Beginner Medical English

A Reference Handbook for Mongolian Students and Healthcare Professionals (DOWNLOAD)

Medical Terminology

ONLINE LESSONS for Healthcare Professionals in Mongolia

Human Anatomy and Physiology

by Dr. Bruce Forciea, 2012 (DOWNLOAD)

Cells: Molecules and Mechanisms

University Cell and Molecular Biology textbook (DOWNLOAD)

Saturday, June 11, 2016

Online Course: Vital Signs - Understanding What the Body is Telling Us

The University of Pennsylvania - Vital Signs: Understanding What the Body Is Telling Us - Professor Connie B. Scanga, Ph.D. - The basic signals the body has for telling us that it’s working properly—heartbeat, blood pressure, body temperature, respiration, and pain—this course examines each of them in detail, the anatomy and physiology underlying them and through them you’ll gain a systemic understanding of how the body functions and how to tell if the body is functioning in a normal state. You’ll learn the mechanisms that cause changes in those vital signs, and how to objectively measure them in yourself and others.

Sign up for the course at: The University of Pennsylvania - Vital Signs: Understanding What the Body Is Telling Us

Week 1: Pulse/Heart Rate
Week 2: Blood Pressure
Week 3: Metabolism
Week 4: Temperature
Week 5: Respiration Rate
Week 6: Pain

Online Course: Anatomy - Know Your Abdomen

  • The University of Leeds- Anatomy: Know Your Abdomen - Professor James Pickering - Do you know where your liver is in your torso? What about your kidneys, or where your stomach actually is? This course will help you identify where your organs actually are, their structures, and their positions relative to one another. You’ll study the gastrointestinal tract (and learn that sometimes “stomachaches” are nothing of the sort), and hear from an abdominal surgeon about the work he does with his patients.

Sign up for this free course: The University of Leeds- Anatomy: Know Your Abdomen

  • FREE online course
  • 2 weeks
  • 2 hours
  • Certificates available

This course will help you identify the positions of the organs within the abdomen, as well as becoming acquainted with common anatomical terminology used to talk about organs and structures and their position relative to each other.
During the two weeks you’ll look at the anterior (front) abdominal wall, exploring how the ‘abs’ are considered in relation to health and beauty. You’ll then move on to look at the composition of the gastrointestinal tract. Focussing on common problems that can occur in this tract, you’ll hear from an abdominal surgeon about the work he does to treat and cure such problems.

Note for students

This course is part of a collection from the University of Leeds which have been specifically designed for those studying at school or college. All of the courses will help to enrich and extend your knowledge in a specific topic and develop your transferable skills. These courses will help you with making decisions about which subject to study at university and will give you examples and evidence when developing your university application.
Throughout the course you will join a community of online learners, providing an opportunity for interactive learning with other students both in the UK and internationally.
Each course is designed to complement your existing studies and aims to:
  • provide evidence for UCAS applications and prepare you for university
  • help you to gain new skills, think critically and learn independently
  • encourage online / social learning
  • develop collaboration and analytical skills
  • embed current research into your online learning

Thursday, January 14, 2016

Plan Your Free Online Education at Lifehacker U: Spring Semester 2016

Your education doesn’t have to stop once you leave school. put together a curriculum of some of the best free online classes available on the web this fall for the latest term of Lifehacker U, their regularly-updating guide to improving your life with free, online college-level classes.

  • University of Glasgow- Cancer in the 21st Century: The Genomic Revolution - Cancer impacts most people at some point in their lives, whether it’s because we’re diagnosed with it, or because someone close to us is. This course examines cancer research, how far we’ve come in recent years, and breakthroughs on the horizon that researchers are eagerly working on right now. You’ll learn about potential treatments being tested in clinical trials right now, get a better appreciation for exactly how difficult a beast cancer is to truly tame from a medical perspective, and hear from patients and caretakers on the topic. 
  • Karolinska Institutet - Behavioral Medicine: A Key to Better Health - Professors Anne H Berman and Sakari Suominen- Behavioral medicine, or the science of changing our behavior to lead to healthier outcomes, is central to addressing many of society’s biggest current medical and health-related problems. But why is such a field necessary in the first place, and why do people tend to act against their own best interests so often? This course will examine those questions, walk you through research into behavioral medicine that’s showing positive outcomes right now, and how those lessons can be applied to your own individual health, or societal health concepts in general. 
  • University of Reading - Heart Health: A Beginner’s Guide to Cardiovascular Disease - Professor Natasha Barrett - Your heart is such an important muscle, and it never rests, never stops, never gives up—until the day it does, of course, and ideally most of us would like to prolong that as long as possible. This course walks through the broad topic of heart health, heart disease—one of our biggest killers, and how cardiovascular disease creeps up, can be avoided, and frontiers of medicine designed to treat it. First, of course, you’ll study the heart in detail, and get a better appreciation for that fist-sized muscle that keeps you alive and kicking. 
  • The Open University - The Science of Nutrition - Professor Audrey Brown - Food may be art, but cooking is chemistry, and nutrition is most certainly a science. It’s not a simple one though, and there’s a lot that goes into it—which is what this course aims to introduce you to. This course uses biology, chemistry, and physics to give you a science-backed understanding of how the body works, absorbs nutrients, how people in different cultures and parts of the world acclimate to their available nutrients and foods, and you’ll even have the opportunity to conduct some experiments to better understand digestion and how enzymes work.
  • University of Colorado Boulder - Gut Check: Exploring Your Microbiome- Professors Rob Knight, Dr Jessica Metcalf, and Dr Katherine Amato - You’ve probably heard all about how in some ways, we’re essentially a walking container for the massive ecosystem that lives symbiotically in our guts. Tons of bacteria live inside us that help us digest and process food, retain or lose weight, and keep us healthy. But what’s so special about them? How did they get there, and why are they so important? This course will answer all of those questions, and help you develop the tools to keep your gut buddies happy and healthy—and by proxy, keep yourself happy and healthy.
  • University of Cape Town - Understanding Clinical Studies: Behind the Statistics - Professor Dr Juan H Klopper - Media publications, food and nutrition companies, and Facebook users alike love to throw around phrases like “studies show,” and sometimes even link to studies they think support their argument. Sometimes they do—sometimes they have no idea what they’re linking beyond a study title. This course will help you understand how clinical research is conducted, how you can interpret the results section of a study to see what conclusions it actually draws, how different studies are conducted and how their results are documented and reported, and of course, how to conduct your own research into a topic and come away with useful sources to back up your positions. 

Tuesday, October 21, 2014

The Human Spirit: Out in Mongolia

Originally posted in The Jerusalem Post on Oct 21, 2014

‘Without saying anything, coloring in embarrassment, Saranchuluun Otgon rolled up her pant leg. Beneath the cloth were the metal wires of a prosthetic foot. Until then, no one on the staff knew.’

Otgon, wearing her prosthetic, trains for a marathon. She is leading the charge for change in Mongolia as to how people with disabilities are viewed. (photo credit:COURTESY SUCCESS CHAIN)

Saranchuluun Otgon arrived in Jerusalem in September 2007 with a master’s degree in social work from the University of Mongolia.

She was one of the 20-something students at one of the city’s most intriguing programs: the foreign student master’s degree program at the Hebrew University of Jerusalem’s Hadassah Braun School of Public Health.

The course draws health professionals from far-flung countries who are dealing with some of the world’s toughest health challenges. Current students are facing Ebola, polio and HIV/AIDS, as well as ongoing issues like maternal and child health and nutrition. Nigeria, China, South Sudan, the Philippines and Haiti were among the countries represented in last year’s class, which graduated recently.

The graduates show up at the ceremony in sensational native costume, and sing emotionally in Hebrew. It’s a moment I savor every year. Then they go home, taking up challenges in cities and rural outposts; they remain loyal informal ambassadors for Israel.

When Otgon joined the program, she traveled together with a fellow student from Mongolia. The two roomed together in the campus dorms.

In case you’re unsure of where Mongolia is, remember that it’s a landlocked country bordered by Russia to the north and China to the south, east and west.

Almost half the citizens live in the capital city of Ulan Bator, infamous for air pollution and encircled by formerly nomadic Mongolians who are looking for permanent homes in the city. (By the way, the old term “Outer Mongolia” refers to the historical region of the Qing Dynasty, and is no longer in use. When I grew up, it was a synonym for something obscure and hard to find.) At the recent graduation ceremony, Dr. Yehuda Neumark, director of the Braun School, revealed a story about a former student – Otgon – that she’d finally allowed him to make public.

“Toward the end of the year of her studies, Saranchuluun Otgon came to my office. Without saying anything, coloring in embarrassment, she rolled up her pant leg. Beneath the cloth were the metal wires of a prosthetic foot. Until then, no one on the staff knew.

“The reason for her divulging this to me was that the device wasn’t working right. We quickly found our way to a prosthetic devices repair lab in the Talpiot neighborhood of Jerusalem.

When I asked Saranchuluun if anyone in her class knew about her foot, she said no one did except her roommate – her colleague and friend from Mongolia.

“I suggested that it would perhaps be beneficial to share this with others in the public health class, and she replied respectfully but adamantly that she didn’t want to.”

Why not? Said Neumark, “She explained that in her country, people with disabilities are stigmatized and there is no awareness for handicap accessibility issues, and if it became known, she would never get promoted very high in the system.”

So they kept it quiet. She finished the year and went home without any of the other students, or even the social coordinator and staff, knowing her secret.

But now it’s out – and not just among her students. A YouTube video making its away around the web reveals Otgon’s story. She was born in 1981 in what Mongolians call the Ger District, a hut city without basic sanitation on the edges of the capital. She was a straight-A student, and loved to dance; Otgon wanted to be a dancer when she grew up.

Horseback riding on vacation in the Mongolian plains, naughty kids spooked the horse and Otgon fell. There was no doctor nearby; the elders treated her injury with herbs and tea. When she got back to the city, doctors were puzzled by the continued pain. She was diagnosed as having cancer in her bone (perhaps a lesion that caused the weakness), and began a program of chemotherapy and radiation. When she was 13, her foot was amputated.

Not when Otgon applied for the program in Jerusalem, nor when she was accepted, did she mention her disability.

The technician who repaired her prosthesis in Talpiot was so moved by her story that he fixed the prosthesis for free, and suggested she come in for a tune-up when she was preparing to return home.

She never did share her personal health challenge with her fellow public health graduates.

Still, Dr. Neumark’s suggestion percolated.

Go public, he said. You have a story to inspire others.

Back in Ulan Bator, she became a fulltime lecturer at the School of Public Health in the Health Sciences University of Mongolia. Then she spent time at Columbia University in New York.

There too, like in Israel, there was much more openness about disabilities. Today, she’s back in Mongolia, working on her PhD. In the meantime, she’s married and given birth to a son.

Five months ago, Otgon outed her disability, showing the world her sneaker-clad artificial foot on Facebook.

She founded an NGO called Chain of Success and in April launched a Facebook group, “Let’s Run Mongolia!” This summer, she organized Mongolia’s first-ever public running event welcoming people with disabilities. Her prosthesis showing, she ran with men and women in wheelchairs, missing arms and legs, blind and deaf. Yes, out there in Mongolia.

Three-hundred participants and 180 volunteers participated in the Let’s Run Together marathons.

Several weeks ago, Otgon presented a TED talk for TED-Mongolia on stigma and social change. She was named the Mongolian Junior Chamber of Commerce International person of the year.

Otgon has a new dream: She wants to run in the 42-km. New York City Marathon! She wrote to Neumark: “It’s a big challenge! I am running to change social stigma and discrimination toward people like me. Also, I am trying to support other disabled people who like sports in my country. Now I am working on the website to gather money to buy another prosthetic leg for someone, another hand-cycle, a travel ticket for the New York Marathon, etc.”

Says Otgon, whom I met briefly when she was here, but has become a Facebook friend of mine, “I’m fed up with being discriminated against and embarrassed.”

Still, my favorite part of what she says has to do with all of us without these challenges.

“I’d like to say to all those who have two arms and two legs that they should use them… use them for good!”

Word: Definition List
  • intrigue: to make somebody very interested and want to know more about something
  • to draw: to move something/somebody by pulling it or them gently
  • far-flung: a long distance away
  • sensational: causing great surprise, excitement, or interest
  • to savor: to enjoy a feeling or an experience thoroughly
  • to room: to share a room, apartment, or house with one or more people
  • dorm: dormitory
  • infamous: well known for being bad or evil
  • to color: if something colors your cheeks, you go red because you are embarrassed
  • prosthetic: an artificial part of the body, for example a leg, an eye or a tooth
  • to divulge: to give somebody information that is supposed to be secret
  • adamantly: determined not to change your mind or to be persuaded about something
  • stigmatized: to treat somebody in a way that makes them feel that they are very bad or unimportant
  • sanitation: the equipment and systems that keep places clean, especially by removing human waste
  • naughty: behaving badly; not willing to obey
  • to spook: to make someone suddenly feel frightened or nervous
  • puzzled: unable to understand something or the reason for something
  • to amputate: to cut off somebody's arm, leg, finger or toe in a medical operation
  • to move: to cause somebody to have strong feelings, especially of sympathy or sadness
  • to percolate: if information or ideas percolate, they spread gradually and become known to more people
  • to out: to say publicly, especially when they would prefer to keep the fact a secret
  • stigma: feelings of disapproval that people have about particular illnesses or ways of behaving
Word MP3s:
= intrigue
= far-flung
= sensational
= savor
= dorm
= infamous
= prosthetic
= divulge
= adamantly
= stigmatize
= sanitation
= naughty
= spook
= puzzled
= amputate
= percolate
= stigma

Sunday, January 5, 2014

Plan Your Free Online Education at Lifehacker U

Originally posted on on Jan 3, 2014

We've put together a curriculum of some of the best free online classes available on the web this spring (yes, and winter) for the latest term of Lifehacker U.

Orientation: What Is Lifehacker U?

Whether you're headed to college for the first time, you're back in classes after a fun, food, and family-filled holiday break, or you're long out of school and interested in learning something new, now's the time to turn it on and increase your skills with some interesting and informative classes and seminars. Anyone with a little time and an interest for self-growth (and a computer) can audit, read, and "enroll" in these courses for their own personal benefit.

If you'll remember from our Fall 2013 semester, some of these classes are available year-round, but many of them are only available during a specific term. Because we're all about helping you improve your life at Lifehacker, we put together a list of courses available this winter that will inspire you, challenge you, open the door to something new, and give you the tools to improve your life. Grab your pen and paper and make sure your battery is charged—class is in session!

Science and Medicine
  • University of Bath - Inside Cancer: How Genes Influence Cancer Development - Dr Momna Hejmadi - If you've ever heard that someone in your family had a certain type of cancer and it made you worried, or that a direct relative of yours died of cancer, you undoubtedly started wondering and researching about whether their type of cancer is hereditary or influenced by genetics. This course explains how genes and genetic expression can influence cancer, how genes can make people more or less likely to develop cancer, and the fundamental differences between cancer cells and regular cells. Essentially how cancer forms, how it differs from normal cells in our bodies, and what makes some people more or less likely to develop it.
  • University of Birmingham - Good Brain, Bad Brain - Professor Alison Cooper - We know a lot about the brain and how it works, but a detailed map of it and what every part of the brain does still eludes us. For as much as we understand about neurology and neuroscience, there's just as much that's not clear to us, or has conflicting reports and studies over the years. This course will guide you into the topic of neurological science, help you get your bearings around how the brain works, what—beyond our thoughts and feelings—it's capable of doing, what we know, and what we're trying to figure out. Designed for the non-technical or non-medical person, by the end of the class you'll have a whole new appreciation for your own brain, and how it works diligently around the clock to keep you alive, inspired, functioning, and healthy.
  • Stanford University - EP101: Your Body in the World: Adapting to Your Next Big Adventure - Professor Anne L. Friedlander, PhD - If you wanted to climb a mountain, base jump, or dive into the deepest parts of the ocean, would you be physically ready? You may be in good shape (or maybe not), but drastic things happen to our bodies when we put them in amazing situations. This course will help you prepare for your next big adventure, and rather than just teach you lessons, you'll hear from experts, doctors, and adventurers, watch them as they do what they do best, and see real videos of amazing things that only humans can do. You'll learn how the body responds to cold, heat, stress, altitude, pressure, even how the aging process works, and more, in a truly exhilarating environment.
Cross-Disciplinary Courses and Seminars
  • University of Virginia - Buddhist Meditation and the Modern World - Professors Kurtis R. Schaeffer and David Francis Germano - You've likely heard about the research and science of meditation, complete with brain scans that show how meditation can be good for you, can soothe anxiety, can help you relax, can help you think, and so on. This course aims to do a deeper dive into that science and the current resource around led, structured meditation from a scientific perspective. The professors aim to combine the ancient with the modern. The class will discuss and approach meditation techniques in their own cultural context, then examine modern research into meditation and its dynamics, relatively modern adaptations of meditation to suit modern lives, and more. By the end of the course, you'll understand not only the science behind meditation, but you'll learn how to do it yourself.
  • Decision Education Foundation - Decision Skills: Power Tools to Build Your Life - Instructor Chris Spetzler - Decision making is difficult. If it weren't everyone would be leaders, and we'd all have the skills we need to not wrangle over or struggle with minor and major life decisions. This course will help you learn to make better decisions, quantify your needs and desires, make allowances for your personal wants and needs, and build a personal structure to make making difficult decisions easier—or at least, more streamlined. By the end of the class, you'll be ready to take charge of your life, instead of letting life happen to you.
  • Vanderbilt University - Nutrition, Health, and Lifestyle: Issues and Insights - Professors Jamie Pope - This course in nutrition and health will help you separate fact from fiction, determine what really is and isn't healthy based on the most current science on the topic, and most importantly disabuse you of the myths, marketing pitches, snake oil, and other beliefs that are so prevalent in pop culture around dieting, nutrition, and health. The goal of the course is to help you find your way to better behaviors and informative resources that will help you make intelligent decisions, instead of being tricked by someone selling a fad diet, the latest hot eating trend that promises cures for all of your ills, or worse, someone selling you pseudoscience with the promise that easy results and health will come to you if you just believe them over all others. The course will walk through the fundamentals of a healthy eating plan, the necessity of exercise and activity, dietary supplements, challenges in food labeling and nutrition info, food allergies and intolerances, and much more.
  • Johns Hopkins Bloomberg School of Public Health - An Introduction to the U.S. Food System: Perspectives from Public Health - Professors Keeve Nachman PhD and Robert S. Lawrence, MD - This course will help you understand where your food comes from (if you live in the United States, that is), separate fact from fiction when it comes to the US food supply, and how all of the distances, people, hands, and machines that handle your food from farm to table play a role in their nutrition, freshness, and your own health and well being. You'll examine case studies and current research that will give you a new appreciation—or new concerns—about the US food system.
Extra Credit: How To Find Your Own Online Classes
If you're looking for more or more varied course material, here are some resources to help you find great, university-level online classes that you can take from the comfort of your desk, at any time of day.
  • Academic Earth curates an amazing list of video seminars and classes from some of the world's smartest minds, innovators, and leaders on a variety of topics including science, mathematics, politics, public policy, art, history, and more.
  • TED talks are well known for being thought provoking, interesting, intelligent, and in many cases, inspiring and informative. We've featured TED talks at Lifehacker before, and if you're looking for seminars on the web worth watching, TED is worth perusing.
  • edX is a collection of free courses from leading Universities like the University of California, Berkeley, MIT, and Harvard. There aren't many, but the ones offered are free, open to the public, and they rotate often.
  • Coursera has a broad selection of courses in-session or beginning shortly that you can take for academic credit (if you're enrolled) or just a certificate of completion that shows you've learned a new skill. Topics range from science and technology to social science and humanities, and they're all free.
  • Udacity offers a slimmer selection of courses, but the ones offered are not only often for-credit, but they're instructor led and geared towards specific goals, with skilled and talented instructors walking you through everything from building a startup to programming a robotic car.
  • Class Central aggregates some of the best courses available from open universities and programs around the web in an easy to sort and search format. Just search for what you want to learn, and if a course is available and starting soon, you'll find it.
  • has a list of universities offering free and for-credit online classes to students and the public at large.P
  • CreateLIVE features a number of interactive courses in business, photography, and self-improvement, many of which are free and available to listen in on at any time of day. 
  • Open Culture's list of free online courses is broken down by subject matter and includes classes available on YouTube, iTunes U, and direct from the University or School's website.
  • The Open Courseware Consortium is a collection of colleges and universities that have all agreed to use a similar platform to offer seminars and full classes—complete with notes, memos, examinations, and other documentation free on the web. They also maintain a great list of member schools around the world, so you can visit universities anywhere in the world and take the online classes they make available.
  • The Khan Academy offers free YouTube-based video classes in math, science, technology, the humanities, and test preparation and study skills. If you're looking to augment your education or just take a couple video classes in your spare time, it's a great place to start and has a lot of interesting topics to offer.
  • The University of Reddit is a crowd-built set of classes and seminars by Reddit users who have expertise to share. Topics range from computer science and programming to paleontology, narrative poetry, and Latin. Individuals interested in teaching classes regularly post to the University of Reddit subthread to gauge interest in future courses and announce when new modules are available.
  • The Lifehacker Night School is our own set of tutorials and classes that help you out with deep and intricate subjects like becoming a better photographer,building your own computer, or getting to know your network, among others.
The beautiful thing about taking classes online is that you can pick and choose the classes you want to attend, skip lectures and come back to them later (in some cases—some classes require your regular attendance and participation!), and do examinations and quizzes on your own time. You can load up with as many classes as you choose, or take a light course load and come back to some of the classes you meant to take at another time that's more convenient for you.
    With Lifehacker U, you're free to take as many or as few of these classes as you like.

    Monday, November 18, 2013

    People power: Mongolia’s battle against tuberculosis

    Originally posted on "" on 15 October 2013
    by Cameron Wright

    Volunteers take anti-TB medications to around 400 patients each month. Image from

    Chinggis Khaan (or as he is known in many countries, Genghis Khan) is Mongolia’s national hero. The famous 12th and 13th century leader used considerable military and political savvy to build one of the largest empires in history. But while he was building an empire, another invader silently spread from person to person.

    This invader, Mycobacterium tuberculosis, favours stealth over force. The disease that it causes, tuberculosis (TB), has endured from ancient times into the 21st century.

    It is estimated that one-third of the world’s population is infected with Mycobacterium tuberculosis and around 5% to 10% of these will develop active TB in their lifetime.

    Even with effective antibiotics, TB is still a major global health problem, though it is rarely seen in developed countries such as Australia. TB disproportionately affects the world’s vulnerable, with over 95% of active cases and deaths caused by TB occurring in developing countries. Mongolia has a high burden of TB relative to its population.

    Chinggis Khaan’s status was re-affirmed in July when the capital,
    Ulaanbaatar’s main square was renamed Chinggis Square. Image from

    The World Health Organization’s (WHO) most recent Global TB Report estimated that in 2011 there were 8.7 million new TB cases and each day, the disease claims around 4,000 lives. For a disease that is treatable and curable, these statistics are alarming.

    This year I’m working with the Mongolian Anti-Tuberculosis Association (MATA). Founded in 1993, MATA is a “home-grown” example of community health workers having a positive impact on TB control. Through a nation-wide network of 300 health volunteers, this organisation coordinates the provision of anti-TB medications, mainly targeting people unable to visit health clinics regularly.

    The WHO recommends that anti-TB treatment is given through a scheme known as DOTS (directly observed treatment, short-course), as adherence to medicines over the typical six-month treatment course can be sporadic unless patients are adequately supported. Under DOTS, each dose of anti-TB medication is supervised and signed off by a health worker or volunteer.

    MATA volunteers take anti-TB medications to around 400 patients each month through home visits, with volunteers serving patients living in their local city sub-district or town. An additional 280 patients attend contracted cafeterias for a free meal along with their anti-tuberculosis medications.

    Volunteers are trained in the basics of TB and can become an important primary source of information, support, early identification of treatment issues and also a vector for encouraging contacts of patients to attend clinics for TB screening.

    L-R: S Munkhjargal (MATA volunteer), D Enkhtsetseg (MATA Volunteer Supervisor), T Bayanjargal (TB clinic nurse in Ulaanbaatar) and Y Byambaa (MATA volunteer). These women are part of the team working towards eradicating tuberculosis in Mongolia. Photo Cameron Wright.

    For their work, volunteers are provided with a small monthly stipend, the Mongolian equivalent of around 30 Australian dollars. They are supervised by MATA staff and work with tuberculosis clinic doctors and nurses who take responsibility for treatment decisions.

    The results of this program so far are impressive. This is best demonstrated by looking at treatment outcomes for a specific group of new patients who have returned positive tests, of which approximately 30% of the national total are involved in MATA’s program.

    Of 621 patients from this group enrolled with MATA in 2011, 600 (about 97%) successfully finished treatment and almost all of these were cured of the disease. This is compared to an overall treatment success rate for this group of around 88%, reported by the National TB Program.

    I spoke to some volunteers based in Bayanzurkh district, an area of Ulaanbaatar (also known as Ulan Bator) with one of the highest prevalence of TB in Mongolia. I asked one volunteer why she was involved in MATA’s program and she replied, through translation,

    There is a great feeling of accomplishment for me and the patient when someone finishes their treatment and is cured. Meeting these volunteers – and witnessing their dedication – makes me think that with time, the TB situation can improve.

    Managing a community-based treatment program on a national scale inevitably comes with a set of challenges. The last two decades have seen widespread internal migration, especially during winter, from the countryside into Ulaanbaatar.

    Multiple factors have caused this including the transition to a market-based economy following the fall of the Soviet Union, with people increasingly seeking opportunities in the city.

    Urban slums are ideal breeding grounds for TB. Image from

    Adding to this, a series of dzuds (particularly harsh winters, commonly associated with a high livestock fatality rate) over recent years has made the continuation of a traditional herder lifestyle untenable for many.

    This has led to an expansion of the “ger districts”, urban slums with a multitude of social problems and high rates of TB. The close living quarters during winter, when temperatures can plummet below -40°C, create ideal conditions for TB transmission.

    Keeping track of TB patients who have started on treatment is one of the main problems our volunteers face in providing treatment, with many people returning to the countryside during summer. Other issues include reaching patients living in very remote places or those frequently moving around.

    Lack of awareness and misconceptions can also be problematic when trying to encourage patients to complete their treatment. A 2012 national survey showed that most people know that TB is curable (84%) and is an air-borne infection (74%).

    But many of those surveyed did not know treatment is provided free of charge (49%) or the signs and symptoms of TB (43%) which typically include a chronic cough, night sweats, unexplained weight loss, fever and/or tiredness.

    Educating the public about TB can greatly improve case finding and treatment efforts and there is still progress to be made in this area. Providing high-quality training to volunteers is another important aspect of the program and this is complex to manage on a national scale.

    Just over half of Mongolians surveyed knew the signs and symptoms of TB. Image from

    Earlier this year I had the chance to participate in the external review of the National Stop TB Strategy 2010-2015, conducted with the support of the WHO. This provided an opportunity for reflection; to praise the many positive achievements of the National TB program and to identify areas where improvements could be made.

    My main observation working in the TB area so far is that teamwork is central to reducing the global TB burden. From MATA, to the National TB Program and more broadly the WHO, the Stop TB Partnership and the International Union Against Tuberculosis and Lung Disease (among others), there is a huge network of people working towards a common goal.

    Through utilising these partnerships, praising the good and improving the not so good, we can work towards making TB join smallpox as a disease of the past, in spite of the huge challenges that lie between this goal and the present situation.

    Definition List:
    • savvy: practical knowledge or understanding of something
    • stealth: the fact of doing something in a quiet or secret way
    • to endure: to continue to exist for a long time
    • adherence: the fact of behaving according to a particular rule, etc, or of following a particular set of beliefs, or a fixed way of doing something
    • sporadic: happening only occasionally or at intervals that are not regular
    • vector: something (like an insect) that carries diseases between larger animals and humans
    • to enroll: to arrange for yourself or for somebody else to officially join a course, school, etc
    • prevalence: that exists or is very common at a particular time or in a particular place
    • untenable: that cannot be defended against attack or criticism
    • to utilize: to use something, especially for a practical purpose
    Pronunciation MP3:
    = savvy
    = stealth
    = endure
    = adherence
    = sporadic
    = vector
    = enroll
    = prevalence
    = untenable
    = utilize

    Monday, November 11, 2013

    The Dangers of Acetaminophen

    Originally posted on on Nov 3, 2013
    by Dr. Edward F. Group III, DC, ND, DACBN, DCBCN, DABFM
    When it comes to proven, over-the-counter solutions for easing pain and controlling a fever, acetaminophen (also called paracetamol, and best known by the brand name, Tylenol) has long been the preferred recommendation for many. It is actually the most widely used product of its kind, and with good reason. When compared to other non-prescription pain relievers and fever reducers, such as aspirin or ibuprofen, acetaminophen is considered to be much more safe — especially for young children, people with weak or compromised liver function, or blood-clotting concerns.

    The Dangers of Acetaminophen

    But, not so fast. Despite being a better choice than some of the alternatives, acetaminophen doesn’t exactly get a free pass. To the contrary, severe health problems such as liver damage and death have been reported, even after “mild” overdose.
    • A 10-fold increase in overdose has been reported in children given injectable paracetamol.
    • In one reported case, an overdose of acetaminophen resulted in death with blistering of the skin and rhabdomyolysis (a breakdown of the muscle fibers) with blood clotting and reduced blood flow to the heart.
    • Overdose in children occurs more quickly with more severe problems than adults.
    • Renal failure has been observed in persons suffering from acetaminophen overdose.
    • One study found that patients taking acetaminophen for dental pain were at a higher risk of suffering accidental poisoning.
    • In 2011, the British Medical Journal reported heavy alcohol consumption, fasting, malnourishment, and the taking of enzyme inducing drugs increased the likelihood of liver damage from acetaminophen use. 
    Even the US Department of Health and Human Services, a division of the FDA, warns of dangers of taking Acetaminophen.

    Simple Mistakes Can Lead to Complicated Problems

    You may be thinking, “Good grief! I thought this stuff was safe!” Well, you’re not alone. There’s a common misconception that, because it’s sold without a prescription, it is also safe to take acetaminophen very regularly to alleviate any and all minor aches and pains. Additionally, the over-the-counter classification has lead some individuals to casually disregard dosage instructions and consume more than directed. If two is great, then four must be better, right? Wrong. Those errors are why hospital emergency rooms deal with more acetaminophen overdoses on an annual basis than they do opiate overdoses.

    A good example would be taking acetaminophen to cope with a slight hangover. Not only is this use unnecessary (you likely need hydration, not acetaminophen), but it can further stress an already stressed liver. In fact, this exact scenario accounts for a large percentage of easily avoidable overdoses.

    Watch for Hidden Acetaminophen

    Another mistake many people make is not reading the labels on the back of over-the-counter products before using them. Use of acetaminophen is prolific among drug manufacturers, and it’s not uncommon to find it included in everything from sleep aids to cold and allergy medications. It’s fairly common for those who are under the weather to take several products at once. These small doses can easily add up, and if you’re not careful, may lead to permanent liver damage.

    In addition to keeping an eye out for hidden sources, and minimizing unnecessary use, using a high quality, all-natural liver supplement and performing a periodic comprehensive liver and gallbladder flush, is a great way to promote the health of your liver.

    Definition List:
    • over-the-counter: that can be obtained without a prescription (= a written order from a doctor)
    • to ease: to become or to make something less unpleasant, painful, severe, etc.
    • to compromise: a solution to a problem in which two or more things cannot exist together as they are, in which each thing is reduced or changed slightly so that they can exist together
    • alternative: a thing that you can choose to do or have out of two or more possibilities
    • contrary: completely different in nature or direction
    • severe: extremely bad or serious
    • overdose: too much of a drug taken at one time
    • -fold: multiplied by; having the number of parts mentioned
    • fasting: to eat little or no food for a period of time, especially for religious or health reasons
    • malnourishment: in bad health because of a lack of food or a lack of the right type of food
    • misconception: a belief or an idea that is not based on correct information, or that is not understood by people
    • to disregard: to not consider something; to treat something as unimportant
    • opiate: a drug derived from opium. Opiates are used in medicine to reduce severe pain.
    • slight: very small in degree
    • hangover: the headache and sick feeling that you have the day after drinking too much alcohol
    • hydration: to make something absorb water
    • scenario: a description of how things might happen in the future
    • prolific: existing in large numbers
    • "under the weather": you feel slightly ill/sick and not as well as usual
    • flush: to get rid of something with a sudden flow of water
    Pronunciation MP3:
    = acetaminophen
    = ease
    = compromise
    = alternative
    = severe
    = overdose
    = fold
    = malnourished
    = misconception
    = disregard
    = opiate
    = slight
    = hangover
    = hydration
    = scenario
    = prolific