All posts by medicinerevisited

Welcome to a New Medicine Website!

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This is a new medicine website that critically reviews all aspects of medicine on an ongoing basis, provides basic and important information for the public and experts. This is not a website, just repeating the current knowledge in different disciplines of medicine, but critically reviews the shortcomings with proposals for revisions in the medical diagnostics, treatment, prevention and suggestions for the future research in each topic. Unfortunately medicine that has been in existence since the antiquity, it has not evolved as much a the other field of science, perhaps for not being profitable for capitalism to invest sufficiently in the health of their people as much as other industries. Hopefully this website along others as such would open the path to the future of medicine, where prevention of diseases will be the primary agenda so humans can enjoy the best of health and not being the subjects of profit making for entrepreneurs, hence fulfill the Hippocratic oath “preserve the purity of my life and my arts.”!

Throughout the history, humans have been able to discover and invent mainly through right questioning and critic, that is the purpose of this website.  Whenever we have followed an idea or belief rigidly, then we were stuck in dogma and any progress had stagnated,like many centuries of dark ages before the scientific revolution.  Through right questioning and critic of our current knowledge in medicine, this site will revisit the field and will attempt to bring on new perspectives on different medical conditions. 

Dr. Mostafa Showraki, MD, FRCPC                                                                       Lecturer, School of Medicine, University of Toronto                                        Author: ADHD:Revisited Book Adhdrevisited.com/medicinerevisited.com       

*All the contents of this website is copyright protected under the international law and registered with the Canadian intellectual property office and cannot be copied, including many new ideas, concepts, proposals and terminologies used throughout its articles, without the author’s permission and mentioning the references.

Your >388,000 hits shows that:

You care about the demise of our being before we extinct not by our wars or earth collision by asteroids or else, but by microbial invasions who have ruled the earth for billions of years!                          Mostafa Showraki

The only good is knowledge and the only evil is ignorance. Socrates

 All truths are easy to understand once they are discovered; the point is to discover them. Galileo Galilei

Perfect as the wing of a bird may be, it will never enable the bird to fly if unsupported by the air. Facts are the air of science. Without them a man of science can never rise. Ivan Pavlov

Synopses:                                                                                                                           Summary and easy read of lengthy articles that you can find under “Synopses” above in the home menu bar

Coming soon:

Longevity:  Could we determine how long one will live?

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Ontario Premier Doug Ford on his heels to fight against COVID, declares Partial Martial Law

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Ontario premier Doug Ford on his heels (as he has recently announced) or in a better word, on his knees in fighting against COVID has panicked again and hopes to make his province citizens panic as well. Frightened of the third wave of pandemic, he has tightened further restrictions on all walks of life and people province wide with his order of stay home. He is about to enter the province into a martial law by empowering the police force to question and control people outside, interrogating where they’e going, or perhaps if they are out for non-essential reasons, for example walking , jogging, exercising or playing, to arrest them. This outrageous and dictatorship order has already angered many people and even authorities, such as human right activists that the order is totally agains the charter of rights. 

The following letter to Premier Ford that has been emailed to him with a copy to prime minister of Canada Justin Trudeau and no response has been received yet, is posted here. This letter with the mortality rates over the past 20 years in Canada, the world and China, is a testimony of unfounded panic over a pandemic that’s not as bad as broadcasted as mortality rates of the past year of 2020 that everyone would assume to have been the highest over the recent years, has not been higher than in the previous years.   Premier Ford was not in charge to question the cause of the highest mortality rate in Canada in 2015 with  5.18% , and in 2017 with 4.63%, and even years back a high rate of 3.70% in 2007, 3.52% in 2011, 3.81% in 2013, all compared with the death rate of 4.47% in the past year of 2020.   In fact no one could believe a country such as Canada that boasts to be one of the best places on earth to live with the highest life styles standards, has higher mortality rate than its population growth and its death rate is on the rise, even compared with the global rate and China’s as an example (See the following table). 

It seems that no one has looked up these data and nobody has questioned China that spread the news of COVID-19 and was on the top of the list earlier on, now in comparison with its huge population by this day has only 90,499 cases, with only 4,636 deaths and over a year since April 26, 2020, it has had only 3 more deaths!  Obviously it seems that China does not test its citizens and does not report any deaths of COVID anymore. A simple look at the following table of China’s mortality rate over the past 20 years, brings up the big question of what happened in this country all of a sudden in the past two years for its death rate jumps from 0.34% in 2018 to 1.97% in 2019 and 1.94% in 2020, a jump of almost 6 times.  But still the highest mortality rates of China in the past two years, matches with the one of the lowest death rate of Canada!

Judge for yourselves.   

Dear Premier Ford:

It’s in the news that you plan to enter the province into Martial Law due to COVID. Further strict restrictions on people and empowering the police to checkpoint people when outside of their homes and questioning where they go and finning them up to $750 is simply a martial law and against the human charter of rights. 

As a physician who has written scientifically from the onset of COVID pandemic on my website “medicinerevisited.com”, fighting with the COVID is futile and wearing masks,closures of all walks of life and restrictions of people’s activities will not control the virus as it has not yet even with vaccinations. In addition to my articles on the above website, I will spell out the following points for better understanding of you and your executive staff, so hopefully to change the direction of your policy in regard with COVID and be the first authority in the world to do so and if the prime minister Trudeau whom I have also cc’d this email, reads it to do so and be the first leader in the world for this new heroic policy:

1-Viruses have been the first living being on earth for billions of years and all other beings including bacteria, funguses, parasites, plants and animals such as us have derived from them.

2-Corona viruses that COVID and common cold are of their species have spilled over from bats and birds into our ancestors, Homosapiens and have lived with us since. 

3-Coronaviruses such as COVID like all the other viruses have different strains (COVID, common cold virus, SARS, MERS are all different strains of Coronaviruses) that are created through mutations.

4-Even if we succeed to wipe out COVID through vaccination , the virus will still survive through its mutant variants.

5-Viruses make at least 65% of our genomes and like a parasite live in their hosts such as humans.

6-Coronaviruses including COVID, opposite to killer viruses such as HIV and HPV, in fact are relatively friendly and foster our immune system, that have been mostly created in our cells by good viruses, who live in peaceful symbiosis with us for ever.

7-COVID and other coronaviruses like many other viruses have been living with us for long, and the discovery of first COVID cases in China, deliberately or accidentally has panicked the whole world. China that was on the top of the list of COVID cases, now is one of the lowest in the pandemic rate compared to its population. Obviously when the whole world’s case numbers is upward and China’s downward, it shows that China has stopped testing people and is aware of the reality of COVID.

8-In the following figure you will see how since 2000, the mortality rate in the world and Canada has been on the rise compared with the population growth. Surprisingly China’s death rate has been declining since 2000, except for the past two years of 2019 and 2020 for some reasons, if their statistics are correct. The world mortality rate has been on the rise since 2016. But Canada’s death rate has been volatile and the past year of 2020 (+4.47%) that everyone would assume to have had the highest death rate due to COVID has been less than 2015 (+5.18%) and 2018 (+4.63%). 

9-The above data show clearly that COVID like its other siblings have been around for long and causing mortalities all around at different rates and are not anything new. The only new event is the panic of the pandemic that deliberately or accidentally started from China to panic the world and close their lives and economy and boost their own (china has had the highest economy growth last year globally).

10-I would recommend the province and Canada as a whole to be the first one to realize this fact, stop testing people and vaccinate only those who want to and open all walks of life and remove the masking order, restrictions, etc.

I will be glad to explain more and if needed to be an assistant.

Best,

Dr.Mostafa Showraki

  Canadian Death # Death Growth Canada Population Growth World Death #M Death Growth World Population Growth China Death Rate
2000 217,230     52.98      
2001 219,110 + 0.86% +0.95% 53.25 + 0.51% +1.29% -0.08%
2002 220,490 +0.63%/ +0.97% 53.49 + 0.45% +1.27% -0.08%
2003 223,910 + 1.55% +0.99% 53.70 + 0.39% +1.26% -0.08%
2004 228,830 + 2.20% +1.04% 53.87 + 0.32% +1.25% +0.62%
2005 229,910 + 0.47% +1.10% 54.02 + 0.28% +1.25% +0.61%
2006 225,490 – 1.92% +1.16% 54.13 + 0.20% +1.25% +0.59%
2007 233,830 + 3.70% +1.21% 54.22 + 0.17% +1.24% +0.61%
2008 236,530 + 1.15% +1.24% 54.30 + 0.15% +1.24% +0.60%
2009 237,710 + 0.50% +1.23% 54.39 + 0.16% +1.23% +0.45%
2010 237,140 – 0.24% +1.19% 54.50 + 0.20% +1.22% +0.45%
2011 245,500 + 3.52% +1.15% 54.64 + 0.26% +1.21% +0.43%
2012 242,410 – 1.26% +1.11% 54.84 + 0.37% +1.20% +0.45%
2013 251,660 + 3.81% +1.07% 55.09 + 0.45% +1.19% +0.44%
2014 253,050 + 0.55% +1.04% 55.41 + 0.55% +1.17% +0.34%
2015 266,160 + 5.18% +1.02% 55.82 + 0.58% +1.16% +0.33%
2016 262,090 – 1.53% +0.99% 56.33 + 0.91% +1.14% +0.34%
2017 274,240 + 4.63% +0.96% 56.94 + 1.08% +1.12% +0.33%
2018 283,770 + 3.47% +0.93% 57.63 + 1.21% +1.10% +0.34%
2019 287,460 + 1.30% +0.91% 58.39 + 1.32% +1.08% +1.97%
2020 300,310 + 4.47% +0.89% 59.23 + 1.44% +1.05% +1.94%

Canada-World Death Rates by Year-Table

 

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Unconscious: Revisited

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Introduction:

Unconscious, the bread and butter of Psychoanalysis, that has widely believed to have been started its inception in the literature by Sigmund Freud at the end of 19th century, it has been indeed coined by the German philosopher Friedrich Scheeling in 18th century. Probing into the history, in fact, unconscious has been known in the scientific arena long ago and in the written materials, as early as 16th century by Paracelsus, a Swiss physician. William Shakespeare has also explored the unconscious in some of his plays very well, and other philosophers such as Schopenhauer, Spinoza, Leibniz, Hegel, Kierkegaard and Nietzsche have discussed the subject.   Indeed Nietzsche in his “Thus Spake Zarathustra” who wrote between 1882 to 1885, not just describes the unconscious (soul/spirit), but the ego and the Self while making a clear distinction between them. “body am I entirely, and nothing more; and soulis only the name of some thing in the body…Ego, sayest thou, and are proud of that word. But the greater thing in which thou art unwilling to believe is thy body with its big sagacity…Instruments and playthings are sense and spirit; behind them there is still the Self. The Self seeketh with the eyes of the senses, it hearkenth also with the ears of the spirit…It ruleth, and is also the ego’s ruler. Behind the thoughts and feelings, my brother, there is a mighty lord, an uknown sage, it is called Self…” He even goes beyond what a century later Freud, the inventor of psychoanalysis discussed, and talks about self-esteem that’s a significant psychological core nowadays. “The creating Self created for itself esteeming and despising, it created for itself joy and woe”.    

 In psychology even Freud has not been the first one to address the topic, but the American psychology and philosopher, William James in his treatise, “The Principles of Psychology” examined the unconscious and subconscious. In fact Freud was influenced by the French Jean-Martin Charcot, a neurologist like Freud, who treated his hysterical patients with hypnosis and reached their unconscious minds. This influence drew Freud from neurology to hypnosis, then the world of unconscious and his following theories of compartmentalization of conscious to “ego”, and unconscious into “id” and “superego”, then “repression” of unacceptable ideas, wishes, traumatic memories and painful emotions by the conscious into unconscious. Freud used his “Interpretation of dreams” at the turn of the 20th century and later on his technique of “Free association” by laying down the patients on his psychoanalytic couch, that became the bread and butter of the future analysts, to reach their patients’ hidden worlds so to cure them.

Freud with all his generalization to expand his theories did not go farther than discussing “neuroses” and treating neurotic and hysterical patients. But the Swiss Carl Gustav Jung, another psychiatrist, who initially had the aspiration of becoming a preacher or minister and later on study archaeology and later on mesmerized by the unconscious, brought his original interest in spirituality and mythology into his psychology. Although psychoanalysis like any other non-scientifically based ideas did not pass the test of time and is almost obsolete in our era, this paper analyzes the Jungian psychology that not for its implication in clinical psychological/psychiatric practice, as it is rarely used nowadays, but for its grandiose generalization beyond the field into culture, philosophy, arts, anthropology and so on. “Man and his Symbols” written by Jung and a few of his immediate associates just before his death that published a few years after, and contains most of his ideas is the subject of this analysis. 

Jungian Psychology: Back to the ancient mythological psychic reading

“Man and his Symbols” and Jung’s other texts along with other Jungian publications, are easily understood even by a lay reader as attempts to take us back to the interpretation of dreams conducted by the ancient oracles and priests, recorded in the history. So as we will see, Jungian psychology did not bring any new idea to the psychology and treating the emotionally and mentally disturbed individuals, in contrary to its claims, but it has been a futile attempt to bridge between the psychology and mystic and mythology.

The whole book of “Man and his Symbols” and the Jungian psychology as we read is an attempt to reach the unconscious of man through the interpretation of his dreams in search of meaningful symbols. As we will see Jung knowledgeable and mesmerized by the mythological and cultural symbols, strives to project them on his patients’ unconscious with a final conclusion and proof of his own theories. Although any dream interpretations, ancient and modern would lead no useful applications for a daily life, but the interpreter like a psychic or ancient oracle and priest projects his own ideas or hypothesis onto the person’s mind. Unlike the modern science that reaches hypotheses first through observation of the events then testing them by scientific methods, the psychoanalysis either of Freud’s or Jung’s start from a firm belief on their hypotheses then strives to prove and force it onto others as unshakable facts. These man made convictions that the history is full of them, out of ignorance of scientific methods, have been commonly overgeneralized and spread thin to cover and explain beyond their starting point or idea. Among all these, Jung psychology despite its contention of modesty, stands out in grandiosity to the point of expansion of its theory “Individual unconscious” to “Collective unconscious” and its psychology to arts, culture and even interpretation of science and scientific discoveries.

Man’s creations, inventions and discoveries all by intuitions:

Jung goes that far to prove that most of great ideas and achievements of our time have not been by hard work of the conscious and intellectual minds, even in science but by intuitions of the unconscious. “We find this in everyday life, where dilemmas are sometimes solved by the most surprising new propositions; many artists, philosophers, and even scientists owe some of their best ideas to inspirations that appear suddenly from the unconscious. The ability to reach a rich vein of such material and to translate it effectively into philosophy, literature, music, or scientific discovery is one of the hallmarks of what is commonly called genius. We can find clear proof of this fact in the history of science itself. For example, the French mathematician Poincare and the chemist Kekule owed important scientific discoveries as they themselves admit to sudden pictorial revelations from the unconscious”. “…Even the most carefully defined philosophical or mathematical concept, which we are sure does not contain more than we have put into it, is nevertheless more than we assume. It is a psychic event and as such partly unknowable. The very numbers you use in counting are more than you take them to be. They are at the same time mythological elements (for the Pythagoreans, they were even divine) but you are certainly aware of this when you use numbers for a practical purpose”. As you see, in Jung’s interpretations, there is not conscious without an underlying unconscious to the exaggerated point that every hard fact such as scientific or mathematical ones, for example numbers are more than what we see or use in our daily awake time. In other words as you read Jung and his psychology, to understand anything better and reach the facts as hard as scientific ones, we need to consult with our unconscious, mostly through our dreams.  

Man guided by unconscious and instinct:

In Jungian psychology more than even Freud’s, dream and unconscious and not conscious mind and the real world of daytime, are the sources of everything, and their functions are restoration of our stability. “The general function of dreams is to try to restore our psychological balance by producing dream material that re-establishes, in a subtle way, the total psychic equilibrium. This is what I call the complementary (or compensatory) role of dreams in our psychic make-up”. In case the reader doubts and cannot believe what he reads by Jung and his psychology, he spells it out “Primitive man was much more governed by his instincts than are his “rational” modern

descendants, who have learned to “control” themselves…For the sake of mental stability and even physiological health, the unconscious and the conscious must be integrally connected and thus move on parallel lines…In this respect, dream symbols are the essential message carriers from the instinctive to the rational parts of the human mind, and their interpretation enriches the poverty of consciousness so that it learns to understand again the forgotten language of the instincts”. Yes in Jung’s mind and theory, instincts are more important than our “poor” intellectual and conscious minds and our primitive ancestors were far more advanced and smarter than what we are. So why humans bothered much through his history to leave the caves and woods, civilize and discover and invent things?!

Back to the magic and fortune-telling:

If the reader of Jung be patient, he will see how he and his psychology would take us back to believe in magic and fantasy, not just as a side-belief but the foundation of reality. “But symbols, I must point out, do not occur solely in dreams. They appear in all kinds of psychic manifestations. There are symbolic thoughts and feelings, symbolic acts and situations. It often seems that even inanimate objects cooperate with the unconscious in the arrangement of symbolic patterns. There are numerous well-authenticated stories of clocks stopping at the moment of their owner’s death; one was the pendulum clock in the palace of Frederick the Great at Sans Souci which stopped when the king died. Other common examples are those of a mirror that breaks, or a picture that falls, when a death occurs; or minor but unexplained breakages in a house where someone is passing through an emotional crisis. Even if skeptics refuse to credit such reports, stories of this kind are always cropping up, and this alone should serve as ample proof of their psychological importance”. So the ghosts and your great grandmother’s superstitions about the occurrence of magical events despite your wise mind’s belief, are all true, at least in Jungian psychology. The hard objects, such as stones as we will read later, have not just lives, but unconscious minds that can guide your conscious and wise mind.  

“Many myths and fairy tales symbolically describe this initial stage in the process of individuation by telling of a king who has fallen ill or grown old. Other familiar story patterns are that a royal couple is barren; or that a monster steals all the women, children, horses, and wealth of the kingdom; or that a demon keeps the king’s army or his ship from proceeding on its course; or that darkness hangs over the lands, wells dry up, and flood, drought, and frost afflict the country. Thus it seems as if the initial encounter with the Self casts a dark shadow ahead of time, or as if the “inner friend” comes at first like a trapper to catch the helplessly struggling ego in his snare. In myths one finds that the magic or talisman that can cure the misfortune of the king or his country always proves to be something very special”. It’s not clear that why we need Jung and his psychology to tell us what we all as humans knew and heard through such fairy and magic tales, and if those were true and not tales, why we needed to advance in knowledge and science?!

Psychology of superstitions:

Jung takes his psychology beyond conviction to belief in symbols, mythology, unconscious and religion, to superstitions. He believes in anything but hard science and prefers “superstition” of the “underworld” to man’s “rationalism”. Don’t believe it, read it with your own eyes: “Modern man does not understand how much his “rationalism” (which has destroyed his capacity to respond to numinous symbols and ideas) has put him at the mercy of the psychic “underworld.” He has freed himself from “superstition” (or so he believes), but in the process he has lost his spiritual values to a positively dangerous degree. His moral and spiritual tradition has disintegrated, and he is now paying the price for this break-up in world-wide dis- orientation and dissociation”.

In case some readers or already followers of Jung do not get it at the firs time, he spells it out: “As scientific understanding has grown, so our world has become dehumanized. Man feels himself isolated in the cosmos, because he is no longer involved in nature and has lost his emotional “unconscious identity” with natural phenomena”. In case you think, Jung means well that through industrialization, we have lost touch with the nature, be more appreciative of the nature and get closer to it, he explains his point of view more clearly. “These have slowly lost their symbolic implications. Thunder is no longer the voice of an angry god, nor is lightning his avenging missile. No river contains a spirit, no tree is the life principle of a man, no snake the embodiment of wisdom, no mountain cave the home of a great demon. No voices now speak to man from stones, plants, and animals, nor does he speak to them believing they can hear”. It seems that not only the primitive man of the past or some present aboriginal men believing in the call of wild, perhaps the modern psychotic man is closer to a true Jungian model of a perfect man! 

Dr.Marie-Louise von Franz who has been called in the introduction to the book as “closest professional confidante and friend” to Jung, in the third chapter of the book writes “Jung once told a group of students about a young woman who was so haunted by anxiety that she committed suicide at the age of 26. As a small child, she had dreamed that “Jack Frost” had entered her room while she was lying in bed and pinched her on the stomach. She woke and discovered that she had pinched herself with her own hand. The dream did not lighten her; she merely remembered that she had such a dream. But the fact that she did not react emotionally to her strange encounter with the demon of the cold of congealed life did not augur well for the future and was itself abnormal. It was with a cold, unfeeling hand that she later put an end to her life. From this single dream it is possible to deduce the tragic fate of the dreamer, which was anticipated by her psyche in childhood”. Just imagine that you have so many of similar frightening dreams throughout your lifetime and according to Jung, you should listen to all of them to prevent fatalities. Assume that you listen to your dream and try to prevent catastrophic events in your future. What are you going to do, stop being anxious and having panic attacks or being depressed? As long as we know nowadays through our daily clinical experiences and patients throughout their own experiences, they are not able to control these negative feelings that are either genetic or reactive to their unfortunate life experiences.

The superstition in Jung psychology goes too far in believing the significance in numbers. Similar to the common superstitious beliefs of some doomed numbers such as 13, Jung psychology believes in the significance of the number 4: “As Jung has demonstrated, the nucleus of the psyche (the Self) normally expresses itself in some kind of fourfold structure. The number four is also connected with the anima because, as Jung noted, there are four stages in its development. The first stage is best symbolized by the figure of Kve, which represents purely instinctual and biological relations. The second can be seen in Faust’s Helen: She personifies a romantic and aesthetic level that is, however, still characterized by sexual elements. The third is represented. for instance, by the Virgin Mary a figure who raises love (eros > to the heights of spiritual devotion. The fourth type is symbolized by Sapientia wisdom transcending even the most holy and the most pure”.

The Jungian psychology seems to have been copied from religious, mythological and mystical texts: “Many examples from literature show the anima as a guide and mediator to the inner world: Francesco Colonna’s Hypnerolomachia, Rider Haggard’s She, or “the eternal feminine” in Goethe’s Faust. In a medieval mystical text, an anima figure explains her own nature as follows: I am the flower of the field and the lily of the valleys. I am the mother of lair love and of fear and of knowledge and of holy hope. … I am the mediator of the elements, making one to agree with another; that which is warm I make cold and the reverse, and that which is dry I make moist and the reverse, and that which is hard I soften. … 1 am the law in the priest and the word in the prophet and the counsel in the wise. I will kill and I will make to live and there is none that can deliver out of my hand”. This religious text from the dark ages of medieval times, seems to be the words of God who claims to be almighty with all his powers.

Again Jung shows the source of his psychology and genius through copying from mythology and religious scripts and ancient superstitious tales. “Just as the Self is not entirely contained in our conscious experience of time (in our space-time dimension), it is also simultaneously omnipresent. Moreover, it appears frequently in a form that hints at a special omnipresence; that is, it manifests itself as a gigantic, symbolic human being who embraces and contains the whole cosmos…It is no wonder that this figure of the Cosmic Man appears in many myths and religious teachings. Generally he is described as something helpful and positive. He appears as Adam, as the Persian Gayomart, or as the Hindu Purusha. This figure may even be described as the basic principle of the whole world. The ancient Chinese, for instance, thought that before anything whatever was created, there was a colossal divine man called P’an Ku who gave heaven and earth their form. When he cried, his tears made the Yellow River and the Yangtze River; when he breathed, the wind rose; when he spoke, thunder was loosed; and when he looked around, lightning flashed. If he was in a good mood, the weather was fine; if he was sad, it clouded over. When he died, he fell apart, and from his body the five holy mountains of China sprang into existence. His head became the T’ai mountain in the East, his trunk became the Sung mountain in the center, his right arm the Heng mountain in the North, his left arm the Heng mountain in the South, and his feet the Hua mountain in the west. His eyes became the sun and moon”. After all there’s Jung to prove all these tales scientifically and apply them in his psychology and brainwash his patients with dark ages superstitious beliefs.

“According to the testimony of many myths, the Cosmic Man is not only the beginning but also the final goal of all life, of the whole of creation. “All cereal nature means wheat, all treasure nature means gold, all generation means man,” says the medieval sage Meister Eckhart. And if one looks at this from a psychological standpoint, it is certainly so”. As we see the source of Jung psychology is medieval religious superstitions, and if we accept “all treasure nature means gold”, we have to accept as well “all generation means man”. “ In practical terms this means that the existence of human beings will never be satisfactorily explained in terms of isolated instincts or purposive mechanism such as hunger, power, sex, survival, perpetuation of the species, and so on. That is, man’s main purpose is not to eat, drink, etc., but to be human. Above and beyond these drives, our inner psychic reality serves to manifest a living mystery that can be expressed only by a symbol, and for its expression the unconscious often chooses the powerful image of the Cosmic Man.   In our Western civilization the Cosmic Man has been identified to a great extent with Christ, and in the East with Krishna or with Buddha. In the Old Testament this same symbolic figure turns up as the “Son of Man” and in later Jewish mysticism is called Adam Kadmon”. So in Jungian psychology the purpose of the man is to be human, that explains as examples to be like Christ, Krishna, Buddha, and Adam, all religious figures. This religious preaching under the cover of a psychology undermines all the other great men in history of science, art and else.

The Jungian psychology gets so entangled in its own superstitious symbolism that every object, numbers and shapes become meaningful and to prove it searches in the antiquity to prove its point. “The history of symbolism shows that everything can assume symbolic significance: natural objects (like stones, plants, animals, men, mountains and valleys, sun and moon, wind, water, and fire), or man-made things (like houses, boats, or cars), or even abstract forms (like numbers, or the triangle, the square, and the circle)…In fact The circle is a symbol of the psyche (even Plato described the psyche as a sphere). The square and often the rectangle) is a symbol of carthbound matter, of the body and reality”. “The symbol of the circle has played a curious part in a very different phenomenon of the life of our day, and occasionally still does so. In the last years of the Second World War, there arose the “visionary rumor” of round flying bodies that became known as “flying saucers” or UFOs, unidentified flying objects)”. And Jung explains the UFOs as “a projection of a psychic content (of wholeness) that has at all time been symbolized by the circle”.

Archetypal Unconscious:

One of the basic tenet of Jungian psychology that Jung and his followers were proud of its discovery, is the “archetypal unconscious”, meaning that our present individual or even collective unconscious is rooted in an archetypal unconscious. Like a comparative anatomists or archeologist, “The experienced investigator of the mind can similarly see the analogies between the dream pictures of modern man and the products of the primitive mind, its “collective images,’’ and its mythological motifs.   Just as the biologist needs the science of comparative anatomy, however the psychologist cannot do without a “comparative anatomy of the psyche.” In practice, to put it differently, the psychologist must have a sufficient experience not only of dreams and other products of unconscious activity, but also of mythology in its widest sense. Without this equipment, nobody can spot the important analogies. It is not possible, for instance, to see the analogy between a case of compulsion neurosis and that of a classical demonic possession without a working knowledge of both”. Step by step through his own conviction, Jung takes us back to our primitive past and beyond to believe and live in mythology and superstitions, and interpret an OCD patient as being possessed by demons, exactly the way it was thought in the dark ages before our scientific revolution.

After life and Resurrection:

Failing to be a preacher or minister, Jung practices such through his psychology by proximate it to the religious beliefs of “resurrection” or life after death and that being better than the life we live in. Interpreting the dream of a little girl, Jung writes “These dreams open up a new and rather terrifying aspect of life and death. One would expect to find such images in an aging person who looks back upon life, rather than to be given them by a child who would normally be looking forward. Their atmosphere recalls the old Roman saying, ‘”Life is a short dream rather than the joy and exuberance of its springtime”. For this child’s life was like a very sacrum vovendum (vow of a vernal sacrifice, as the Roman poet puts it. Experience shows that the unknown approach of death casts an adumbratio (an anticipatory shadow) over the life and dreams of the victim. Even the altar in Christian churches represents, on the one hand, a tomb and on the other, a place of resurrection, the transformation of death into eternal life”.

Religious Psychology:

Scanning visually through the book of “Man and his Symbols”, one may initially assume that’s a religious and mythology text than of psychology, indeed that’s the case as page after page, the reader is suggested to believe in many superstitious and religious thoughts beyond magic, fantasy, resurrection to magical healing. “I will illustrate this by an experience I once had with the primitives of Mount Elgon in Africa. Every morning at dawn, they leave their huts and breathe or spit into their hands, which they then stretch out to the first rays of the sun, as if they were offering either their breath or their spittle to the rising god, to mungu… these and similar terms designate a “power” of extraordinary efficiency and pervasiveness, which we should call divine. Thus the word mungu is their equivalent for Allah or God. When I asked them what they meant by this act, or why they did it, they were completely baffled. They could only say: “We have always done it. It has always been done when the sun rises.” They were consequently unable to explain themselves. I concluded that they were offering their souls to mungu, because the breath (of life) and the spittle mean “soul-substance.” To breathe or spit upon something conveys a “magical” effect, as for instance, when Christ used spittle to cure the blind or where a son inhales his dying father’s last breath in order to take over the father’s soul”.

Jungian psychology as Jung himself asserts, it is more like confession extrapolation by a priest or theologian guarding of the soul than psychological treatment. “It is significant that the psychological doctor (within my experience) is consulted more by Jews and Protestants than by Catholics. This might be expected, for the Catholic Church still feels responsible for the cur a ammarum (the care and welfare of souls). But in this scientific age, the psychiatrist is apt to be asked the questions that once belonged in the domain of the theologian. People feel that it makes, or would make a great difference if only they had a positive belief in a meaningful way of life or in God and immortality… Because we cannot discover God’s throne in the sky with a radio telescope or establish (for certain) that a beloved father or mother is still about in a more or less corporeal form, people assume that such ideas are “not true.” I would rather say that they are not “true” enough, for these are conceptions of a kind that have accompanied human life from pre-historic times, and that still break through into consciousness at any provocation…But since we are dealing with invisible and unknowable things (for God is beyond human understanding, and there is no means of proving immortality), why should we bother about evidence? Even if we did not know by reason our need for salt in our food, we should nonetheless profit from its use. We might argue that the use of salt is a mere illusion of taste or a superstition; but it would still contribute to our well-being. Why then should we deprive ourselves of views that would prove helpful in crises and would give a meaning to our existence?”

In contrast to Jung, Freud did not believe in the existence of a supernatural force that has pre-programmed us to behave in a certain way. He asserted “Religion is an illusion and it derives its strength from the fact that it falls in with our instinctual desires.” Freud regarded this illusory God is based on the infantile need for a powerful “father figure”. Freud argued that humanity created God in their image. Freud places the “Mind” above conscious and unconscious and in creation of God and any type of religion. The idea that religion causes people to behave in a moral way is incorrect according to Freud because he believed that no other force has the power to control the ways in which people act. . In some of his writing, such as his book “Totem and Taboo” Freud suggested that religion is an attempt to control the Oedipal complex. Unlike Jung who gives into religion, mysticism, superstitions, symbolism and in fact “Totemism” or spirituality, Freud believes that religions rooted in Totem and taboo, repress instincts and drives, such as sexual, aggression and cause people’s unhappiness and lack of progress and freedom. He examples “sacrifice” in the heart core of any religions from Paganism to monotheism even in Christianity, when Jesus himself was sacrificed for the rest of the world as a father figure, and his body and blood as symbols was first offered to his disciples in his last supper as bread and wine that still continues to this day in Communion as a rite.

Jung admits to his religious psychology “I stress this point because, in our time, there are millions of people who have lost faith in any kind of religion. Such people do not understand their religion any longer. While life runs smoothly without religion, the loss remains as good as unnoticed. But when suffering comes, it is another matter. That is when people begin to seek a way out and to reflect about the meaning of life and its bewildering and painful experiences”. As it seems from his very own words, Jungian psychology, like any religious institution, preaches us not to lose faith, even if our lives run smoothly without belief in any religion or spirituality or parapsychology. As if all the religious teachings in the world have not been enough that Jung steps in to convince people to have faith and return to the primal times to believe in supernatural powers. Perhaps since no religions could prove the faith to their followers, Jung steps in to declare that there is no need to prove anything, we just need to cultivate and believe in non-provable things: “There is, however a strong empirical reason why we should cultivate thoughts that can never be proved. It is that they are known to be useful. Man positively needs general ideas and convictions that will give a meaning to his life and enable him to find a place in the universe…It is the role of religious symbols to give a meaning to the life of man. The Pueblo Indians believe that they are the sons of Father Sun, and this belief endows their life with a perspective (and a goal) that goes far beyond their limited existence. It gives them ample space for the unfolding of personality and permits them a full life as complete persons. Their plight is infinitely more satisfactory than that of a man to have faith in our own civilization who knows that he is (and will remain nothing more than an underdog with no inner meaning to his life”.

Here Jung spells out his religious psychology in case the reader thinks his psychology is only about unconscious and symbolism. As we read according to Jung, we humans have no place in universe, no matter how much we achieve until we have faith in the unknown and a power above and beyond us. While all Jung’s convictions, explanations and justifications arise from his conscious mind and he is well aware of all man’s achievements and his higher place in the nature among animals, he strives to undermine them and takes us all back to our primal lives. He ignores that if we all start again, we end up here somewhat similar, and also he forgets that even animals and objects all have places in the universe without having conscious and unconscious minds. Moreover as if he really does not know that all man’s ideas like his in psychology or else are all the byproducts of his conscious mind. Even the subject of “unconscious’ that he and other psychoanalysts of other schools believe in, is the byproduct of their conscious minds.    

Jungian Psychology: Not far off Freudian Psychoanalysis

Conventional Freudian psychoanalysis did not last more than half a century due to its sexual and “arrested development” scientifically unfounded hypothesis projection onto poor patients, to whom none of such analyses or interpretations made sense. Jung due to his grandiosity and religious background, derailed from the conventional Freudian formula, despite Freud’s advise and took psychology or psychoanalysis farther back to mythology, magic and religion. In spite of all his efforts to depart from classis psychoanalysis and create his own school of psychology, his psychology still has remnants of basic psychoanalysis of Freud at least in the belief of “arrested development”, meaning that neurotic people’s mental development have arrested in some points in early life. “Gradually a wider and more mature personality emerges, and by degrees becomes effective and even visible to others. The fact that we often speak of “‘arrested development” shows that we assume that such a process of growth and maturation is possible with every individual. Since this psychic growth cannot be brought about by a conscious effort of will power, but happens involuntarily and naturally, it is in dreams frequently symbolized by the tree, whose slow, powerful, involuntary growth fulfills a definite pattern. The organizing center from which the regulatory effect stems seems to be a sort of “nuclear atom” in our psychic system. One could also call it the inventor, organizer, and source of dream images”.  

The Self:

The above that has been written in the book “Man and his symbols” by Dr.Marie-Louise von Franz , the closest professional confidante and friend of Jung, continues with “Jung called this center the “Self” and described it as the totality of the whole psyche, in order to distinguish it from the “ego,” which constitutes only a small part of the total psyche. Throughout the ages men have been intuitively aware of the existence of such an inner center. The Greeks called it man’s inner daimon; in Egypt it was expressed by the concept of the Ba-soul and the Romans worshiped it as the “genius” native to each individual. In more primitive societies it was often thought of as a protective spirit embodied within an animal or a fetish”. Of course the Jungian’s interpretation of such “Self” is not as in the “Self Psychology” of Heinz Kohut and others that was developed in 1960s, 70s and 80s, and was more practical and made sense for the patients and readers and got closer to the modern psychology and psychotherapy. The Jungian’s perception of “Self” as it is transparent in the above statements and the rest of the book is in fact “Soul” or “Spirit” and back to ancient and superstitions and para-psychology beliefs.

“The Self can be defined as an inner guiding factor that is different from the conscious personality and that can be grasped only through the investigation of one’s own dreams. These show it to be the regulating center that brings about a constant extension and maturing of the personality. But this larger, more nearly total aspect of the psyche appears first as merely an inborn possibility. It may emerge very slightly, or it may develop relatively completely during one’s lifetime. How far it develops depends on whether or not the ego is willing to listen to the messages of the Self”. While ego and the individual is downgraded and squeezed into “Self” that’s soul or spirit in Jungian’s psychology, still it seems that it is up to ego to realize the self and make it a reality. “It even seems as if the ego has not been produced by nature to follow its own arbitrary impulses to an unlimited extent, but to help to make real the totality, the whole psyche. It is the ego that serves to light up the entire system, allowing it to become conscious and thus to be realized”. So if it is up to ego, then it must be a conscious effort to mature the Self and actualize it in the real world out of its dark unconscious. In other word, Jung and his followers fall into their own made up traps, and while trying hard to prove the power of unconscious in controlling the conscious, here it is all up to ego in the individual conscious to help the Self to mature and step out of the underworld of unconscious!

“The individuation process is more than a coming to terms between the inborn germ of wholeness and the outer acts of fate. Its subjective experience conveys the feeling that some supra-personal force is actively interfering in a creative way. One sometimes feels that the unconscious is leading the way in accordance with a secret design. It is as if something is looking at me, something that I do not see but that sees me, perhaps that Great Man in the heart, who tells me his opinions about me by means of dreams”. As we see Jungian psychology circumstantially beats around the bush throughout the book and its psychology, making up different terminology, all to bring us back to the soul, spirit or Jungian “Self” to prove that man with all his might and intelligence (conscious) is a prisoner to his unconscious or unknown fate, impulse or supernatural forces! Jung indeed proved that no matter how educated a person would be, he or she could still be bound by his past superstitions and mystics and believe in super-personal powers, hidden forces and fate like the primal humans.  

“Many people have criticized the Jungian approach for not presenting psychic material systematically. But these critics forget that the material itself is a living experience charged with emotion, by nature irrational and ever-changing, which does not lend itself to systematization except in the most superficial fashion. Modern depth psychology has here reached the same limits that confront microphysics. That is, when we are dealing with statistical averages, a rational and systematic description of the facts is possible. But when we are attempting to describe a single psychic event, we can do no more than present an honest picture of it from as many angles as possible. In the same way, scientists have to admit that they do not know what light is. They can say only that in certain experimental conditions it seems to consist of particles, while in other experimental conditions it seems to consist of waves”. These convictions throughout the Jungian’s psychology writings are so transparent and self-defeating that one might not need critical interpretations. That’s true the Jungian psychology admits not to be a science, the way psychology is today, but a serious critic of science, its methods and attempts desperately to take us back to the dark ages and the beliefs in the unknown, spirits, intuitions, impulses, and unconscious.

The Shadow

Like Freud’s stratification of psyche to ego, id and super-ego, Jung divides the psyche into ego, self and shadow. In interpretation of a Frenchman’s dream, “This dream shows us that the shadow can consist of many different elements for instance, of unconscious ambition (the successful portly man) and of introversion (the French- man). This particular dreamer’s association to the French, moreover, was that they know how to handle love affairs very well. Therefore the two shadow figures also represent two well-known drives: power and sex. The power drive appears momentarily in a double form, both as an official and as a successful man. The official, or civil servant, personifies collective adaptation, whereas the successful man denotes

ambition; but naturally both serve the power drive. When the dreamer succeeds in stopping this dangerous inner force, the Frenchman is suddenly no longer hostile. In other words, the equally dangerous aspect of the sex drive has also surrendered.   Obviously, the problem of the shadow plays a great role in all political conflicts. If the man who had this dream had not been sensible about his shadow problem, he could easily have identified the desperate Frenchman with the “dangerous Communists” of outer life, or the official plus the prosperous man with the “grasping capitalists’. In this way he would have avoided seeing that he had within him such warring elements”. To separate himself from Freud, Jung comes up with different compartmentalization of unconscious and other than “Ego” that he borrows, he avoids the other sects of unconscious, id and super-ego and creates “Shadow”.  

Moreover while Freud started with interpretation of dreams to analyze his patients, soon he progressed in his own term and school of psychology to “Free association”. Freud who was not as rigid as Jung in his own theoretical conviction, soon realized that his earlier techniques of interpretation of dreams and hypnosis is one way street of analysis by the psychoanalyst that may not agree with the patient’s opinion. In fact one of the prompt in invention of free association by Freud came from one of his early client, “Miss Elisabeth” who protested against interruptions of her flow of thought, that was described by his official biographer, Ernest Jones as “one of the countless examples of a patient’s furthering the physician’s work”. Soon in explanation of the significance of his new technique, Freud reveals “The importance of free association is that the patients spoke for themselves, rather than repeating the ideas of the analyst; they work through their own material, rather than parroting another’s suggestions”. Indeed Jung early on as it is shown in his semi-biography, the 2011 film “Dangerous method” by David Cronenberg, in collaboration with his patient and lover then colleague, Sabina Speilrein, tested such free association with their “word association test” and published it in 1906. But his religious background and upbringing on one side and his grandiosity to depart from Freud and create his own school of psychology, led him to leave that kind of scientific method and succumb to his mystic mind.

To comment and explain further the “shadow” in Jungian psychology, it is not a clear concept as ego, id and superego as they are in the Freudian psychology. Dr.Marie-Louise von Franz continues in the book in explanation of Jung’s new terminology of Shadow: “When Jung called one aspect of the unconscious personality the shadow, he was referring to a relatively well-defined factor. But sometimes everything that is unknown to the ego is mixed up with the shadow, including even the most valuable and highest forces…. In the unconscious, one is unfortunately in the same situation as in a moonlit landscape: All the contents are blurred and merge into one another, and one never knows exactly what or where anything is, or where one thing begins and ends. (This is known as the “contamination” of unconscious contents.)”. So shadow not only structurally blurred and not well-defined as Jung assumed, it is also functionally bewildered. “The fact that the shadow contains the overwhelming power of irresistible impulse does not mean, however, that the drive should always be heroically repressed. Sometimes the shadow is powerful because the urge of the Self is pointing in the same direction, and so one does not know whether it is the Self or the shadow that is behind the inner pressure”.

The shadow could be close to self, to ego or wild at large having his own kingdom of function. “The shadow becomes hostile only when he is ignored or misunderstood. Sometimes, though not often, an individual feels impelled to live out the worse side of his nature and to repress his better side. In such cases the shadow appears as a positive figure in his dreams. But to a person who lives out his natural emotions and feelings, the shadow may appear as a cold and negative intellectual; it then personifies poisonous judgments and negative thoughts that have been held back. So, whatever form it takes, the function of the shadow is to represent the opposite side of the ego and to embody just those qualities that one dislikes most in other people. It would be relatively easy if one could integrate the shadow into the conscious personality just by attempting to be honest and to use one’s insight. But, unfortunately, such an attempt does not always work. There is such a passionate drive within the shadowy part of oneself that reason may not prevail against it”. As we read, the shadow is like a tyrant and does opposite to what ego wants, if ego is positive, he would be negative and if ego is negative, he would be positive. So while before we read that shadow at times cannot be discriminated against Self, here we read it is opposite to ego, but it seems overall that the shadow runs wild in his own no man’s land, it could be friendly, but mostly an enemy.  

“And there is an additional disadvantage in projecting our shadow. If we identify our own shadow with, say, the Communists or the capitalists, a part of our own personality remains on the opposing side. The result is that we shall constantly (though involuntarily) do things behind our own backs that support this other side, and thus we shall unwittingly help our enemy. If, on the contrary, we realize the projection and can discuss matters without fear or hostility, dealing with the other person sensibly, then there is a chance of mutual understanding or at least of a truce. Whether the shadow becomes our friend or enemy depends largely upon ourselves”. Therefore as we see, shadow in Jungian psychology is not as clearly defined in structure and function to be analyzed and interpreted and of use for either the analyst or the patients. Despite shadow being a wild beast in the dark underworld of unconscious, there’s as above an admission by Jungians again that “Whether the shadow becomes our friend or enemy depends largely upon ourselves”. So again it is up to the individual’s conscious or ego to control it and make it an ally or enemy.  

Anima and Animus 

Like Oedipal and Electra complexes in Freud’s psychology, Jung attempts to make his own parallel concepts in these matters by inventing “Animus” and “Anima”. Although these terminologies were passed on to him by his second lover, another Swiss analyst, Toni Wolff, who also gave him the ideas of other Jungian concepts, such as “Persona” and “Psychological types”. On Animus and Anima, Marie-Louise von Franz in the book explains: “Difficult and subtle ethical problems are not invariably brought up by the appearance of the shadow itself. Often another “inner figure” emerges. If the dreamer is a man, he will discover a female personification of his unconscious; and it will be a male figure in the case of a woman. Often this second symbolic figure turns up behind the shadow, bringing up new and different problems. Jung called its male and female forms “animus” and “anima.” The anima is a personification of all feminine psychological tendencies in a man’s psyche, such as vague feelings and moods, prophetic hunches, receptiveness to the irrational, capacity for personal love, feeling for nature, and last but not least, his relation to the unconscious”. The Oedipal and Electra complexes in Freud’s psychoanalysis would throw off and be felt as insults to the patients upon interpretation of an analyst that they have unconscious sexual desires towards their fathers or mothers. Similarly, the above statements of Jungian’s psychology of animus and anima, would throw off the patients or readers as anima or the female aspect has been interpreted as having “vague feelings and moods, prophetic hunches, receptiveness to the irrational”. Moreover “The anima (the female element in a male psyche) is often personified as a witch or a priestess who have links with “forces of darkness” and “the spirit world”.  

Jung with his animus and anima gets close to Freud’s Oedipal and Electra complexes and perhaps more so to the devilish character of Eve in the religious texts. “In its individual manifestation the character of a man’s anima is as a rule shaped by his mother. If he feels that his mother had a negative influence on him, his anima will often express itself in irritable, depressed moods, uncertainty, insecurity, and touchiness…Within the soul of such a man the negative mother-anima figure will endlessly repeat this theme: “I am nothing. Nothing makes any sense. With others it’s different, but for me … I enjoy nothing.” These “anima moods” cause a sort of dullness, a fear of disease, of impotence, or of accidents. The whole of life takes on a sad and oppressive aspect. Such dark moods can even lure a man to suicide, in which case the anima becomes a death demon”. Sadly psychoanalysis that ruled the world of psychology at least in the first half of the 20th century, enforced on to the people’s minds that they are ruled by either their sexual desires even towards their parents or by their demonic under-thoughts, principally springing out of their parents. As we read in the above statements, the “mother-anima” keeps repeating in your ears “you are nothing, you enjoy nothing, you are impotent and better to kill yourself and get rid of your miserable self.

“Just as the character of a man’s anima is shaped by his mother, so the animus is basically influenced by a woman’s father. The father endows his daughter’s animus with the special coloring of unarguable, incontestably “true” convictions – convictions that never include the personal reality of the woman herself as she actually is. This is why the animus is sometimes, like the anima, a demon of death. For example, in a gypsy fairy tale a handsome stranger is received by a lonely woman in spite of the fact that she has had a dream warning her that he is the king of the dead. After he has been with her for a time, she presses him to tell her who he really is”. In fact Jung was not the first in psychology to stress on “Symbols”. Freud in his “Interpretation of dreams” at the turn of 20th century, symbolized the dream contents of his patients in sexual terms, poles as male and holes as the females genitals. Jung following Freud’s footstep, but not admitting to, believes “Men project the anima on to things as well as women. For instance, ships are always known as “she”…the captain of a ship is symbolically “her” husband, which may be why he must (according to tradition) go down with the ship if “she” sinks. A car is another kind of possession that is usually feminized, i.e., that can become the focus of many men’s anima projections. Like ships, cars are called “she.” And their owners caress and pamper them like favorite mistresses”.

“The animus, just like the anima, exhibits four stages of development. He first appears as a personification of mere physical power for instance, as an athletic champion or “muscle man.” In the next stage he possesses initiative and the capacity for planned action. In the third phase, the animus becomes the “word,” often appearing as a professor or clergyman. Finally, in his fourth manifestation, the animus is the incarnation of meaning. On this highest level he becomes (like the anima) a mediator of the religious experience whereby life acquires new meaning. He gives the woman spiritual firmness, an invisible inner support that compensates for her outer softness”. One may wonder how Jung came up with the idea of four stages of development of anima and animus. But no matter how, he shows why by revealing the truth behind the philosophy of his psychology, being a pure spiritual and religious one, as the last stage of development of animus, is a “religious experience” that “gives the woman spiritual firmness”.

Dr. Mostafa Showraki, MD, FRCPC                                                                       Lecturer, School of Medicine, University of Toronto                                        Author: ADHD:Revisited Book Adhdrevisited.com/medicinerevisited.com       

References:

  1. Nietzsche F. “Thus Spake Zarathustra”. Translated by Thomas common. 1997. Wordsworth Editions Limited.
  2. Jung CG., von Franz ML., Henderson JL., Jacobi J., Jaffe A. “Man and his Symbols”. 1964. J.G. Ferguson Publishing.
  3. Freud, S. “Totem and Taboo”. London WW Norton 1989
  4. Freud, S. 1930. Civilization and its discontents.
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COVID-19: Most recent humans’ Tragedy turning into a Comedy!

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Introduction:

It’s already more than a year since the official announcement of the first cases of COVID-19 in the Wuhan Province of China, in December 2019, so to be titled and popularized, the recent global coronavirus pandemic infection, as COVID-19 (Coronavirus infectious disease of 2019). Soon later on after the first discovery of the COVID in December of 2019, it was revealed that the infection had been diagnosed and reported in China as early as November and October of 2019. While COVID was reportedly confined to China in 2019, soon after the new year celebration, the whole year of 2020 was spoiled by the spread of the infection to other countries, first labeled epidemic then soon pandemic.

First as all we know and remember, China lost its first rank on the list of COVID-19 cases and its mortalities, to western European countries first Italy, then Spain, France and the rest. Soon the western European countries also lost their top ranks to US, then Brazil, Russia, now India, Mexico, and so on. It has been criticized from the beginning, on this site that the world and the authorities of all countries through media have scared their subjects more with panic than the mortalities of the pandemic that has not exceeded anywhere more than 1-2%. While almost all the mortalities have befallen on elderly population specially in crowded pathologic environments such as nursing homes and on the subjects, young and old with underlying severe medical conditions with compromised immunities, the world authorities and media have not slowed down or stopped their scarecrow roles, but have intensified it.

As if there is a global benefit in panicking people, there’s already the news that even vaccinating everyone, that has been labeled as offence to the virus, people still should be on the defence as well, like a good sport team. Moreover there is more scary news in the media that the virus has mutated and its mutation version could be resistant to our man made vaccines that have already cheered up to be back living mask and restriction free as the life was before. As if there are some sources benefitting the panic of people and their lockdowns. When a single tragedy is exaggerated and overgeneralized, it will be a comedy and not believable anymore. We all know the story of how a simple phobia could be overgeneralized and scare the subject even from the shadow of the initial fearing stimulus. For example, a person phobic of dogs, if not helped and treated, he or she soon will be afraid of even the sound of barking of a dog when no dog is in the scene or the shadow of dog or even a puppet dog. That is how a tragedy would turn into a comedy and will become a belief to the subject, while to the outsiders it will be funny and a comedy. The current panic of the pandemic with a very low mortality rate, perhaps to the eyes of an alien from the outer space would look as very funny and a comedy!

Aside all the gossips, publicity, conspiracy theories and panics, the following main text will instigate the logics, if any left, or common sense, if each of us have any, lest the abundant scientific evidences against a panic that should not have propelled our hearts from the start, but should have fueled our brains a bit, at this era of the total brain wash by media, particularly the world wide web. We will see how we all like herds have followed and have been fooled by the scarecrows, who perhaps are as ignorant as all of us, by believing that wearing masks could block the viral entry into our bodies, lest the lockdown and closure of all paths of life. In the years to come, when we look back we will see how the panic of pandemic, made us all look like fools. This is a comedy that a virus with a mortality rate of 1-2% almost all in elderly population and immune compromised subjects, with almost no mortality in healthy, young, middle aged, even healthy elderlies, scared us all like never before. We were not scared, did not wear masks and were not forced to lockdown by SARS and MERS with 30-40% mortality rates, or the common influenza virus that became pandemic during the first world war and still kills 30-40% sporadically the elderlies and very sick people (1-5). Did we ever wear masks when visiting the relatives in hospitals or nursing homes inflicted with the influenza virus that was and is still very fatal?

Lastly before begin the main text in detail, you the reader of this passage, would you be scared and panic if you know that even if you’re infected with the virus and certain that it will not kill you 99.99%, will you still wear a mask or give in to the lockdown?! Wouldn’t you be infuriated with all the scarecrows who scared us all over a year and keep going to the new year, as if we are crows and easy to be fooled?!

 COVID-19: A proof of humans’ fragility and ignorance

Good to know your friends and better your enemies:

First of all we need to know, in case we don’t, that not all microbes or viruses are bad, invasive or fatal, but majority of them friendly, necessities and backbones of life. As detailed in the earlier articles on this site on the Coronavirus, viruses as the smallest living particles, through symbiosis have been living within other larger beings including us humans since the inception of life. This symbiosis or living together has been a close and long-term biological relationship, interaction and dependency between all the biological organisms in a mutualistic or parasitic manner. We may already know about good bacteria in our skin, saliva and guts and many of us consume these good bacteria in healthy food products such as dairies, e.g. microbiata for a healthier living (6-9).  

We never buckled up to fight against over 100 trillion microbes living in our human’s gut that are vital for the maintenance of our immune system in fight against bad infections and diseases. The science have already informed and warned us not to disturb such endosymbiosis of our gut bacteria, and break the peace pact between them and us by tipping the balance of this equilibrium through causing a stagnant and unhealthy environment for them. For example through constipation, these healthy micorbiata could not be nourished well and over time turn to pathogens with the initial insult to the host by damaging the mucosa of the gut and giving in to malignancies such as colon cancer (10-12).

 As it has already detailed in the other articles on this site on Coronavirus, while the healthy and good bacteria is known to the majority of people, the viruses out of scientific arena, are still known as invasive, aggressive and bad. Indeed viruses due to their much minute sizes and their cellular structures, particularly RNA or particle viruses that cannot survive independently, have much more endosymbiotic roles not only in the large size beings like us, but even within bacteria. This mutualistic relationship has been explored in detail recently pointing to the vitality of viral endosymbiosis not for short-term survival but in long-terms and in the hosts’ evolution as the major partners in the hosts’ genomes. In fact the viral symbiogenesis seems to be the most important factor in the evolution of all forms of life on earth (13-14).

 Viruses that have been until recently associated with diseases and studied as such, are the most abundant and diverse biological entities on the planet. Recent biodiversity surveys in desert, ocean, soil, animals and plants have revealed the vital roles of viruses in every ecosystem. Due to their obligatory existence as endosymbiont within all other beings larger than themselves, the viruses had to possess evolutionary plasticity to form and maintain the most excellent models of symbiotic relationships. Moreover and most importantly the viruses are the main force behind the genome diversities and genetic evolutions across all species. In fact majority of virus-host interactions all around are commensal or friendly. But even in the case of antagonistic interactions, when there is resistance from the host by fighting the virus through its immune armamentarium, the plasticity and obligation of the virus for endosymbiosis living and evolutionary genetic diversification, assists the survival of the host at the end of the arm race, as the end of life of the host would be the end of life of the virus (15-19).

A great example of such co-evolution and assistance in survival is the “interferon”, a master regulator of the immune system and cell metabolism found in nearly all cell types that has evolved within lives through viral interactions. Other great examples of such mutual benefits to both sides of equation of symbiosis between the viruses, bacteria and the larger hosts, and more so to the benefit of the hosts are evolution of mitochondria, chloroplasts and other cellular vital organelles within any cells that divide and replicate independent of the cells in living creatures like us. In fact the notion of Darwinism based on competitive survival has been replaced in the modern scientific media to the cooperative and symbiotic evolutionary survival (20-25).

One important distinction needs to be appreciated by all specially at this time of COVID panic, is the difference between the virulence or power of entry of bacteria and viruses and aggression and fatalities. The virulent microbes and viruses such as coronaviruses that force themselves for entry to the hosts for survival and symbiosis are in fact not aggressive or fatal, but friendly and commensal. In other word the more virulent for entry the microbes or viruses, the friendlier they are. If we appreciate that our immune system and even our genomes are basically made by tinier living particles such as viruses, and if we want to refine our system on an evolutionary path to healthier and longer living, we need to let the virulent friendly microbes and viruses in and to live with them in peace for a better and healthier life. In fact it has been shown scientifically that the good and virulent bacteria and viruses, for their own evolutionary survival that directly depends on the survival of the hosts, fight and kill other fatal and killer bacteria and viruses within or entering the host, even their own killing particles if needed. In a better word, the good virus for its own survival that’s the survival of the hose in short term and the co-evolution in long-term, weeds out or kills its own bad and ugly killer particles that at times, like traitors act against their roots (26-31).

 Studies on plants that were first to appreciate the importance of viral interactions and symbiosis in ecosystem, diversity and evolution of the plants, have shown for long how viruses assist the plants in coping with their adverse environments such as drought, thermal tolerance and adversarial invasions. In human studies, GB virus C has been shown to fight against HIV through down-regulation of cell receptors for entry, reduced replication, promoting interferon and interactions with interleukin immune pathways. Latent herpes virus and cytomegalovirus have also been shown to enhance the T cells immune response to influenza and other fatal microbial invasions. Endogenous retroviruses that make up at least 8% of human genomes and non-retroviral endogenous viruses have been revealed in recent years that have been contributing for million of years to the genetic evolution and diversities of all living forms on earth (32-34).

This so-called endogenization of viral elements has sculpted the evolution of extant genomes in all domains of life. The significance of the contribution of viral interactions in the evolution of their hosts’ genetic make-up, diversity and survival has became possible only since the sequencing and analysis of hosts genomes such as humans in the recent years. In brief, viruses that have until recently been considered fatal and antagonistic to life, at least in the field of virology, genetics, evolution, ecosystem and biodiversity, have been appreciated as the most important vital elements of life on the planet (35-40).     

In the case of Coronaviruses, it has also been shown as early as mid-90s, that mouse hepatitis virus strain A59 (MHV-A59) a member of the family of coronaviruses, containing a single-stranded positive-polarity RNA genome, similar to other coronaviruses, e.g. SARS and COVID-19, favours the co-evolution between the mouse and the virus. Impediment in such co-habitation, like our present time resistant to COVID-19, has been shown to cause a lash back against the host (mouse) by creating a genetic bottleneck for the subsequent selection (mutation) of a more virulent variant of the virus. Therefore the most recent news of eruption of new mutant versions of COVID-19 could be an example of such lash back or genetic bottleneck that has been shown in the lab experiments on mice long time ago (41-43).     

We all now need to know at this very important time in our short history that evolution has and is being made possible through mutations. All the living diversities that bedazzle us all around have been possible only through genetic mutations. Among all the living beings, the viruses have the most mutation capacities for survival and endosymbiosis. Through these mutations, the viruses such as coronaviruses have evolved into so many varieties such as common cold flu viruses, SARS, MERS and now COVID-19. These mutations for survival and co-evolution has not been confined within one or intra-species, but between or inter-species, and that’s why coronaviruses have been shared among bats, birds and humans. Most recently in 2018, it has been shown that how MERS-CoV by altering the surface charge of its spike (or crown where the name of Corona derives from) surpasses the host cell receptor resistance for entry. This fact has also been shown in another coronavirus, Enteropathogenic porcine epidemic diarrhea virus (PEDV) and porcine delta coronavirus (PDCoV) that how they circumvent or subvert the host’s first line of defence for entry (41-43).     

One more fact that we even as lay people need to know now as our lives have been affected seriously by the panic of ignorance, that has robbed us from our normal ways of life, is “the genetic mutation pressure”. This scientific phenomenon well known to geneticist and evolutionists, means the genetic mutation is enforced and removes any resistance and obstacle on achieving its goal of co-evolution. For example and relative to our topic of COVID, on the path of its evolution and adaptation to its host and breaking any resistance, the human coronavirus OC43, that’s the simple common cold virus, has evolved and changed to many genotypes and variants that had already been shown in the human samples in France and China among other places. What we have seen and suffered by the novel coronaviruses of SARS, MERS and now COVID-19 in the recent years are all the tips of an iceberg of biodiversity and power of co-evolution of the coronaviruses deep down in the ocean of a universal ecosystem on earth (42-47). 

Conclusion:

In an article in March of this year at the start of the current global panic over the pandemic of COVID-19, attacking and resisting towards this coronavirus that has never been an enemy but a friend, a peaceful co-existence with the virus on its path of co-evolution was called to action. But as it has been a rule and not an exception, the ignorance and panic of our human race, did not pay any even tiny attention to this very fact of nature and to the contrary, resistance and fight against the nature and co-evolution through sanitization, wearing masks and lockdowns were put in action. While it is quite understandable that the content of the original paper and the present one are way beyond the simple minds of the majority, our governments and authorities, since our lives now depend on digesting these facts, we all have to, and have no choice, to arm ourselves with the knowledge of such facts, or our demise is invincible. 

A brief nutshell of the previous and present papers, for many who could not read through the whole contents, or retain their essence, is summarized here:

*Microbes including bacteria, fungi and even viruses are the backbones of life on earth, and many of them are good, friendly and necessities of life.

*The lives of eukaryotes that all animals on earth including humans have evolved from, have been only possible through symbiosis (living together in peace) and endosymbiosis (living within) of all living beings.

*While everybody with their naked eyes could see some examples of symbiosis, such as co-existence and dependency of animal and human lives on plants, or the growth of moss or fungi on trees and rocks, we need also to learn about the endosymbiosis that we cannot see with our naked eyes.

*Many of us may have already learnt about good microbes in our saliva and gut, or on our skin, and some of us already consuming microbiata food such as dairy products for a healthier living. This understanding and accepting bacterial endosymbiosis within us, should now more than ever take us to the viral endosymbiosis within us.

*Viruses due to their smaller sizes, more simple genetic and cellular constructs and more power of entry and mutations, not only live within us and other larger animals, but within plants and even bacteria as their hosts. Hence the lives of all these hosts and viruses depend on each other in a mutualistic inter-dependency.

*Viruses are the backbones of co-evolution (evolving together) and on this path, they advance the cellular and immune systems of the hosts towards better co-adaptation and co-existence. The evolution of many vital cellular organelles and the immune armamentarium of the hosts including humans, e.g. mitochondria and interferon have been possible only through the bacterial and viral endosymbiosis.

*In fact prior to the first living cell, consisting of cellular organelles and DNA, existed double-stranded RNAs, and before that single-stranded RNAs that give rise to the first form of life that was virion or viral particles (48-51).

*Since the existence of bacteria and viruses in endosymbiosis depend on the lives of their hosts, majority of them have never been enemies or pathogens causing destructive illnesses, but friendlier than what even scientists presumed before, through advancing our cellular and fostering our immune systems against the random environmental adversaries, such as incidental pathogens and harsh climate changes (52-53).

*The bacteria and viruses perhaps like many other things could be divided into “The Good, The Bad and The Ugly”, based on their friendliness or pro-evolutionary, life destroying, animosity and anti-evolutionary natures. The examples of ugly viruses could be HIV (Human Immune deficiency Virus) and HPV ( Human Papilloma Virus) that cause severe illnesses, morbidities and mortalities. The examples of bad viruses that are somewhere between the ugly and good ones are Hepatitis Virus, Measles Virus that cause moderate illnesses with some morbidities but very low or no mortalities. The examples of the good viruses are some Coronaviruses such as OC43 of the common cold and COVID that causes mild to moderate illness with the lowest degrees of morbidities and mortalities (54-58).

*The first Coronavirus OC43 that spilled over from bats onto our Homosapiens ancestors million years ago and has been living within us since, causing mild common cold has never been an issue of concern lest panic that has been caused by its variant, COVID-19. Viruses specially evolutionary ones such as coronaviruses mutate all the time on the path of adaptation and co-evolution. Therefore the mutant variants of coronaviruses are not just limited to a few types of these viruses such as COVID, SARS and MERS, or the most announced ninja mutant of COVID, panicking all of us more than before. We notice things in general out of curiosity (scientists) or when get hurt (all of us), but life outside of us is immense and has always been going on with or without our knowledge, approval or panic (61-64).

*Lastly the novel mutations of viruses are under the environmental and evolutionary pressures of adaptation towards survival. The emergence of COVID is such a good and evolutionary mutation for the survival of the coronaviruses and their hosts such as us humans. Obviously wearing masks and lockdowns of all paths of life could not and will not stop such evolutionary pressure, and any aggressive and stubborn resistant could cause more mutations including killer ones. Bottom line even the lay people would not mind a mild infection that does not kill them, but they mind the closure of their lives and their suffocation by the ignorant and controlling authorities and governments that now in a universal dictatorship treat all their subjects as slaves in cages (65-69). 

Dr.Mostafa Showraki, MD, FRCPC, Lecturer, School of Medicine, University of Toronto. 

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Living with Coronavirus in Peace and no Panic

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(Hope the authorities across the globe read this paper and change their course of actions)

(Please read and if agreed pass around to the world due to the urgency of the situation)

Introduction:

The new coronavirus that is now popular with the title of COVID-19 around the world and boasting in spreading at a pandemic level, causing more panic than killings, is the seventh in the line of the class of coronaviruses. This family of viruses head by the common cold or flu virus that has lived in symbiosis with humans for long, and had never caused fatalities and created panic in us. Viruses such as Coronaviruses that have lived for billions of years, much longer than any other beings on the earth keep evolving for survival. This is more true for RNA viruses such as Coronaviruses that depend on hosts to survive, due to lack of DNA for independent living. So on the path of their evolution for survival, they evolve in different types invading the hosts like humans. SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) that hit humans’ population a few years ago before COVID-19 are other types of Coronaviruses. In fact the outbreak of Coronaviruses in different forms over the past several years is a good indicator that these viruses are pushing for survival and coevolution now within the human hosts (1-7).

 In this article I discuss the wise option of living with Coronaviruses in peace with no panic and resistance. This contention that might surprise many is not new in the nature as living in peace or “symbiosis” among the living creatures from plants, animals, bacteria and viruses to us humans have been a rule and part of the law of survival than exception. This has been well known in the scientific and medical circle that I will refer to here, though a call for a peace with the microbial invasions have not been forthcoming yet. The symbiosis between two livings could be obligatory or facultative (optional) that could be different on each side of the equation or relationship. For example in the case of microbes and viruses, the symbiosis on their parts is obligatory as they cannot survive without the hosts, but is optional on the hosts part to let them in or fight back and being killed.

Symbiosis and Endosymbiosis:

Symbiosis, a Greek word meaning “living together”, is any type of close and long-term biological relationship, interaction and dependency between two biological organisms in a mutualistic, commensalistic or parasitic manner. Endosymbiosis or living inside of the tissues of the hosts that most microbes, such as bacteria and viruses do, including many bacteria already living in peace within us, e.g. in our digestive system, assists with our normal living. A peaceful and healthy endosymbiosis in fact leads over time to reduction of the genome size and power of the invader or endosymbiont and lower its fatality due to the adaptation with the host. This has been a vital part of “co-evolution” in nature on earth since its living inception. In fact eukaryotes, the origin of plants, fungi and animals like us all have evolved through this symbiogenesis. Mitochondria, chloroplasts and other cellular organelles that divide and replicate independent of the cells in living creatures like us is an obvious example of such evolutionary endosymbiosis. In fact the notion of Darwinism based on competitive survival has been replaced in the modern scientific arena to the cooperative and symbiotic evolutionary survival (8-10).

Read the full text here:

LIVING WITH CORONAVIRUS IN PEACE AND NO PANIC

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Brain Tumors: When our most precious organ is invaded

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Introduction:

Like other cancers, brain tumors could be benign or malignant, primary starting in the brain or secondary, metastasized from elsewhere. The brain tumors also could arise from its outside covering or meninges or from its own brain matter, which consists of grey (neurons) and white (glia cells). Half of the brain tumors are gliomas and about 8% of myelin or nerve sheath, both of white matter, over 20% meningiomas, 15% of Pituitary adenomas and only over 5% from the brain or grey matter tissue. The cause of most brain tumors are yet unknown and the genetic cases such as neurofibromatosis, tuberous sclerosis are very rare (2). This leaves epigenetic factors such as radiation and microbial invasions as the principal causative agents that will be the main focus of this article.

For over a century the medical field has been well aware of infesting cysts throughout the body that anchor in different tissues and organs including the brain, where hydatid cysts have been reported in the brain as primary and secondary target (3-5). Other than hydatid cysts that caused by parasitic tapeworms getting into humans from intermediate hosts (e.g. sheep, goats) and definite hosts (e.g. dogs), other microbial, fungal and viral infections such as tuberculosis and mycosis have been reported as different cysts and cystic tumors in the different parts of the brain since over a half century ago (6-7). Although majority of the microbial brain invasions are limited to the defensive wall (cover) of the brain or meninges or in the viral cases only causing a generalized encephalitis, some aggressive ones rise to create cysts and tumors often malignancies.

In their frontier and heroic study, Schuman, Choi and Gullen showed that the parasitic toxoplasma gondii infection that simply passes to humans from domestic chickens and other fowls could be the causative agents of several brain tumors. Investigating 171 primary central nervous system neoplasms over 18 months period in 1963-1964 from four Minnesota’s hospitals, they traced down the pathogenic routes of several cases of gilomas, acoustic neuromas, neurofibromatosis, mengiomas, pituitary tumors, craniopharyngiomas and miscellaneous brain tumors back to toxoplasmosis infestations (8).    

Finn, Ward and Mattison in 1972 reported previous tuberculosis infection in a quarter of 26 patients with cerebral gliomas (9). This group a year later to replicate their surprised finding, noted previous tuberculosis infection in 21.7% of 92 patients with cerebral gliomas compared with only 7% of 100 controls (10). Such association between previous tuberculosis and cerebral gliomas were replicated later on and in larger samples by others (e.g. 11). Of viral invasion causing brain tumors, Copeland and Bigner in 1977 inoculated an avian sarcoma virus in the brain of rats at different ages and showed 100% causation of brain tumors, with higher such chance at earlier age of inoculation (12). Similar result in rats was published a year later by Roszman, Brooks, Markesbery and Bigner who showed a parallel immunological suppression by the virus between rats and humans (13). Soon other viruses such as Herpes virus were also shown to be causative agents of different brain tumors in animal studies (e.g. 14).

A decade later in 1987, Corallini and colleagues demonstrated the presence of BK virus DNA in 25.6% of human brain tumors of 74 patients and 44.4% in 9 patients with pancreatic islets tumors (15). BK virus that is widespread worldwide except for isolated regions of Brazil, Paraguay, and Malaysia in its primary invasion or infection is mild and unapparent, manifesting generally as mild respiratory or urinary tract infections. During its primary invasion, the virus through blood spreads to several body organs and remains in a dormant state. The reactivation of virus to cause more damages and tumors across different organs occur upon immunological impairment (16-17). While the brain tumors have been reported to be the more common neoplasms caused by this virus (18-21), bone tumors, insulinomas, Hodgkin’s Lymphoma, Kaposic’s Sarcoma and urinary tract tumors have also been reported (e.g. 22-23). Other viruses such as human JC virus and HIV have also been reported causing brain tumors in animal and human studies (e.g. 24-26).

Soon the idea of vaccination therapy for brain tumors such as malignant gliomas started to grow and have an application. Different viral-mediated (Herpes Virus, Rertovirus, Adenoma Virus, and Epstein Barr Virus) gene therapy started to be applied effectively in animal then clinical studies as vaccinations (27-34). In the recent years the gene or vaccination therapy has progressed so that even RNA-binding and other gene proteins instead of viral vectors have been used in the treatment of different brain tumors such as medulloblastomas in children (e.g.35-36). Altogether these gene therapies in the cancer treatment research filed is known as Suicide gene therapy (SGT), as the brain tumor cells are killed and suppressed in growth (37).

Conclusion:

Even our precious brain with its defensive blood-brain barrier that protects our brains from many toxins and invasions, is not immune and exempted from the microbial invasions. From simple and acute brain infections such as meningitis and encephalitis to longer processes of developing tumors in different part and layers of the brain, microbes are the offending agents. From the tinniest viruses such as BK virus with unapparent and mild primary generalized body infection like a flu to the largest such as tapeworms all invade every parts of our being including our precious brain.

 Knowing the microbial invasions underlying brain tumors for almost a century, but calling the cause of these malignancies as idiopathic (unknown) in the official medical textbooks and literature is ignorance. Acknowledging the underlying pathogenesis of brain tumors by microbial invasions holds the vital promise of prevention and early intervention and right treatments. For example monitoring patients with past history of tuberculosis infections, we could identify and save a quarter of them from developing tuberculomas and gliomas. Also identifying and monitoring other viral, bacterial, fungal or even parasitic infections could prevent or early detect development of different brain tumors caused by these insulting agents.

Finally it has been the diligent observations of some medical scientists into the underlying pathogenesis of brain malignancies by microbes that has led to the recent developments of different viral-mediated or RNA- and related protein-mediated vaccines for the treatment of different brain tumors. In fact these novel treatments cleverly have used the microbial invasion strategies at the service of defense and treatment.

Dr.Mostafa Showraki, MD, FRCPC

Lecturer, School of Medicine, University of Toronto

Author: ADHD: Revisited Book, Amazon Kindle Books

www.adhdrevisited.com/www.medicinerevisited.com


Reference:

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  4. Langmaid C, Rogers L. (1940). Intracranial Hydatids. Brain. 63: 184.
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  6. Iwata K, Wada T. Mycological studies on the strains isolated from a case of chromoblastomycosis with a metastasis in central nervous system. Jpn J Microbiol. 1957 Oct;1(4):355-60.
  7. Dastur HM, Desai AD, Dastur DK. A cystic cerebral tuberculoma treated surgically. J Neurol Neurosurg Psychiatry. 1962 Nov;25:370-3.
  8. Schuman LM, Choi NW, Gullen WH. Relationship of central nervous system neoplasms to Toxoplasma gondii infection. Am J Public Health Nations Health. 1967;57(5):848–856.
  9. Finn R, Ward DW, Mattison ML. Immune suppression, gliomas, and tuberculosis. Br Med J. 1972;1(5792):111.
  10. Ward DW, Mattison ML, Finn R. Association between Previous Tuberculous Infection and Cerebal Glioma. Br Med J. 1973;1(5845):83–84.
  11. Macpherson P. Association between previous tuberculous infection and glioma. Br Med J. 1976;2(6044):1112.
  12. Copeland DD, Bigner DD. Influence of age at inoculation on avian oncornavirus-induced brain tumor incidence, tumor morphology, and postinoculation survival in F344 rats. Cancer Res. 1977 Jun;37(6):1657-61.
  13. Roszman TL, Brooks WH, Markesbery WR, Bigner DD. General immunocompetence of rats bearing avian sarcoma virus-induced intracranial tumors. Cancer Res. 1978 Jan;38(1):74-7.
  14. Adler R, Glorioso JC, Cossman J, Levine M. Possible role of Fc receptors on cells infected and transformed by herpesvirus: escape from immune cytolysis. Infect Immun. 1978 Aug;21(2):442-7.
  15. Corallini A, et al. Association of BK virus with human brain tumors and tumors of pancreatic islets. . Int J Cancer. 1987 Jan 15; 39(1):60-7.
  16. Brown P, Tsai T and Gajdusek DC. (1975). Seroepidemiology of human papovaviruses. Discovery of virgin populations and some unusual patterns of antibody prevalence among remote peoples of the world. Am. J. Epidemiol.,102,331–340.
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  18. Do ̈rries K, Loeber G and Meixenberger J. (1987). Association of polyomaviruses JC, SV40, and BK with human brain tumors. Virology,160,268–270.
  19. Martini F, et al. (1996). SV40 early region and large T antigen in human brain tumors, peripheral blood cells, and sperm fluids from healthy individuals. Cancer Res.,56,4820–4825.
  20. De Mattei M, et al. (1994). Polyomavirus latency and human tumors.J. Infect. Dis.,169,1175–1176.
  21. De Mattei M, et al. (1995). High incidence of BK virus large-T-antigen-coding sequences in normal human tissues and tumors of different histotypes. Int.J. Cancer,61,756–760.
  22. Monini P, et al. (1996). Latent BK virus infection and Kaposi’s sarcoma pathogenesis. Int. J. Cancer,66,717–722.
  23. Monini P, et al. (1995). DNA rearrangements impairing BK virus productive infection in urinary tract tumors. Virology,214,273–279.
  24. Wold WS, Green M, Mackey JK, Martin JD, Padgett BL, Walker DL. (1980) Integration pattern of human JC virus sequences in two clones of a cell line established from a JC virus-induced hamster brain tumor. J Virol. 33(3):1225-8.
  25. Nagashima K, Yasui K, Kimura J, Washizu M, Yamaguchi K, Mori W. (1984). Induction of brain tumors by a newly isolated JC virus (Tokyo-1 strain). Am J Pathol. 116(3):455-63.
  26. Gasnault J, Roux FX, Vedrenne C. (1988) Cerebral astrocytoma in association with HIV infection. J Neurol Neurosurg Psychiatry. 1988 Mar;51(3):422-4.
  27. Ram Z, Culver KW, Walbridge S, Blaese RM, Oldfield EH. In situ retroviral-mediated gene transfer for the treatment of brain tumors in rats. Cancer Res. 1993 Jan 1;53(1):83-8.
  28. Chen SH, Shine HD, Goodman JC, Grossman RG, Woo SL. Gene therapy for brain tumors: regression of experimental gliomas by adenovirus-mediated gene transfer in vivo. Proc Natl Acad Sci U S A. 1994 Apr 12;91(8):3054-7.
  29. Kramm CM, et al. (1995). Gene therapy for brain tumors. Brain Pathol. 1995 Oct;5(4):345-81.
  30. Wakimoto H, Yoshida Y, Aoyagi M, Hirakawa K, Hamada H. (1997). Efficient retrovirus-mediated cytokine-gene transduction of primary-cultured human glioma cells for tumor vaccination therapy. Jpn J Cancer Res. 88(3):296-305.
  31. Rosolen A, et al. (1998). In vitro and in vivo antitumor effects of retrovirus-mediated herpes simplex thymidine kinase gene-transfer in human medulloblastoma. Gene Ther. 5(1):113-20.
  32. Timiryasova TM, Li J, Chen B, Chong D, Langridge WH, Gridley DS, Fodor I. (1999). Antitumor effect of vaccinia virus in glioma model. Oncol Res. 11(3):133-44.
  33. Benedetti S, et al. (2000). Gene therapy of experimental brain tumors using neural progenitor cells. Nat Med. 6(4):447-50.
  34. Izumo T, Ohtsuru A, Tokunaga Y, Namba H, Kaneda Y, Nagata I, Yamashita S. (2007). Epstein-Barr virus-based vector improves the tumor cell killing effect of pituitary tumor in HVJ-liposome-mediated transcriptional targeting suicide gene therapy. Int J Oncol. 31(2):379-87.
  35. Bish R, Vogel C. (2014). RNA binding protein-mediated post-transcriptional gene regulation in medulloblastoma. Mol Cells. 37(5):357-64.
  36. Yao H, et al. (2015). Enhanced blood-brain barrier penetration and glioma therapy mediated by a new peptide modified gene delivery system. Biomaterials. 37:345-52.
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Autoimmune Disorders: Relapsing-Remitting Vs. Progressive

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Introduction:

The majority of autoimmune disorders like cancers are progressive and fatal. The exceptions seem to be only autoimmune demyelinating disorders and its most common type, Multiple Sclerosis (MS) that in majority of cases have a relapsing-remitting course and a better prognosis. Although MS at the onset could manifest as a clinically isolated syndrome, it soon takes the form of either relapsing-remitting or progressive (primary). Later on in the course of illness a minority of the relapsing-remitting MS (RRMS) may change its course to progressive and poor prognosis and this group is classified secondary progressive MS (SPMS) against the primary progressive MS (PPMS) that has a progressive course from the onset (1)

 Unfortunately it has not yet been sufficiently questioned and studied why MS and other similar autoimmune demyelinating disorders possess could have a relapsing-remitting course and a better prognosis, while the nature of autoimmune disorders are generally progressive with morbidity and mortality. Autoimmune disorders that like cancers as detailed in other articles on this site are the results of microbial invasions, and no microbes such as bacteria or viruses invade our beings to fool around, remit and relapse. So then why if autoimmune demyelinating disorders such as MS are also the byproducts of microbial invasions such as EBV (Epstein Barr Virus), have a remission and relapse course while the invasion targets our most precious organ, the brain. In fact the answer when probe to it well lies in our brain, not the invaders. It’s the brain that protects itself and fights back against the invasion and strives to undo the damage. This interesting fact that so far seems to happen only in the brain and at least to the myelin sheaths of the brain is a very new discovery in the very recent years. But this has not yet been applied in the explanation of the relapsing-remitting course of autoimmune demyelinating disorders such as MS, and this article could be the first.

The Brain fights back:

While the great majority of brain cells are essentially stable throughout life, oligodendrocyte precursor cells (OPCs) that generate new oligodendrocytes hence new myelin sheaths have been observed widespread in the brain even in adult life (2). The myelin or myelin sheaths that cover the nerve cell axons act as the nervous system wires for the conduction of information from one neuron to the other, or one area of the brain to the other. The white matters or the highways of the brain are basically made of the myelin and myelin sheaths that are the targets of microbial invasions in the autoimmune demyelinating disorders such as MS. Generally the process of myelination or the generation of myelin and myelin sheaths that start early in the third trimester, continues throughout adolescence and early adult life that contribute and correspond to the continuation of the general brain development until mid-20s (3). The reason or need for the long development of the brain through ongoing myelination is building its widespread communication infrastructures for learning, skills developments and other higher cortical functions that create cognitive and skills maturity.  

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Autoimmune Disorders: Relapsing-Remitting Vs. Progressive

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Reactive Depression: Lost in Translation!

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Introduction:

The old classification of depression into Reactive and Endogneous that are still observed in the clinical practice cannot all be accommodated under the current rubric of Major Depression. This is because psychiatric nosology under DSM and its latest 5th edition is still descriptive, and not etiologic. In this article both reactive and endogenous categories of depression are revisited from the perspective of today’s understanding of etiological pathways. From an epigenetic perspective, the old dichotomy of Reactive vs. Endogenous are inter-related through the impact of the environment (e.g. stress). This includes familial or prenatal depression, where the environmental impact is before birth, or childhood depression where the early life stress is the precipitating factor to the genetic susceptibility. In conclusion, searching for both environmental impact (e.g. stressors) and genetic predispositions in depression, even at a clinical level could help clinicians with better therapeutic decisions.

 The differentiation of major depression into ‘reactive (stress-induced)’ vs. ‘endogenous (e.g. genetic)’ dates back to the German psychiatrist, Kurt Schneider (Schneider, 1920) who borrowed the term ‘endogenous’ from Emil Kraepelin. The differentiation was an early attempt at an etiological classification of depression (Mendels & Cochrane C, 1968). Despite the extensive use of these terms and despite the popularity of the catecholamine deficiency hypothesis of depression (Schildkraut, 1965) and the effectiveness of tricyclic antidepressants that began with the introduction of imipramine in the 1950’s, psychiatric nosology then gave up on the attempt of classifying depressions according to etiology.

 Although the aim of DSM-III in 1980 was for psychiatry to do what the rest of medicine does, to classify disease according to cause, this proved impossible and a non-etiological, purely descriptive system was devised that relied on categories based on symptoms and their severity. DSM-III divided the depressions into major and minor (DSM-III, 1980). Almost four decades later, DSM5 continues to be descriptive and non-etiological (DSM5, 2013). This has continued despite research that points to distinguishable pathways leading to the symptoms of major depression (Ghaemi & Vohringer, 2011; Malki et al. 2014; Mizushima et al. 2013; Parker 2000).

In this article an attempt depression is reviewed on a pathophysiological basis through 1) the impact of stressful events and their timing 2) gene-environment interactions and 3) biological circuits affected by different kinds of depression. The generic term of “depression” that has been used in this paper, refers mostly to major or unipolar depression, though it can at times also applies to minor depression and dysthymia. This article also excludes the normal reaction of mood to stress below clinical level of severity and dysfunction.

The timing of the stress onset:

In reference to stress leading to depression, there is a major differentiation between an early childhood adversary or later in life (adulthood) stress. While these two types of depression, one with an early onset in childhood or adolescence, and the other one with a later onset in adulthood, could be referred to as “Reactive Depression”, they are fundamentally different. (Hazel NA., et al., 2008) This differentiation between reactive depression in the past decade has been recognized in the literature as “Juvenile” and “adult” onset with different pathophysiological pathways that perhaps demand different treatment pathways as well. (Jaffee SR, et al., 2002; Weissman MM, 2002)

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Autoimmune Disorders: Relapsing-Remitting Vs. Progressive

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Anxiety & Depression Survey

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Struggling with Anxiety more than usual so that causes dysfunctions in one or more areas of life seems to be very common and more than the current statistics in DSM5 (Diagnostics and Statistics of Manual of Mental Disorders) 5th edition. Please take a few minutes and answer the following survey as an attempt to identify the true rate or prevalence of the common anxiety disorder that’s medically known as GAD (Generalized Anxiety Disorder). To a get close estimate of the prevalence of this condition, we ask everyone who visits this site to fill out the survey even if you don’t have no history of anxiety or depression. 

Thank You.  

1. How old are you?

2. Do you usually get anxious, tense or stressed upon performance such as in school upon tests, exams, presentations or interviews?

 
 

3. Do you usually get anxious, tense or stressed in social situations, crowds or with strangers?

 
 

4. Do you dislike and usually try to avoid anxiety provoking situations?

 
 

5. Are you a worrier and do you anticipate the worst of the situations?

 
 

6. Have you found difficult to control your anxiety and worries?

 
 

7. Are you usually restless or feeling keyed up or on edge?

 
 

8. Do you feel easily fatigued?

 
 

9. Do you usually have difficulty concentrating or experience your mind going blank?

 
 

10. Are you usually irritable?

 
 

11. Do you usually have muscle tension?

 
 

12. Do you usually have any sleep disturbances such as difficulty falling or staying asleep, or having restless, unsatisfying sleep?

 
 

13. Have you ever had any anxiety or panic attacks with uncomfortable physical symptoms such as heart race, sweating, shortness of breath, chest pain, dizziness, shakes?

 
 

14. Has your anxiety caused dysfunction in any parts of your social, occupational, or any other important parts of your life?

 
 

15. Have you ever had any episode of depression?

 
 

16. Has your depression been long for more than 2 weeks?

 
 

17. Has your depression been reactive to your stress, anxiety and situational?

 
 

18. Have you been helpless towards the situations that you could not control?

 
 

19. Have you ever become hopeless towards life?  

 
 

20. Have you ever been suicidal?

 
 

21. Have you ever attempted suicide?

 
 

22. Have you ever been diagnosed with GAD (Generalized Anxiety Disorder)?

 
 

23. Have you ever been diagnosed with Major Depression?

 
 

24. Have you thought or been told that you have mood swings?

 
 

25. Have you ever been diagnosed with Bipolar Disorder?

 
 

26. When did you first experience your anxiety?

 
 
 
 
 

27. When did you first experience your depression?

 
 
 
 
 

28. Have you ever sought medical help for your mood condition?

 
 

29. Have you ever been in psychotherapy?

 
 

30. Have you ever taken any antidepressants?

 
 

31. Have you ever taken any tranquilizers such as Lorazepam (Ativan), Clonazepam, Diazepam?

 
 

32. Have you ever taken any other psychiatric medications?

 
 

33. Have you tried more than a few times to use alcohol or street drugs for alleviation of your mood condition and which one of the following?

 
 
 
 
 
 

34. Does anybody else in your family suffers from anxiety and worries?

 
 

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Stem Cell Therapy: Does it work and for what?

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Introduction:

Stem cells are the primordial or original cells that give rise to life and being of a living thing, from animals and humans. Zygote formed from the fusion of sperm and oocyte is the first line of stem cell that is “totipotent” meaning it gives rise to embryonic stem cells and from there to epiblast and embryonic germ stem cells, that are all “pluripotent” meaning they form all the differentiated cell types of a given tissue. These pluripotent stem cells lineage give rise to the primordial germ cells that form all the tissues from skin to bone marrow and all other body tissues. The aim of stem cell therapy over the past half a century has been to induce pluripotent stem cells (IPS) in different body tissues to repair or replace the damaged tissues and cells of specific organ or parts of the body in vitro (in lab) and in vivo (in live beings) (1-2).

 Bone marrow transplant has been the earliest stem cell therapy in the treatment of leukemia and lymphoma and has been widely clinically practiced over almost half of a century all over the world with quite success. Later on umbilical cord blood storage and use for transplants has been clinically practiced, while other forms of stem cell therapy such as the use of induced pluripotent stem cells (IPS) for a wider treatment of cancers and autoimmune disorders of different organs and tissues have been mostly experimental. Another common clinical use of bone marrow transplants has been in chemotherapy of cancers, to introduce the hematopietic stem cells within the bone marrow to replace the destroyed healthy cells by chemotherapy. The most common side-effects of bone marrow and other transplants traditionally has been graft vs. host reaction that rejects the transplant. Another stem cell therapy, “Prochymal” based on allogenic stem cells therapy using mesenchyme stem cells has been used recently in the management of such transplant rejections (3-4).

 While in the past it was thought that the stem cells are basically in bone marrow and umbilical cords and most organs and tissues unlike the epidermis of the skin do not possess the capacity of renewal, in recent years it has become apparent that some other tissues in fact contain stem cells for potential renewal (5). One main reason of the delay in the stem cells therapy has been lack of recognition of different stem cells across different tissues with different potential capacities unlike the progenitor bone marrow and umbilical cord stem cells. As explained above while many of these stem cells are pluripotent, most are multipotent or unipotent, meaning having the capacity of their own specific tissue cells regeneration (6-7). In fact and with a comprehensive perspective, cancer cells could be considered as stem cells for their capacity of turnover and proliferation. This fact has been known and discussed as early as late 80s, but only recently has received widespread attention and acceptance. The cancer stem cell concept is important for opening a new venue to the novel approaches in anti-cancer therapies that instead of killing all or partial cancer cells with the potential of regrowth, to target the cancer stem cells for final cure with no possibility of relapse (8-9).

 The advancement in stem cell research over years has led to the distraction and culture of progenitor or totipotent stem cells in vitro first from the animal models such as mouse, and now from the human’s blastocysts, with the ability of generation all the differentiated cells of a being such as human, hence “cloning” that puts the science in the jeopardy of Frankenstein as it has long been anticipated and infuriated (10-11). Other than blastocysts, the progenitor or embryonic stem cells with capacity of generating differentiated tissues of the whole being, it has been shown that epiblasts first from mouse and now humans could created such pluripotency (12-14). Moreover and morally riskier is the capability of adult stem cells to be reprogrammed to a pluripotent state, through transferring the adult nucleus into an oocyte or by fusion with a pluripotent cell. The most famous example of this cloning has the creation of “Dolly” the sheep by transferring of a somatic nucleus into an oocyte (15-18).

 From a therapeutic not creational standpoint, the ability of regenerating new cells in the damaged and destroyed tissues is the art and science of IPS (induced pluripotent stem cells). Despite knowing for long that some amphibians could naturally regenerate limbs, eye or other injured body parts, therapeutic regeneration or regrowth of damaged or destroyed tissues medically by IPS is quite recent (2, 19-20). Since the original retrovirus-mediated induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by some defined factors in 2006-2007 (21), rapid progress has been made to generate iPS cells from adult human cells (22), a range of tissues that can be reprogrammed (23), and from patients with specific diseases (24). The number of transcription factors required to generate iPS cells has also been reduced (25), and the efficiency of iPS cell generation has increased (26), and techniques have been devised without viral vectors integration (27).

 From Research to the bed side:

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Stem Cell Therapy: Does it work and for what?

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ADHD:Subtypes or one Type?

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Introduction:

The literature on pathophysiology of ADHD is quite inconsistent with mixed results to synthesize all the findings in any domain of neuropsychological, neuroanatomical, neurochemical or genetics to link them to the correspondent clinical phenotypes of the current ADHD subtypes. On a descriptive level, the symptomatology of two distinct ADHD subtypes of hyperactive-impulsive (ADHD-HI) and inattentive (ADHD-I) are quite different and hardly seem to come under the same disease entity as it has long been categorized by DSM classifications with no change in the recent DSM5 (1). While ADHD-I or ADD as it was labeled in the past, it is an “attention-deficit” disorder, ADHD-HI beyond an attention-deficit disorder, it is a behavioural disorder with cardinal symptoms of hyperactivity, impulsivity and behavioural disinhibition (2-4). As a result, the majority of research samples, hence the conclusions of the literature for clinical practice have relied heavily on the “combined subtype” that is an ill-defined combination of both subtypes. This ill-defined combined subtype usually is not consisted of 6 symptoms of either subtypes as required by DSM5, but some of the symptoms of each, in a mixed and arbitrary construct with no clear underlying pathophysiology as either subtypes. This contradicting fact has long caused an intense argument in the literature on the total validity of ADHD as a homogenous or single disorder with a single pathophysiology or two or more heterogeneous disorders with different pathophysiology (5-7), that I will attempt to review and explore in this paper.

 ADHD: Homogenous or Heterogeneous?

In fact throughout the history, ADHD has been a homogeneous condition, first described as “hyperkinetic” or “hyperactive” syndrome or disorder of children, with recognition of “impulsivity” as a component of hyperactivity first by Laufer et al. (8) in 1957. The second edition of DSM, i.e. DSM-II in 1968, (9) published by the APA, that for the first time recognized the condition as a disorder, labeled it as “hyperkinetic reaction of children”. It was not until the third edition of DSM (10) in 1980 that recognized the condition as an attention deficit with hyperactivity and labeled it as such, i.e. ADHD, that we started facing a combined and heterogeneous disorder. Unfortunately since then the research samples have been mostly undifferentiated or of combined subtype with rare comparison between the two subtypes, so to clarify any distinctions between the two if any.

 The few available comparison studies between the subtypes have shown that there is a distinct difference between the two with the conclusion of the most that ADHD is a heterogeneous condition with differences not only in symptomatology and the course of illnesses across the brain development, but differences in cognitive functions and different etiopathophysiology (11-12). Goth-Owens et al. (13) in their comparison study of 572 children and adolescents with pure inattentive subtype (ADD), combined type (ADHD-C) and non-ADHD controls, reported slower cognitive interference speed in the ADD vs. ADHD-C and controls comparisons. A similar result was reported by Carr et al. (14) who reported an attenuated attentional blink versus controls and ADHD-combined addressed in a sample of 145 ADD/ADHD and typically developing comparison adolescents (aged 13-17). A similar result has been reported by Solanto et al. (15 ) that predominantly inattentive subtype show worse performance than combined subtype and control groups on the WISC-III Processing Speed Index. This has made some researchers to question the validity of DSM current diagnostic criteria of ADHD to include two distinct subtypes of inattentive and hyperactive/impulsive under the same diagnostic umbrella. (16) Martel et al. (17) in comparison between the two subtypes, reported “a composite executive function factor was significantly related to inattentive but not hyperactive-impulsive symptoms.” The authors concluded “Executive function weakness in adolescent ADHD is specifically related to symptoms of inattention-disorganization.” Nigg et al. (18) also reported that symptoms of inattention-disorganization were uniquely related to executive functioning when hyperactivity-impulsivity controlled. “Inattention was associated with slower response speed, and hyperactivity-impulsivity with faster output speed. Results were not accounted for by IQ, age, gender, education level, or comorbid disorders.” Also Marshal et al. (19) found academic underachievement in a group of 6-12 years old with ADHD without hyperactivity. Friedman et al. (20) have reported that such cognitive deficits continue until late adolescence and Nigg et al. (21) who report their extensions to adulthood.

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ADHD:Subtypes or one Type?

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Hating Chemicals: Natural Medicines and Vitamins

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Introduction:

Natural medicine or Alternative Medicine or the field of Naturopathy with their widespread health food stores that have filled up the shelves of pharmacies as well is based on the propaganda that medications are chemicals and unsafe and their own products natural and safe. The field of naturopathy and the natural or herbal medicines that have dominated the health products market and sell more than prescription medicines, is solely based on the notion that the prescribed medications are chemicals and theirs are not. The irony is that everything is chemical, the oxygen in the air that we breath (O2), the water that we drink (H2O), and all the food that we eat, and so on.

In fact the prescribed medications that are nowadays synthesized in pharmaceutical factories have been originally made out of plants, e.g. Digoxin for heart attacks, Atropine for pupillary dilatation and else, Codeine for pain relief, L-Dopa for treatment of Parkinson’s, Aspirin, Quinidine an anti-arrhythmic, Reserpine a hypotensive, Theophylline a diuretic, and Yohimbine an aphrodisiac among so many others. Investing and profiting from the popular lack of sufficient knowledge and also the mass suggestibility, the field of alternative medicine has gone so far that simple food items such as garlic, cranberry and fish oils have nowadays been packaged in capsules, tablets and sold to consumers (1-2).

Although the science of Medicine originated from the herbs and plants, it was not until the modern era that the real based evidence medicine as we know it developed a competitor as “alternative medicine” to promote the use of natural medicine and other forms of healings. This alternative medicine or “naturopathy” from the start by the Bavarian priest Sebastian Kneipp in late 19th century to Benedict Lust, the founder of naturopathy in US, started their propaganda against evidence-based or real medicine and medications, including vaccinations even in children and against killing infections such as small pox or chicken pox. Although naturopathy or alternative medicine cover an extensive area and different treatment modalities, e.g. acupuncture, aromatherapy, massage therapy, Chinese medicine, homeopathy, herbology, reflexology, Reiki and chiropractic, the focus here will be on the promotion of the use of natural or herbal medicines, vitamins, minerals and supplements that have become a huge profit making business and available everywhere even on the shelves of pharmacies and grocery stores (3).

 The efficacy and safety of herbal medicines:

In argument against the core of natural or herbal medicine that they are natural and safe while prescription medicines are not, there are numerous studies across the globe demonstrating evidence to the contrary. It is well known even to the lay people that one could get poisoned by food, consuming plants or even coming in touch with them. Mushroom poisoning and contact dermatitis by poison ivy are the two very common examples that almost everyone is aware of. A total of 216 medicinal plants belonging to 77 families in North and Central America and Caribbean have been reported as toxic. These herbal medicines and alike that have been promoted and used for different illnesses such as rheumatism, wound healing, flu, headache, dysentery, gastritis, constipation, diarrhea, body pains, cancer, antiseptic, digestive, diuretic, fever, infections, menopause, dysmenorrhea, postpartum, diabetes, asthma, anemia, inflammation, muscle relaxant, hair loss, seizures, hypertension, anxiety, depression, psychosis, weight loss or simply to purify body and the blood, have been reported to cause many side-effects and toxicities (4).

The list of these untoward effects and toxicities like the claimed positive effects are numerous, e.g. nephrotoxicity (toxicity of kidneys), hepatotoxicity ((toxicity of liver), dermatitis, hypertension, nausea, vomiting, diarrhea, muscle paralysis, cardiotoxicity (toxicity of heart), gastritis, even being carcinogenic, sleepiness, muscle paralysis, respiratory failure, neurotoxicity (toxicity of nerves and central nervous system), causing abortions, hallucinations (hearing voices or seeing visions), edema (swelling), hemorrhage, blurred vision, vertigo, stupor, confusion, being narcotic and addictive among others (5-16).

Other than the above gross and obvious toxicities, the herbal medicines could caused molecular and cellular toxicities (cytotoxicity), even mutagenicity and genotoxicity (causing gene mutations and toxicities). Some herbal medicines could also cause toxicities during pregnancy and reproduction and cause abortions. These facts are only the tip of the iceberg of the possible side-effects and toxicities of the herbal medicines as most people do not report to their physicians and refer to emergency rooms of hospitals when intoxicated. Moreover there are untoward interactions of the herbal or natural medicines with the prescription medications that again many patients do not report to their physicians or pharmacies when use these products in addition to their prescribed medications (17-20).

 The case of naturopathy or homeopathy and their broad advertisements in media, specially in social media, TV, and many journals are beyond control. Nowadays to skip the drug agency controls, many of these products are offered in the common food products such as drinks, teas and even candies and other snacks. Moreover the health benefits of certain herbs, vegetables, plants and food as simple as garlic or fish oil have been exaggerated and they have been produced and released into tablets, capsules and sold in the market at a much higher prices, instead of promoting these basic food items in meals. These propagandas have been at the cost of advertising against the consumption of some food health promoting foods that nowadays are missing from many people’s diet such as dairy products, eggs, lipids, red meat and fruits (21-22).

 Read the full text here:

Hating Chemicals: Natural Medicines and Vitamins

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Fibromyalgia/Chronic Fatigue Syndrome: Controversy or Truth?

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Introduction:

Fibromyalgia that is diagnosed and labelled by physicians in clinical practice and even research interchangeably with Chronic Fatigue Syndrome is still a controversy by some, while a clear diagnostic entity by others. As the label of fibromyalgia denotes, it is a condition of generalized body (musculoskeletal) and joint pains. The Chronic Fatigue Syndrome label indicates the patient suffering from a general body fatigue. These two labels if they are two conditions may overlap as some patients and present with both generalized symptom clusters. That is why the two conditions are considered by some as one and inter-related. While these conditions were misdiagnosed or under-diagnosed in the past, they may be over-diagnosed in the recent years. Either way the diagnosis of these conditions often is clinical and by history and physical examinations (only if muscle and joint tenderness present) as any lab or imaging tests are often non-conclusive. Therefore the pathophysiology of these conditions is still known by many as idiopathic, without any known aetiology or pathologic pathway(s).

 More than a controversy, Fibromyalgia and Chronic Fatigue Syndrome (FCFS) are elusive and the diagnosis by many could be descriptive and clinical by symptoms counting like major depression. But there is at least one or more types of FCFS that are associated with many other medical conditions, e.g. IBS (Irritable Bowel Syndrome), non-ulcer dyspepsia, esophageal dysmotility, interstitial cystitis, chronic prostatitis, vulvodynia, vulvar vestibulitis, temporomandibular joint syndrome, sickle cell anaemia, osteoarthritis to name a few. The association with some of these comorbidities that are known as autoimmune disorders, could easily classify this type (s) of FCFS as an autoimmune condition(s) (1). The common conception behind the pathogenesis of FCFS is over-focussing on the pain symptoms that could be due to super-sensitivity or hyperalgesia of the nociceptive process in the central nervous system. But here the focus will be more on the type or types of FCFS that have some true underlying pathologies (1-2). This or these pathological condition (s) are inflammatory, systemic throughout the body and associated with one or more inflammatory or autoimmune disorders (e.g. 3-4).

In the Search of a True Pathologic Fibromyalgia & CFS:

A Chronic Pain Syndrome or A Systemic Musculoskeletal Inflammation?

The first thing to reach the truth of FCFS is to separate these two different conditions that currently are diagnosed under the generic umbrella of fibromyalgia and chronic fatigue syndrome. First of all since both a chronic pain syndrome due to hyperalgesia or super-sensitivity of the nociceptive receptors in the central nervous system, and a systemic musculoskeletal inflammation could cause chronic fatigue syndrome, this secondary or post-morbid condition in this article will be excluded and the literature on fibromyalgia is solely explored (5-8).

 Although a systemic musculoskeletal inflammatory condition could cause chronic generalized body pain, but the reason for the pain is not hyperalgesia or hyper-sensitivity of the nociceptive receptors in the central nervous system, but peripheral inflammations. This inflammatory condition is separated and searched for its underpinning pathology as the true pathological fibromyalgia, as pain even a generalized type could be subjective and not a true objective and pathological condition. Even tenderness of the muscles and joints without any proof of underlying pathology such as inflammation could be all subjective. Therefore this subjective condition or Chronic Pain Syndrome that could be due to a hyperalgesia or hyper-sensitivity of the nociceptive receptors of the brain or in a simpler word due to hyper-perception of pain by an individual is separated from a true fibromyalgia in this paper. This sole pain condition that is simply subjective could be perhaps associated more with other subjective conditions such as depression or being influenced by psychosocial processes (9-12).

Fibromyalgia: A Systemic Musculoskeletal Inflammatory Condition  

Unfortunately since most samples of fibromyalgia studies are mixed with chronic pain syndrome and other subjective conditions without any underlying physical pathology, the physical findings of any inflammatory biomarkers are below the real level of the pathological reality of the condition. But despite this limitation, there are studies that have been able to show the presence of an underlying inflammatory process in the true cases of fibromyalgia.

Read the full text here:

Fibromyalgia/Chronic Fatigue Syndrome: Controversy or Truth?

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When one is not enough: Multiple Autoimmune Syndrome

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Introduction:

The world even the medical filed are all terrified by the cancers, while the autoimmune disorders are more prevalent across the globe. While the incidence of all cancers world wide is about 17 millions cases in 2018 that makes it .22%, the prevalence of only very common autoimmune disorders is over 3.45% or over 266 millions internationally, making them more than 15 times prevalent than the cancers. (1-2) The common autoimmune disorders that to some including physicians might not be recognized as such diseases in the above estimate of prevalence (with an average prevalence per 100,000 in brackets) are as follow: Diabetes type 1 in all ages (946); Hypo- and Hyper-Thyroidism (691); Rheumatoid Arthritis (381); Ulcerative Colitis (378); Crohn’s Disease (225); Psoriasis (197); Multiple Sclerosis (182); Uveitis (149); Polymyalgia Rheumaica (112), Celiac Disease (50); Sjogren Disease (48); Chronic active Hepatitis (45); SLE (Systmeic Lupus Erythematosus) (32); Vilitigo (29); Systemic Sclerosis (23); Alopecia (21); Addison’s Disease (18); Myasthenia Gravis (18); Primary Billiary Cirrhosis (12); and Systemic Vasculitis (10). (1)

 As discussed in a few articles on different cancers such as breast, prostate, ovarian and endometrial, lung, colorectal, skin cancers and leukemia on this site, cancers are mostly epigenetic than genetic (3-10). Of the epigenetic factors, microbial invasions are the frontiers on the assaults and causation of different cancers. The epigenetic factors such as infections as part of their offensive strategies, weaken the defensive power of the targeted organ, causing dysplasia, polyps or other benign forms of tumours before progressing to malignant cancers that are the killers of the assaulted organs. In a relatively similar process, autoimmune disorders are caused by epigenetic factors including microbial invasions. While cancers are localized assaults, autoimmune disorders are more generalized attacks of epigenetics to our living system.

 

It is not yet very clear to our scientific strive to differentiate at the onset of the invasion which disease will ensue at the end. It seems so far to our limited knowledge that the pathogeneses of either cancers or autoimmune disorders, or the impact of what organ or system of the body are multi-factorial. This depends on the invader, what organ or system it attacks or what is its specialty, and also on the condition of the targeted organ or body system. The control of the invaders is by avoidance (e.g. too much exposure to the sun in skin cancer), prevention (e.g. vaccinations when possible and available), early recognition of he early stages of the attack and recovery (e.g. surgical removal of polyps or benign tumours). But more importantly is the fostering of our body system to be more immune and protective against such invasions that are all around us and often could not be avoided. This strategy is about reinforcing our immune system that is perhaps the major defense against autoimmune disorders (3-15).   

 It is suspected that the incidence of autoimmune disorders are on the rise that could be due more to our less defensive immune system than the stronger environmental factors such as microbial invasions. It also seems that single autoimmune diseases are rising up to multiple autoimmune diseases or syndromes. This makes the hypothesis of increasing the rate of autoimmune disorders due to our poorer immune system seem more right as multiple autoimmune syndromes occur more in the subjects with less defensive or weaker immune system. In this article through a search into our available scarce knowledge data on this growing monster, I will attempt to bring these syndromes and their pathogenesis more to the light of recognition and hope to the arena of prevention (16-18).

 

Humans: More Knowledge, More Tools, More Vulnerable:

For the sake of simplicity and unified terminology with the rest of the field, the term of Multiple Autoimmune Syndrome (MAS) for any multiple autoimmune disorders that occur together in a person. The condition is so on the rise due to our defenseless immune system that the expert consider MAS when there are three or more of autoimmune disorders clamp together in an individual. About 25 percent of patients with autoimmune diseases have a tendency to develop additional autoimmune disorders. Surprisingly for whatever reason, MAS often involves one dermatological or skin condition such as alopecia, vitiligo or psoriasis (19).

 For long and before the discovery of MAS, the medical field was acknowledged of a few systemic autoimmune disorders, spreading to more than one organ of the body, and the most commonly known is SLE (Systemic Lupus Erythematous) that is a progression from skin lupus but spread beyond to the joints and more. Later on in the course of the history of medical knowledge, we recognized more concurrent autoimmune diseases in autoimmune hepatitis autoimmune bowel diseases, e.g. ulcerative colitis and crohn’s disease. Association of skin autoimmune diseases such as vitiligo and alopecia in MAS is another important and significant observation that could one day lead us to more understanding of the pathogenesis of these metastatic autoimmune disorders. Moreover on the epigenetic or the invader’s front, some such as cytomegalovirus by producing multiple autoantibodies are capable of spreading into different organs and causing MAS (20-21).

 

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When one is not enough: Multiple Autoimmune Syndrome

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Sport Injuries: When Young and Healthy Break

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(To: My daughter Tiffany, Mohammad Ali, Rafael Nadal, Milos Raonic and all the injured athletes of the world) 

Introduction:

When my daughter, a junior tennis player, injured her wrist this summer it took her about two months to recover and get back to the game. Having had to retire from a few important tournaments, I realized more of the significance and self-destruction that sport injuries could cause to a person. We all know about the consequences of sport injuries in famous world sport leaders such as Mohammad Ali who developed Parkinson syndrome (not the disease but what’s called in medicine “Punch Drunk Syndrome” with Parkinson-like symptoms). Sport injuries are almost unavoidable in athletes, and in the tennis the fans know how many operations the current world number one, Rafael Nadal has had just on his knees, or Canadian Milos Ranoic broke his hip at age 20 by falling on the grass court in Wimbledon.

Different sports are more prone to injuries and different parts of the body are more common to injuries in different sports. For example tendonitis of the wrist, elbow, shoulders and injuries to the knees, ankles and foot are more common in tennis. But head injuries are more common in boxing and hockey, while foot, legs and knees injuries are more common in soccer. Overall some sports are more prone to injuries due to the nature of the sport and the behavior of the athletes and due to more lenient rules and prohibition executed by the specific sport authorities and the referees in some specific sports such as hockey. While the physical injuries are more obvious and attended to, the mental and emotional injuries due to the stress and expectations of the athlete performance by the athlete, coaches, fans and families should not be ignored(1).

We need not to forget that sport injuries do not occur only in professional athletes that comprise a small population in sports in general, but in many healthy youngsters who engage in sports curricular in schools or extra-curricular sport activities. There are more than 30 millions injuries alone in the United States in teenagers and children. We also need to realize that some sport injuries when befall on the neck and head could lead to permanent disabilities and loss of lives that often happen to the otherwise healthy and young ones. We need not to be scared and avoid the sports for ourselves and our children, as playing sport or exercise is the best that we or they can do as a guarantee for a healthy life, but we need to know how to do it right so to prevent injuries. Although this article is focused on sport injuries in the athletes of all ages and different levels, but ordinary people who engage in harsh and in-calculated exercises could have injuries as well (2).

In this article after classifying the common sport injuries, considering different age groups, in non-professionals and professionals, and across different sports, and also among ordinary people regarding over-use and improper injuries, prevention of such injuries will be discussed.

 Soft-Tissue Injuries:

Soft-tissue injuries are the most common type of injuries that include simple cuts, lacerations and bruises, easily seen by the naked eyes. But deep soft-tissue injuries that could affect tendons, muscles, blood vessels, nerves and could cause more pains, discomfort and longer disability mostly due to deep inflammations, may be ignored. The most common of these deep soft-tissue injuries are tendonitis and neuritis or neuralgic pains that demand longer and more specific treatments.  

  Read the full text here:

https://medicinerevisited.com/sport-injuries-when-young-and-healthy-break/

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Asthma: A Tribute to Ernesto Che Guevara

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(“I went to see an old woman with asthma, a customer at La Gioconda. The poor thing was in a pitiful state, breathing the acrid smell of concentrated sweat and dirty feet that filled her room, mixed with the dust from a couple of armchairs, the only luxury items in her house. On top of her asthma, she had a heart condition. It is at times like this, when a doctor is conscious of his complete powerlessness, that he longs for change: a change to prevent injustice of a system in which only a month ago this poor woman was still earning her living as a waitress, wheezing and panting but facing life with dignity. In circumstances like this, individuals in poor families who can’t pay their way become surrounded by an atmosphere of barely disguised acrimony; they stop being father, mother, sister or brother and become a purely negative factor in the struggle for life and, consequently a source of bitterness for the healthy members of the community who resent their illness as if it were a personal insult to those who have to support them….In those dying eyes there is a submissive appeal for forgiveness and also, often a desperate plea for consolation which is lost to the void, just as their body will be soon lost in the magnitude of mystery surrounding us.”)    

Ernesto Che Guevara,

Motorcycle diaries

Introduction:

Asthma that is the narrowing of the airways of lung, causing difficulty in  breathing with sound of wheeze, is a chronic disease often starts in childhood and is an interaction between the environmental allergens or pathogens and the individual lung’s susceptibility or genetic make up. This early onset asthma that often leads to asthma attacks, frightening the person and the relatives for the fear of inability in total breathing and death, is usually due to an allergic eosinophilic reaction of the lung airways, causing their narrowing due to thickness of their smooth muscle walls and also obstruction caused by reactive sputum (1-3).

 But not all asthma is an allergic eosinophilic reaction of the lung airways and there is a heterogeneity even in the inflammatory asthma known and reported since 1922 by Huber and Koessler (4). It has been shown and reported that any problems with the lung function such as reduced its function even as early as infancy could lead to late on obstructive lung disease such as asthma (5-6). At the same time, having a history of allergy or atopic sensitization as long as not related to such sensitivity in the lung airways, it will not necessarily lead to asthma in childhood. (7) Following an epigenetic model of causation in asthma, the airway hyper-responsiveness or sensitivity or overwhelming the lung airways with too much dust mites, heavy smoking specially at an early age could prolong the childhood asthma into adulthood and also cause exacerbations and further attacks (8).

 Other than the common allergic or eosinophilic asthma with an early onset in life and running a chronic course, microbial invasions of the lungs and respiratory airways, also contribute to asthma. There have been reports on neutrophilic and lymphocytic infiltrations of the lung airways among others causing the narrowing of the airways, hence asthma (9-10). Such infiltrations of other white blood cells even in the airways or sputum of allergic or eosinophilic asthma that for long thought to be due to T helper type 2 disease and as an allergic reaction, has more recently been shown to have an underlying immunologic susceptibility. This is the beginning of a new understanding of asthma and its genetic susceptibility as an immune or perhaps an early autoimmune disease (11-12).

Che Guevara: An Iconic Asthma Sufferer

Ernesto Guevara was an Argentine physician, who later on by his Cuban comrades was popularized as “Che”, meaning comrade or friend, and since then he has been known as Che Guevara. Before joining the Cuban revolution along with Fidel and Raul Castro and other guerillas, since he suffered from a severe asthma with frequent attacks from his childhood, causing him staying home sick often, he spent all his sick time reading a lot of everything from literature, poetry, philosophy, politics and else. He was also in love of photography and travelling, that his trip across South America, that he called one nation, on a motorcycle with his friend Alberto Granado, under the title of “The Motorcycle Diaries”, before his graduation from medical school and becoming a revolutionary, has been a popular book and film. Despite his severe asthma in his continental trip, he swam at night across Amazon river, a considerable distance of 4 kilometers (2.5 miles) when visiting and helping the lepers in a leper colony in Peru. He unlike the doctors and nurses in the colony, did not wear gloves to shake hands and touch the lepers, but bravely did so with his bare hands.

 

Read the full text here:

https://medicinerevisited.com/general-medicine/asthma-tribute-ernesto-che-guevara/

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Sleep: Our yet not well discovered inner world!

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Introduction:

As adults we spend or should if we dont one third of our time in sleep and as children up to half of their time. We all sleep when tired and when have a good sleep, we would feel rested. We therefore know that the sleep function is for restoration of physical tiredness or fatigue. But sleep is not just for restoration of physical fatigue, but for the restoration of the mental or brain fatigue as well. We may think that during the sleep, the body is totally shout down and in rest. But surprisingly the body is quite active in sleep and like a factory, does self-restoration or repair during the hours of sleep. In deep sleep, if we can get any, the physical restoration or repair is done and in REM (Rapid Eye Movement) or dream stage of sleep, the mental or brain restoration or repair is done. More importantly, many hormones such as growth hormone in children are secreted in sleep and mostly in deep sleep.

 In this paper, the architecture or different stages of sleep will be explored. Then the sleep-wake cycle that is a major component of our circadian rhythm and our body homeostasis and health balance will be exposed. Then the importance of sleep hygiene and lack of it and the disorders of sleep will be discussed. The treatment for sleep disorders and the most common one, insomnia or sleeping pills will not be discussed, as majority are of Benzodiazepine class of drugs, addictive and more habit forming and perpetuating the insomnia. The purpose of this article among the others on this site is more to understand the pathophysiologic process of every disease, so hopefully soon move towards the prevention. Finally what is a very dilemma and question for many, the world of dream and its interpretations will be explained.    

 

Stages of sleep:

During a night sleep of about 8 hours that is normal for adults, the body or brain goes through about 5 cycles, starting with the stage 1 that is the drowsiness or falling asleep stage lasting only a few minutes. Then the second stage that comprises about %45-50 of a normal adult sleep, that is still light and the person could be aroused by sounds and noises and it is the usual toss and turn stage of sleep. The second stage lasts about 40-45 minutes in each cycle that lasts normally 90 minutes. Then the deep sleep kicks in that is comprised of stages 3 & 4 and most adults do not get it much nowadays, while they need to have it at least %20 of their sleep. These stages of 3 & 4 or deep sleep is for the restoration of physical fatigue and if the person does not get it enough, he or she would not feel rested in the morning.

The next stage of sleep in the cycle is REM (Rapid Eye Movement) sleep that is the dream stage of sleep when the individual enters the world of his or her dreams. This stage that comprises about 20-25% of a night sleep is very active not just for the eyes that moves fast as its term suggests, but the whole body physiology such as heart beat, respiration and else are active even more than in the waking state.  After the first cycle of sleep and REM, the brain may not start over from stage 1, unless someones sleep is very light and broken and keeps waking up in the middle of the night, or after a nightmare. So in a normal restful sleep, after the first cycle and REM, in the second cycle and thereafter, the brain starts from stage 2 and the rest. If the individuals sleep is light, he or she may not go much or at all through the deep sleep of stages 3 &4 that is very common in the modern era of sleepless nights. Therefore everybody gets mostly stage 2 and REM sleep even if one does not remember having any dreams. REM sleep due to its high brain and physiological activity, has the vital role of restoration of brain fatigue. Thats why people with many mind preoccupation or worries may have lots of dreams and even nightmares. The following figure shows how the body enters the different stages of sleep from a waking state and the repeated sleep cycles throughout a night sleep:

 Now in the following each stage of sleep will be discussed in more detail:

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Training New Physicians:Towards the Future

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Physicians or medical doctors who are in charge of our health and well-being world wide, are the products of different medical training standards around the world. The medical schools training could last from 5 to 8 years to graduate a general practitioner or GP. Many medical schools around the world accept the high school graduates after an entry exam into the medical schools that mostly last about 6 years. This could be true in many developed countries such as in Europe. But in US, Canada and UK that hold higher standards in medical training, the entry into medical school is much more sophisticated, longer and more competitive. The applicants in these countries, mostly need a bachelor degree principally in biological science or alike, passing a medical entry test, MCAT (Medical Colleges Admission Test), voluntary works, references, etc. to be accepted to medical schools that is highly competitive. In these countries, then the medical schools training is four years, all focused on medical sciences, from the basic to the clinical and specialties, concluding general practitioners. But there are no jobs or positions for GPs per se in these countries without any specialties, and the shortest training for these would be family practice that lasts two years that is equivalent of GPs in other countries, only after 6 years of post-graduate studies past high school. Therefore one could easily appreciate the difference in the quality of medical training across the globe that could be translated to the quality of medical care. (1-3)

 In many places in the world after graduation from medical schools, there might not be any final general exams of all the pre-clinical and clinical subjects for licensing to practice general medicine. But in US, Canada and UK there are several step exams during the medical school years and after graduation for licensing to practice medicine. In US there are three step of such exams, step 1, testing basic medical sciences in one-day of 8-hours session, step 2 consisted of two sub-steps of clinical knowledge (one-day of 9-hour test) and clinical skills (one-day of practical clinical skills assessment with mock patients). The final step licensing exam, or step 3 of USMLE (United States Medical Licensing Examination) assesses the capability of the application of basic medical and clinical sciences in a two-day exams, 7-hours the first day and 9-hours the second day including clinical skills assessment of 13 simulation cases across major medical disciplines. (4-5)

In Canada there is a similar licensing exams or MCCQE (Medical Council of Canada Qualifying Examination). The first part of MCCQE in 3.5 hours assesses the general medical knowledge, followed by 4-hours of clinical decision making scenarios assessment. The part 2 of MCCQE consists of an objective structured clinical examination in total simulated clinical sessions with patients, that could be taken after one year past the clinical training graduation.

 In England, unlike US and Canada but like many other parts of the world, entry into medical schools are right after graduation from high schools, though the competition is quite high and the rate of acceptance is not more than 10%. Other than traditional or multiple mini-interview, depending on the university, there is the United Kingdom Clinical Aptitude Test (UKCAT) required by most universities and Biomedical Admission Test (BMAT) required by five universities. The medical courses in English medical schools are “problem-based learning” and “lecture-based learning”, and consist of 2-3 years in pre-clinical and 3 years in clinical. The graduates after these 5-6 years of medical training are recognized as Foundation House officer (FHO) and are only permitted to work in supervised clinics and hospitals for one year before being granted independent license to practice as GP and fully register in the General Medical Council. (6-7)

 

Which system is better?

Is the straight entry from high school to medical school better or an entry after a four years under-grad university education? While entry into medical school in most parts of the world is probably the hardest among any other university courses, when entered most students graduate and there is not much scrutiny and not much failure. A major difference between the two systems is the age and maturity of the applicant. In the straight from high school entry with 6 years course, the applicant is younger and less mature, but in the other system entry after a bachelor degree, the applicant is four years older and more mature. At the same time in the first system of straight six years medical studies, two years basic medical sciences and four years of clinical, the students acquire more knowledge due to studying medicine two years longer. But in the four years course after a bachelor degree, unless those students who have studied four years of basic medical sciences, the rest have only four years to study medicine, including basic and clinical sciences. That is why in countries with this latter system such as US and Canada, there is no GP or licensure to practice after graduation from medical school, unless finishing a specialty training that equivalent to general practice is family practice in these countries that require an additional two years of training. At the end both system in regard with training, education and knowledge could be equivalent, but the only difference will remain age and maturity that the latter system could provide more better health care service due to age and maturity.(8-9)

 Are the licensing examinations well justified?

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Heart Attack: The Killer of all

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(In the memory of my father, a common man, but a poet)

Introduction:

Heart attack that medically known as Myocardial Infarction (MI) is the leading cause of death in the developed countries and the second in the developing world with over 12% of the cause of the death worldwide. The prevalence of such deaths due to heart failure after acute myocardial infarction from the 10% within 30 days and 20% in 5 years in the 70’s, have skyrocketed to 23% and 34%, respectively, in the 90’s. MI usually is a result of Coronary Artery Disease (CAD) of the blood supplies to the heart muscles, that is caused by the occlusion of these arteries by atherosclerotic or lipid plaques that finally rupture and leading to the necrosis or infarction of the cardiac muscles, impeding its pumping function, finally failure and death.

 

The accumulation of the atherosclerotic plaques which is a long or chronic process, after years warns the individual with symptoms of Angina, e.g. chest pain that my feel like heartburn, radiating to left arm, shoulder and other associated symptoms such as nausea and vomiting, shortness of breath, numbness on the left side, faint feeling and cold sweat, etc. While the precipitating process is long, the end result could be sudden and acute, causing sudden death in minutes even at times without warning or chest pain, so called silent MI or heart attack. In certain situations, MI could happen without a precipitating long process, by coronary arteries spasm due to the use of some illicit drugs such as cocaine and extreme cold among others. (1-2)

 

Why a beating heart stops?

A beating heart does not stop incessantly, as it looks in the heart attack or myocardial infarction to be sudden and acute. Underlying a stopping heart or attack that is seemingly acute and sudden, there are chronic or long-standing processes that lead to its standstill. There are more than one factor in the process that ends in the heart attack and understanding of these factors could help to prevent sudden death from heart attacks. Although there are many modern treatment modalities from angioplasty to coronary bypass, saving an infarcted or a partially or more complicated dead heart muscle, hence saving lives, the ultimate goal in this arena needs to be prevention of such fatal accidents, as there are many unfortunate instances such as my father’s that any treatment even advanced ones could be already too late!

 

While to many people, including the patients themselves and their clinicians, heart attack or myocardial infarction is interpreted as coronary arteries (blood supplies to heart itself) occlusion, there is a big and long-standing secret behind it. Moreover the great majority of myocardial infarctions are not fatal, whether treated or untreated, and understanding, prevention and treatment of the precipitating factors are crucial as subsequent attacks may kill the person if not the first one, like in the case of my father. Among many of these factors, there are comorbidities or other illnesses such as diabetes mellitus or hypertension, plus the size and location of the infarct that influence the clinical course, treatment and prevention. The exact anatomic territory infarcted and whether it includes the sinus node or AV node or important neuro-receptors; whether many small arteries are occluded (especially downstream of narrowed main coronary branches) are all important. Also whether the heart is hypertrophied, dilated, infected, or infiltrated; and whether there may be intra-cardiac, extra-cardiac, or intracranial neuro-pathological conditions that could destabilize cardiac electrical activity are needed to be identified. (3)

 

Moreover it is known that apoptosis plays a major role in myocardial infarction or ischemia, but it also occurs within the heart completely and independently of infarction. There is also the vexing dilemma that an effective coronary collateral circulation, which is determined primarily by trans-anastomotic pressure gradient, is made less effective by exactly those treatments that reestablish flow in an occluded coronary artery. Since thrombolysis and angioplasty are automatically considered urgent treatment for an occluded coronary artery, it is prudent to remember the complex causes that determine whether the patient lives or dies. (3)

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Skin Cancer: When our good sun hurts! (In the memory of Bob Marley)

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Introduction:

Skin cancers are divided into three main types of Basal cell carcinoma, Squamous cell carcinoma and Melanoma, based on the abnormal cell development and proliferation of the type of skin cells. While Basal-cell carcinoma grows slowly and is more localized to the skin tissue, Squamous-cell carcinoma is more aggressive and malignant and can lead to metastatic far distance spread to other body tissues and could be fatal. Melanomas that arise from the melanocytes or skin pigment cells, are the most aggressive, malignant and metastatic, that killed Bob Marley.

 

While the sun is the source of life on earth and our own life in different aspects depend on its shinning, such as regulation of our circadian rhythm, sleep-wake cycle, and the color of our skin, its excess could contribute to more than 90% of skin cancers cases. The risk nowadays are higher due to a thinner ozone layer, and also the increase fad of artificial tannings as another common source of ultraviolet radiation. The longer and more intense exposures, such as from childhood and the sensitivity of the skin’s subject, for example the white skins, the living zones, such as regions with intense sunshine like Australia and New Zealand, and also the less defensive immune system, the more risk of cancer. (1-2)

Despite all these, and the skin cancer being the most common of all cancers world wide, the early intervention of the skin cancers, even melanoma through removal of the locus of the cancer such as the mole, radiotherapy and medications, have increased the survival rate of all the skin cancers higher than other cancers, close to 90% recovery rate. That takes us to the sad story of Bob Marley, who due to his religious beliefs, refused the full treatment of his melanoma on his toe from 1977, so the cancer spread to his brain and killed him mercilessly on 11 May 1981, at age only 36 and deprived the whole art of music and his global friends form a longer legendary career. (3-5)

Bob Marley, a musical icon, the father of reggae and an international messenger of love and peace, who started with band “The Wailers” , and a national symbol for Jamaica, with all his spirituality, yet could not survive from a small mole on her toe that finally spread to his brain and killed him. His songs such as “One love”, “Is this Love”, “Redemption Song”, “Waiting in Vain”, “Satisfy my Soul”, “O’Woman don’t cry”, “Buffalo Soldier”, “I shot the Sherriff”, “Jamming” and more has no need for an introduction as he is know and loved still to this day by billions. He could easily be the only human’s messenger and representation in popular music and culture. Unfortunately his religious commitment to Rastafari, not to allow the amputation of his cancerous toe so to prevent the spread of the melanoma, deprived him of such a great life and his fans to enjoy his music years longer.

 

Sunlight: Good, Bad and Ugly

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