wiped out and reprogrammed during sensitive periods (primordial germ cell development and pre- and post-implantation periods). If you do see transgenerational epigenetic “inheritance” you must ask (a) are they transmitted transgenerationally, i.e., via gametes, or (b) brought about by mothering style, placenta alteration, newborn nutrition, etc. People (particularly, science journalists) are eager to claim true epigenetic inheritance through gametes referring to dutch famine, Overkalix, etc. However, subsequent careful studies did not indicate transgenerational effect of the famine. It is surprising that it is epigeneticists that caution about making sexy claims in epigenome inheritance. Others seem to liber

My memory and clarity of mind

I used to have memory problems years ago. Now I don't. I hardly forget things now. I may not necessarily take action on things I remember, but I don't forget them. I still have one problem; I don't listen well. But I have improved in this area also. This is my new year resolution. Listen well. I don't know what caused my memory to improve. It could be one or more of the following. Started lots of online (MOOC) courses a little over a year ago. I have done 25 courses so far. This has been a lot of exercise to my brain. I am still continuing this.  I started Bikram yoga about a year ago. This has improved my strength. Yoga requires a lot of mental concentration, being very still in poses and out of poses, focus on breathing. My Mercer county college teaching. This is not a recent activity, I have been doing this for almost 18 years now. But it does require a lot of preparation and work to my brain. It may be that these days I feel I don't need to remember muc

Irrational happiness

Happiness is a strange thing. I remember, when I was in 10th grade, I lived with my uncle. One of my chores was to bike to the milk dairy and bring a bottle of milk. One day, I was a little bit late. When I reached the dairy there was a huge line. On many days milk runs out and I was doubtful if I would get milk. When I reached the counter there was just one bottle left and I got milk! I have never felt so much happiness, all that hard work to get there biking six miles each way notwithstanding. Incredible happiness for a bottle of milk?! If I didn't have milk, no coffee for the entire day for anyone at home. My uncle and aunt would be unhappy. My nephew and nieces would taunt me for getting up late. Happiness, I guess, is because I avoided all this potential unhappiness. In my place, the town collects recycling stuff every two weeks. One time, I didn't put it out for recycling. A lot had collected. I was very unhappy? Should I be unhappy? It would get collected in two we

Sam Berns who died due to progeria at age 17

Progeria is a genetic condition that accelerates aging. Sam's philosophy for a happy life: 1. Be OK with what you ultimately can't do, because there is so much you CAN do. 2. Surround yourself with people you want to be around. 3. Keep moving forward. [4. Never miss a party if you can help it.] Watch  http://www.youtube.com/watch?v=36m1o-tM05g

100 years old - still working as a teacher!

(Ref.  http://www.nj.com/education/2014/01/oldest_american_teacher_celebrates_100th_birthday_with_students_at_sundance_school.html ) Agnes Zhelesnik  is 100 years.  She joined Sundance school in North Plainfield, New Jersey when she was 81 as a home economics teacher and still continues to teach there. She has no plans of retiring. She teaches  cooking, sewing,  knitting and crocheting to  pre-K through Grade 5. Zhelesnik  has hardly missed a day, she had a little trouble one week in the last 20 years! She goes to school with her daughter who also teaches at the school (see them in the photo above). Watch  http://www.cbsnews.com/videos/americas-oldest-teacher-still-thriving-as-she-turns-100/

Which MOOC companies are best?

I am generalizing it based on my experience so far. There three companies. Coursera (coursera.org) EdX (edx.org) Udacity I have never taked a MOOC from Udacity. The reason I took Coursera and EdX courses is they mimic the regular university courses. They start and end on specific days, there are homeworks, quizzes, exams, etc. just like in college courses. I like this discipline. There are grades and one may or may not be able to earn a certificate. Most courses just give pass/fail (if fail, you don't get a certificate). Few courses do offer certificate with distinction. Coursera, currently, offers lot more courses than EdX. But EdX is catching up. You have a bigger choice of subjects with Coursera currently. In terms of standards and quality, both are far superior to colleges I have attended. But, in general, at least so far, EdX courses have lot more rigor and higher quality professors. Two toughest and highest quality MOOC courses I have taken so far are both EdX c

Why did chikungunya spread to India from Africa?

Chikungunya is caused bu chikungunya virus. This virus and disease were primarily confined to African countries transmitted to humans by a mosquito called Aedes aegypti. There was amino acid change due to mutation in  viral glycoprotein which made it possible to be spread a new mosquito species called A.albopictus. Now it is Africa, Asia, Europe, and Australia. The virus has been located also in US though cases of chikungunya is not yet prevalent.

Our skin - largest organ - outer layer is dead!

Our skin is the largest organ in the body. The outermost layer is dead cells. So, we are pretty much dead outside. This provides the protection against viruses that are abundant in the air. The skin also has anti-microbial peptides made by our cells and bacteria. Skin is not perfect, we could still get infection through mosquito or animal bites, scratching, injuries. There are mucosal surfaces like respiratory tract, alimentary, urogenital tracts. These have epitheleal living cells that are suceptible to viral entry. We cannot seal these tracts with concrete because we need to breathe and eat to live. We take in 6 litres of air per minute. However, we have pretty good defenses. The epitheleal cells are covered with mucous which traps viruses. We make 20 to 200 ml of mucous per day in the respiratory tract. The virus particles trapped in mucous get swallowed through ciliary action. This happens 30 times per hour.

How does vaccination work?

I copied the following from  http://academy.asm.org/images/stories/documents/Flu_web.pdf "Whenever you are infected by a pathogen, your immune system generates compounds called antibodies that bind to the infectious agent and target it for destruction. After the infection is cured, a few of the white blood cells that make those specific antibodies continue to circulate in your blood. Called “memory cells”, these cells are quickly activated if the same infectious agent attacks you again, preventing the infectious agent from establishing itself and preventing you from getting sick. That is why vaccination works: a vaccine presents the immune system with a harmless form of an infectious agent so that if you are infected by the real thing, your immune system will be primed to destroy it quickly" However, "...the last year’s flu victims will  not have immunity if they encounter a different subtype  or strain this year."

January Focus MOOCs

My new MOOCs are starting one after another after year end holidays. I always sign up for more than I can handle and eventually drop a few. I did some analysis and decided to basically focus in January on the following MOOC activities. 1. Finish up the classical mechanics final exam (starting tomorrow). Prepared intensely for this for more than two weeks. Really anxious about this. 2. Take the following two new MOOCs seriously a. Virology 2: How viruses cause disease? (Columbia U) b. Economics with Calculus (Caltech) 1/11/14 Update: Finished MIT's Classical Mechanics Final. Got 100%! I was a little bit apprehensive after Exam3 which was brutal. Prepared really hard. Feel so comfortable now with drawing free body diagrams, formulating and solving equations of motion for harmonic oscillations, mass-spring motion, angular momentum, all types of Newtonian dynamics.  Achieved 95% overall to satisfy for A in the course. This was the hardest course but also most satisfying among

Body, Mind, and Consciousness

The question is who is "me?" We often identify our body and mind with self. First, is mind different from body? Mind, I would say, is part of the body. After all, what is mind? It is amalgamation of thoughts, past and present aided by memory. The memory is physical space that stores information just as in a computer. Thoughts are the result of electrochemical interactions in the body. So thoughts and the mind are just manifestations of bodily processes. If we accept mind as part of the physical body, is there something else that I could characterize as real "me"? Some people may call it the soul. I want to call it the consciousness. Have you noticed the noun "consciousness" doesn't have the plural. Is it an omission on the part of grammarians or is consciousness really universal and a single entity? I would think the latter. So, your consciousness is the same as my consciousness. I would contend the real me is my consciousness. So, I am you and

Second double - not so sweet!

I did the second double 8 am and 10 am again. Unlike the previous one on 12/29/13, this one was hard! I should have eaten a fruit or something before. With the previous one I had eaten some fruit before and took a couple of oranges to eat in between. I sat out several postures and felt terribly tired after the second one. Well, you learn from your mistakes.

Bikram after 2 hours of shoveling snow and yoga right after made yoga easier!

Last night there was heavy snow still snowing hard when I woke up in the morning. Spent two hours shoveling snow, thought I would be tired for 9:30am Bikram. I was pleasantly surprised in Meredith's class. My legs felt stronger and less shaky in the balancing series. Perhaps I should run or do treadmill before yoga.  Perhaps one could ask why do we need strength in this modern age when we don't have to hunt or run f rom predators. The strength sure made all the shoveling a breeze. I marvel at the strength I have built up in the months of Bikram yoga when I carry easily the grocery bags all at once from the car inside. Besides carrying groceries, strength, more importantly, makes you preserve and improve muscle mass even as we age, we won't fatigue as easily, chronic conditions such as back pain disappear.

Recovery after Strenuous exercise

When I started Bikram yoga almost a year ago on Jan 6th 2013, I would feel tired, body aching, knees or some part of the body in intense pain for hours. People would tell me may be I shouldn't do yoga everyday but give the body a break between yoga days so it would do the necessary repair and regeneration. I ignored these advises and just continued my Bikram practice everyday non-stop (except for the time when I went India for a month - even there I went to Pathanjali Yoga). After many months now, my body has adjusted to my schedule and can deal with whatever repairs are needed. The body should be subservient to me, not the other way around. If the body tells me it needs 48 hours for all the repair between workouts, I tell the body "listen pal, I ain't giving you 48 hours. 24. Do it in 24." Some yoga instructors tell "listen to your body." Jess, my yoga instructor says, "if I listened to my body, I would still be on the couch." Even in a 90-