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)

Monday, November 18, 2013

People power: Mongolia’s battle against tuberculosis

Originally posted on "TheConversation.com" on 15 October 2013
by Cameron Wright

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

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 shutterstock.com

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 shutterstock.com

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 shutterstock.com

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 GlobalHealingCenter.com 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

Monday, November 4, 2013

LINK: IBiology.org

Logo
iBiology is a brand-new site where you can find all of the iBioSeminars and iBioMagazine talks in one place, along with a new section called iBioEducation where you will find…

Nico StuurmaniBiology Microscopy Courses: Microscopy Courses featuring
over 65 lectures and lab demonstrations about the theory and practice of light microscopy.

New Lecture series: New series with the flipped-classroom in mind. We asked speakers to create ~30 minute lectures that explain a topic for high school/undergraduate introductory biology students including:

New Lectures
  • Cell Biology [Cytoskeleton]: Molecular Motors (Lasker)
  • Cell Biology [Organelles]: Mitochondria, Mysterious Membranes
  • Human Health [Organelles] The Immune System
  • Microbiology [Bacteria Communities] Tiny Conspiracies
  • Molecular Biology [DNA Repair and Replication]: DNA Replication
  • Neuroscience [Circuits and Behavior]: One Second in Your Brain
Lectures from iBioSeminars
  • Biochemistry [Carbohydrates]: Glycans
  • Cell Biology [Cytoskeleton]: Actin Polymerization, Cell Motility, Molecular Motors, Comet Tail Formation
  • Cell Biology [Cell Cycle]: Cell Cycle Overview, Cell Cycle Control, Separating Duplicated Chromosomes, Cyclins and CDKs
  • Cell Biology [Organelles] Experiments in Cellular Organization
  • Development [Regeneration]: Stem Cell Overview, History of Regeneration, Adult Stem Cells
  • Ecology [Ecology]: Microbes Are Ancient, Ubiquity of Microorganisms
  • Human Health [Pathogens]: Prion Disease
  • Microbiology [Viruses]: Influenza Virus Infection
  • Molecular Biology [Transcription]: Introduction to Transcription
  • Molecular Biology [RNA Regulation]: Splicing Overview, Splicing Mechanism, Splicing Experiment
  • Neuroscience [Circuits and Behavior]: Genes and Behavior, Odor Experiment, External Signal Response, Circadian Clock
  • Neuroscience [Molecular Neuroscience]: Neural Stem Cells
BiochemistryiBioEducation Short Clips
Want to watch a few short videos when you have a break in the day? In iBioEducation's Exploring Biology section, you can find over 350 short clips organized by topic.

  • 1
     
Biochemistry
Biochemistry
Cell Biology
Cell Biology
Development
Development
Ecology
Ecology
Evolution
Evolution
Genetics
Genetics
Human Health
Human Health
Microbiology
Microbiology
Molecular Biology
Molecular Biology
Neuroscience
Neuroscience
Plant Biology
Plant Biology
Techniques
Techniques
ABOUT iBiology.org

iBiology’s mission is to convey, in the form of open-access free videos, the excitement of modern biology and the process by which scientific discoveries are made. Our aim is to let you meet the leading scientists in biology, so that you can find out how they think about scientific questions and conduct their research, and can get a sense of their personalities, opinions, and perspectives. We also seek to support educators who want to incorporate materials that illustrate the process and practice of science into their curriculum. This project is made possible by the good will of many biologists who are committed to making their work broadly accessible and to conveying the excitement of biology to a worldwide audience.

iBiology.org (formerly ibioseminars.org and ibiomagazine.org) was developed to bring the best biology to people throughout the world for free. Started in 2006 by University of California – San Francisco and Howard Hughes Medical Institute investigator, Professor Ron Vale, iBiology has grown to include over 300 seminars and short talks by the world’s leading scientists. Our collection includes talks by many Nobel Laureates and members of the United States National Academy of Sciences. In 2013, we released our first full-length course in Light Microscopy and expanded the educational resources we offer. iBiology is funded by the National Science Foundation, the National Institute of General Medical Sciences, and the Howard Hughes Medical Institute, and supported by the American Society for Cell Biology and the University of California, San Francisco.