January | 2013 | principleintopractice

Archive for January, 2013

How did I get here…

Posted in General, Life, Med school, Principle into Practice on January 31, 2013| 2 Comments »

It’s currently the time of year when the Student Affairs personnel at my school people are rallying the troops (third year medical students) to start thinking about what we want to be when we “grow up”. It’s early days yet, but the words “personal statement” seem to inject fear into my classmates. I guess most of them don’t write a blog for a hobby…

I haven’t started to write a statement yet, and I’m sure it’ll be an angst filled experience when I finally get down to it, but mulling it over got me thinking back to the personal statement I submitted when I first applied to medical school.

I was not a traditional med-school applicant. I was not “pre-med” (a major I would discourage anyone from pursuing) and I had never shadowed a doctor nor shown any interest in a medical profession. I had a broad interest in all things scientific. I took the MCATs on a dare and did well enough to consider applying to medical school. My love of science made the MD/PhD route intriguing to me, so I decided that in addition to the PhD programs I was interested in I would also apply to a few MD/PhD programs.

A couple weekends ago I was up in Boston and enjoyed a dinner with Kamal Patel of Pain Database and others. It was an enjoyable evening, and while discussing the merits and perils of being a med student I somewhat jokingly suggested to Kamal that I should dig up my old personal statement and post it on my blog. He thought it seemed like a great idea (surprisingly, alcohol was not involved in this discussion), so now that I’ve had a bit of downtime I’ve dug it up and given it a look over.

In hindsight, I seem a little overenthusiastic (so many exclamation points!!!!), but generally I think that my enthusiasm for life is genuine. One of the closing lines is something that I still deeply believe. In fact, it is a sentiment that comes through in the name of this blog.

“I believe that the practical application of knowledge is the most rewarding result of study and curiosity.”

Even 8 (eek!) years ago, I wanted to put principles into practice.

Without further ado…

(Unedited, except to abbreviate the names of the professors I worked with)

_____________________________________

Until a few years ago I could still see the remnants of my first “experiment” in my garden every spring: red tulips growing along the fence line of the vegetable patch. As long as I can remember, I’ve been asking questions and trying to figure things out. The directions on a pack of tulip bulbs told me to plant them six inches deep, six inches apart. But at five I had to ask… why? Luckily I’ve been blessed with equally inquisitive parents, so my father indulged me, and the next day we were digging holes ranging in depth from one inch to two feet. The next spring I waited expectantly. Somewhat to my disappointment, they all came up! That wasn’t supposed to happen! Only the next year did it become clear that six inches seemed about optimal for a perennial show.

My quest for understanding and knowledge through experience has been a lot of fun, taken me many places, and introduced me to many people. As a child I would spend days in the woods and fields around my house exploring and trying to understand nature. When I wasn’t out adventuring, I was home reading books; I was amazed at what there was to learn! When I first started riding horses it was hard to find me away from barns, vet offices, or anywhere else I could learn about horses. While this led me to compete at national quiz competitions, I have most enjoyed becoming a thoroughly knowledgeable horse person. I apply what I know to working with my own horses and those of others, and enjoy teaching and helping local kids and even adults with general equine knowledge and veterinary care.

I particularly enjoy teaching others about polocrosse, an exciting combination of polo and lacrosse. I started playing on my first pony, a well-trained, athletic pony that did everything I asked her to do. When it was time for me to get a bigger horse, I looked at a number of horses that were ready to play, but eventually decided to buy a young ex-racehorse with a lot of potential and very little training. At times it was hard to watch my peers get better so quickly on their well-trained horses, and at times I thought I should give in and get a horse that was ready to play, but the challenge excited me, and I stuck with it. After four years of hard work, a lot of sweat, a few falls, and occasional bouts of anguish, I’m proud to play on a horse that I brought to the game on my own, and I know that I am a better rider because of the experience.

Now in college, I still can’t learn and do enough. I have joined a number of groups on campus, and am on the executive boards of the campus-wide Programs and Activities Council, the Biochemistry Club, and Alpha Zeta, a co-ed honors/service/social fraternity. Going to a large state school, I have had the opportunity to take a wide range of classes that apply to my major, my interests, and things that just seem neat! During the fall of my freshman year I became SCUBA certified so that I could travel to Little Cayman during the winter break to study coral reefs with a marine geologist. I was so enthusiastic that she invited me to apply for a summer internship studying the reefs around the island. I applied, got the position, and spent two weeks documenting species diversity, morbidity and mortality of coral around the island.

A fascination with Moorish architecture and Picasso’s Guernica, and a desire to test my Spanish on its home ground, led me to drag my mother to Spain. My basic grasp of the language and her ability to rent a car made for an incredible trip. For ten days we traveled in the south of Spain, seeing architecture and experiencing the culture. Similarly, a fascination with Guinness Stout, Ireland, and the Irish led me to take a youth-hostelling trip to Dublin. These and other trips have heightened my curiosity and driven my desire to see and experience more of the world.

During college, the curiosity that my parents initially encouraged when I was a child developed into a desire to do scientific research. In addition to the coral reef project, I am glad to have had several other exciting research experiences. I was fortunate to receive a Center for Bioinorganic Chemistry summer grant to work in the laboratory of Dr. GZ on the biodegradation of aromatic hydrocarbons by Pseudomonads. Another year I got funding to study the incidence of Lyme disease in mice and their parasites along a rural to urban transact in New Jersey in the laboratory of Dr. MS. I am now conducting my senior thesis work in the toxicology lab of Dr. LW, studying the effects of 2,3,7,8-tetrachlorodibenzo-p–dioxin, an environmental contaminant, on developing fish embryos. The curiosity that once inspired me to plant rows of tulips has brought me to believe that medical science is the most exciting and dynamic field I could hope to enter, yet I am hesitant to devote my life purely to lab work and research. I believe that the practical application of knowledge is the most rewarding result of study and curiosity. I want to enter the medical field to combine my drive to discover and understand with my love of people, and become a doctor working at the frontiers of clinical science.

Read Full Post »

This sh*t is bananas…

Posted in Food, Life on January 27, 2013| 9 Comments »

Whenever I type the word “bananas”, I hear a certain Gwen Stefani song in my head… This post is going to be painful to type!

I just wanted to put up a quick post on one of Americans’ favorite fruits. According to the USDA, bananas are the most consumed fruit in the United States, accounting for 25% of fresh fruit consumption. Bananas are rich in potassium, magnesium, and manganese, and while some who embrace a low-carb lifestyle may find fault with them, they are without doubt a whole, real, food. While our modern domesticated varieties are very different from wild bananas (and no, the shape of the banana is NOT proof of creationism!), bananas can be part of a healthy diet for most people. Bananas are a staple of many traditional diets, and their leaves are also used for cooking in many cultures.

A wild banana, courtesy of Wikimedia commons. I wonder how they taste?

In America, the word banana is synonymous with the Cavendish banana, but this is certainly not the only variety and many argue it is not the best. “Best” is, of course, subjective. Choosing a “best” banana is like choosing a best apple*. Seasonality and freshness matter, as does personal preference.

Variety makes life interesting. Genetic variation is necessary for evolution. Food variation makes out diet more interesting (and broadens our nutrient intake while minimizing exposure to potential toxins). Over the past year or so, I’ve made it my goal to try as many varieties of banana as I can find- so far I’m doing pretty well.

Cavendish bananas (a triploid variant of Musa acuminata) can be found just about anywhere. Grocery stores, cafeterias, and many gas stations have these ubiquitous yellow fruit on offer year round.

At my local grocery store I can usually find other Musa varieties. Next to a small selection of yucca, aloe, and other somewhat “exotic” offerings I can almost always find plantains (a hybrid between Musa acuminata and Musa balbisiana). They usually have green plantains, sometimes yellow, and occasionally brown. The color varies with ripeness. Green plantains are the least ripe and are not sweet, while yellow- or even better, dark brown- plantains are sweet. Plantains are best eaten cooked. (Personally I love to fry them up in coconut oil. The greens are great with a squeeze of lime, some chile, and salt, while the sweeter fruits are good plain or with a shake of cinnamon or cocoa.)

Occasionally my local supermarket has Niño bananas ( a diploid variant of Musa acuminata known by a number of other names), and I can almost always find these at the Asian supermarket I like to visit. I find that these small bananas have a similar taste, though slightly different texture, than Cavendish bananas.

At my favorite Asian supermarket I’ve also found Burro bananas, which (at least to me) seem like a hybrid between plantains and Cavendish. It can be eaten cooked or raw. To me they have a slightly tart, almost lemony, flavor when eaten fresh. They have a distinct shape- shorter than Cavendish and very angular.

This weekend, I found yet another type of banana to add to my list. I was visiting a friend on Long Island and took a trip through an ethnic supermarket that caters to the local Hispanic population. Like so many ethnic supermarkets, this store had a fabulous produce section- with a great variety of fruits & vegetables, all really fresh and reasonably priced. The meat department was also extensive, with lots of interesting cuts, including goat! (A friend and I were recently bemoaning the fact that you can rarely find goat in the US- I’ve only ever had it when my family bought whole animals from a local farmer).

At the store on Long Island I finally came across Red bananas (another triploid variant of Musa acuminata). As the name suggests, this variety is a dark red, almost purple. Otherwise, it looks like a slightly smaller Cavendish. I picked up a couple but I haven’t tried them yet as I don’t think they’re quite ripe.

The variety of different bananas I picked up. From left to right: Niños, Reds, Cavendish, and plantains.

I only have to find one more type of banana to knock off every variety on this list, and I will continue to keep my eyes open for other, unusual varieties. Some of my family members have tried Manzano bananas while visiting Hawaii, and as the name promises, they do taste a bit like apples (Manzano is spanish for apple).

Actually, it looks like Hawaii has many interesting types of bananas, and I’m in desperate need of some sunshine and relaxation… looks like it’s time to go look at plane tickets to Hawaii!!

I wish… I start an EMS elective tomorrow. I’m looking forward to working with first responders as we pick up and transport patients to our University Hospital. From all reports, this is an exciting elective!

*When it comes to apples, GoldRush are, without a doubt, my favorite, but the “best” apple on any given day depends on what is fresh, what is in season, and what you’re in the mood for!

Read Full Post »

The evolution of medicine…

Posted in Disease, General, Historical, Med school, Surgery on January 25, 2013| 5 Comments »

When I tell people that I’m interested in evolutionary medicine, I sometimes get the response “Evolutionary medicine? Or the evolution of medicine?”.

I’ll admit, I’m actually interested in both, but my interest in Evolutionary Medicine is much stronger than my interest in the history and progression of medicine, though this subject can be rather fascinating. I’ve listened to a course on the history of medicine, attended some extra lectures, and occasionally pick up a book to indulge this interest, but as a third (soon to be fourth, in 2 weeks!) year medical student, I generally have a hard enough time trying to make sense of our modern medical practices without spending too much time thinking about medical history.

Sometimes, however, the evolution of medicine plays out right in front of your eyes.

Today I took the end-of-clerkship exam for my obstetrics and gynecology rotation. I actually enjoyed this clerkship a lot more than I had initially anticipated (a good thing, as I am increasingly thinking that I will pursue a residency in Family Medicine, which includes obstetrics). I found myself a lot more enthusiastic to go to the OR to scrub in than I was during my surgical clerkship many months ago (it’s amazing what a year of clinical medical education will do to you).

This clerkship was split into a number of portions: labor and delivery (L&D), night float, women’s health clinic, maternal-fetal medicine (MFM), reproductive endocrinology and infertility (REI), gynecology, and gynecologic oncology… Quite the smorgasbord! On night float and L&D I would frequently end up in the OR to scrub in on a cesarean delivery, on gyn and gyn onc I was in the OR daily for a range of procedures from small biopsies to extensive tumor staging cases.

Major advancements in surgery include the discovery and utilization of anesthesia (Imagine being awake and able to feel everything in surgery! Better not, actually…), and the acceptance of germ theory (for which we should thank John Lister (1827-1912), namesake of Listerine!). Many other discoveries, techniques, and inventions have changed the practice of surgery, but these two are biggies. The third, looming, problem that needs to be addressed is the perturbation of cytokines during and after surgery, but that is a story for another day!

An interesting progression of surgery is the way in which surgeons gain access to the abdomen and pelvis. Traditionally, as one might imagine, the easiest way to visualize and manipulate the internal organs was to do an open procedure, literally cutting a person open to directly access the area to be operated. In the 1980s, gynecologists started to train in a new technique- laparoscopic or “minimally invasive” surgery- in which a small camera is inserted into the abdomen (which has been inflated with an inert gas to create space*) so that surgeons can visualize the internal structures without opening the belly. Instruments can be introduced into the abdomen through small incisions, and organs and instruments can be manipulated inside the body** and visualized on a screen.

Initially this technique was used for only very small procedures (such as a tubal ligation, “having your tubes tied”), but as surgeons became more proficient, the complexity of the cases that could be performed in this manner increased. The utility of this technique was recognized, and in the 1990s, general surgeons started to train in laparoscopic techniques. Now, many surgeries, both gynecologic and general, are performed laparoscopically (somewhere along the way, urologists started using this technique as well).

To be a good laparoscopic surgeon takes a lot of time and training. Cut yourself a 31 or 42 cm stick and imagine trying to do small and precise tasks with the end, which you can only visualize on a screen. Now imagine you have to dissect out delicate pieces of anatomy, correctly identify them, preserve or remove tissue accordingly. As a student on the gynecology service, there was really no reason to scrub into “lap” cases (though they were generally good cases to observe, since the screens make the procedure easy to follow), but on surgery I would sometimes scrub in and occasionally be allowed to steer the camera or “bag” a specimen for removal (really, the resident would drop the sample into the endocatch bag, but they would generally act like it was a great triumph for the student!). It all looks fairly easy until you actually have your hands on the instruments and have to find your way around the belly (or if you’re the med student with the camera, make sure the surgeon is seeing what she wants to see!).

Once you are proficient with laparoscopic techniques, there is a lot you can do. One of the fellows on the Trauma service was a specialist with laparoscopic techniques, and he could “run the bowel” (visualize it from end to end) more rapidly laparoscopically than many surgeons could do open. Getting proficient, however, takes a lot of time, especially if one is to master skills such as laparoscopic suturing.

Many gynecological and general procedures are now done using laparoscopic techniques. If you have your gallbladder or appendix removed, it’s likely you will have a “lap-chole” or a “lap-appy”, and the offending part will be removed with only a few small incisions visible.

In the last 10 years (I think), there was been “the next step” in laparoscopic surgery… the invention and utilization of a laparoscopic robot. I should be clear that surgery is still under the control of a surgeon, and no one has “robot surgery”, but the “latest and greatest” (though is it really?) advancement in surgery is “robot assisted laparoscopic surgery”.

In robot cases, the abdomen is accessed similar to a traditional laparoscopic case, except the various instruments are subsequently attached to a robot, instead of being wielded by surgeons (though an assistant was needed at the patients side in the cases I saw to swap out instruments and to suction). Using “the robot” allows surgeons a lot more precision and accuracy, and according to one of the surgeons I observed, you become proficient much more quickly on the robot than you do with traditional laparoscopic techniques.

Is it progress?

On my week of gynecology, I witnessed the same surgery (supracervical hysterectomy) done open, laparoscopically, and with a robot-assist. Some cases, due to the underlying pathology or anatomy, must be done open. If the uterus is too adherent to other structures or if there might be malignancy that could spread if not removed in one piece, open surgery is probably the best option. All things being equal, recovery from an open procedure is much longer than for the other options.

When it comes to laparoscopic surgery, robotic surgeries can potentially accomplish much finer tasks than general laparoscopy with significantly less blood loss (the robotic hysterectomy that I observed had an estimated blood loss of 20cc- they probably take more at your annual physical). The laparoscopic case I saw also had minimal blood loss and was accomplished very quickly- the surgeon has decades of practice under his belt.

So- is this the evolution of medicine? Will robots fill every OR, and will the best surgeons be those who spent many hours as a child (or as an adult, as often is the case) playing video games? (I had to have a quick google, which resulted in this.).

Who am I to say? I’m just a MS3.97 (yes I calculated), with no great knowledge of surgery. All I can say is that the progression of medicine is amazing. We (generalists, specialists, surgeons, and other health care practitioners) have amazing technology at our fingertips. We have access to impressive diagnostics, powerful drugs, and amazing technology that allow us to diagnose, treat, and definitively fix disease. But we must be judicious. Diagnostics and treatments (pharmacologic and surgical) have consequences- some big and some small.

Sometimes the question shouldn’t be “what type of surgery”, or “which drug”, but rather “is surgery necessary?” or “how will treatment help” (I don’t think the cases I described above were unnecessary, but Obstetricians/gynecologists, because of the horrible state of medical-legal affairs, often seem to err on the side of doing too much and/or acting very quickly). We can do amazing things with medicine. Contrary to how this may sound, I’m not acquiring medical knowledge with no intent of using it. Rather, I think that those with medical knowledge have a responsibility to help patients decide what is the best option for them– physically and personally. At least that’s the kind of doctor I want to be…

But hey- we have some pretty cool tools out there to help us when we need them!

A surgical robot- Courtesy of wikicommons

*It’s amazing how laparoscopy can pervert your perception of anatomy. When the abdomen is pumped full of gas it looks like organs are flopping around with lots of space, when in reality everything is rather tightly packed during day-to-day living.

** I write abdomen or “belly”, but I generally mean abdomen and/or pelvis.

Read Full Post »

New Year in Dubai- part 2

Posted in Life, tagged Dubai, New year, Travel, UAE on January 22, 2013| 1 Comment »

I’m back! While I should probably be studying for my upcoming Ob/gyn exams (practical exam tomorrow, written test on Friday), I thought I’d take some time this evening to get part 2 of my trip to Dubai up.

As I mentioned in my last post, people in the United Arab Emirates (UAE) have historically lived either on the coast or in land at oases. Most of the major cities- for example Dubai, Abu Dhabi, and Sharjah – are on the coast, but there are some cities that have grown up around oases in the desert.

During my trip to the UAE I visited Al Ain, the second largest city in Abu Dhabi and the fourth largest city in the UAE. Al Ain was built around an oasis: a source of water and thus agriculture in the desert. From groundwater and runoff from the mountains, farms were built where water was found. I saw a number of oases, all which were extensively planted with date trees. I did also spy one farm where they grew lush grass- animals did not graze this land, but I saw men cutting portions and carrying the greenery to livestock (I saw it being fed to goats).

Looking over the Al Ain Oases. Al Ain also has a truly world class zoo.

Another oasis, this one at a historic homestead.

One more- this one was next to the oldest mosque in the UAE.

At some oases I saw pens of goats, chickens, sheep, and doves (I believe these are used for falconry training). Camels, which survive with much less water in much harsher lands, were seen roaming the deserts and dunes along highways. As we drove from Dubai to Al Ain, I saw many camel farms as well as camels being ridden and camels loose in the desert. We also passed a camel racetrack!

Speaking of deserts…

A highlight of my trip to the UAE was going on a “desert safari”. My environmentalist side felt a little guilty, but “dune bashing” through the dunes in an area known as “Big Red” (technically in Sharjah) was a lot of fun.

Stunning scenery

"Dune Basing." Let your tires down to 15psi, and make some tracks.

“Dune Bashing.” Let your tires down to 15psi, and make some tracks.

The landscape of the desert is incredibly different from anything I’ve ever experienced. I tend to find peace and happiness in green, wooded, and wild areas, but the dunes posses a beauty that is unlike any other natural environment I’ve encountered. We went dune bashing with another friend of my brother (another native Sharjan), who has been taking people out into the desert on safari for thirteen years. Going out into the desert is what he does everyday professionally, but when I asked him what he did with his days off and his evenings he said he spent them in the desert. It’s where he’s happy and it’s where he finds peace- a sentiment I can understand. Nature, in many forms, is deeply soothing.

The UAE gets very little rain. The cities, which aren’t designed with rain in mind, handle even a small amount of rain very poorly, flooding with even the smallest precipitation. Likewise, the sand of the deserts quickly forms an impervious surface when wet, and water runs off into deep ravines known as wadis- dry riverbeds. If you’re ever camping in the desert, resist the urge to pitch your tent in a wadi- with even a small amount of rain you and your tent may be swept away in a torrent.

As someone who is named after the geologist Charles Lyell I was immediately fond of the these deep desert ravines that showed how water had eroded through many layers of rock, exemplifying the theory of uniformitarianism. I also really enjoyed the scenery as we went “Wadi Walking” through Wadi Wurayah in Fujeira.

Wadi walking.

I hope this gives a scale of these Wadi’s… Some of these scenes really reminded me of Indiana Jones and the Last Crusade, though that movie was filmed at Petra in Jordan.

This Wadi is home to the tallest waterfall in the UAE- I haven’t found it documented, but it’s probably 15’ max…

Record breaking waterfall.

This is a good time to point out one of the serious problems in the UAE- garbage and graffiti. Every inch of stone at this waterfall was covered in grafitti, as you can see. A more widespread problem is garbage. I was deeply saddened (and annoyed) by all the trash that was around the waterfall and at other beautiful places. Despite the big signs warning against leaving garbage, there was no end of detritus. I saw people actively throwing cigarette cartons, bottles, and food wrappers throughout the Wadi and at the beach in Dubai. I found the litter in the dunes most demoralizing. People would camp and make bonfires and leave all of their garbage strewn about the site. There were very few expanses of unspoiled sand.

On a day trip to Abu Dhabi I visited the Sheikh Zayed Grand Mosque, the largest mosque in the world outside of Mecca. Most mosques are closed to non-muslims, but this one is open to the public… as long as you follow “Mosque manners”.

Sheikh Zayed Grand Mosque

Mosque Manners

I obliged…

The Sheikh Zayed Grand Mosque is stunning. It is massive and beautiful, though the interior design is definitely not my style (perhaps I’m just used to the solemn interior design of churches, but I found the bright colorful baubles and chandeliers out of place). The flooring outside the mosque is marble, and when you take your shoes off (you’re not allowed in the mosque wearing them) the floor is surprisingly cool, despite the desert heat and sun, thanks to radiant cooling. Inside the mosque, bright carpet covers the floor, which is specially designed to be removable in pieces so that it can be regularly cleaned (in accustom with islamic rules). There are also large digital displays on the wall with 6 times listed: dawn, and the 5 times at which muslims are supposed to pray throughout the day.

As you travel throughout the UAE, you see prayer rooms and mosques tucked away. Muslims are supposed to pray 5 times a day, and while they do not have to pray in a mosque or prayer room, it is preferred. These religious areas are labelled with women’s and men’s entrances, and I believe the “mosque manners” above apply to all. Certainly, muslims can’t always make it to a mosque to pray, and you occasionally see people get out a prayer mat, clean their hands and feet, and pray in a (relatively) quiet corner on a public street.

While out in Fujeira, we stopped at the oldest mosque in the UAE. It dates from the 1400s and is overlooked by 2 towers. The architecture is very unique.

The oldest mosque in the UAE. It has very unique architecture.

As I mentioned in my last post, UAE law is deeply influenced by Sharia law, and Muslims may not eat pork (or drink alcohol). Pork (and products with pork in them) is off limits and is kept in its own area in supermarkets. I really couldn’t get enough of these signs.

Look at the cuddly pigs on the wall!

Also, while Dubai is a global city and quite tolerant, it remains relatively conservative in comparison to the western world. There are many requests for modest clothes (I awkwardly toured the Emirates Palace Hotel in Abu Dhabi trying to conceal my flip flops), and public displays of affection are generally frowned upon if not expressly forbidden. (Also, weekends in the Muslim world are Friday and Saturday.)

No kissing (unfortunately I cut off the top right with the request that people wear clothes that cover shoulders and knees.

Dubai initially grew along an inlet from the ocean known as “Dubai Creek”. As time passed, the creek became used as a port for traders. As trade increased, the decision was made to develop the creek further, and it was dredged and reinforced so that it could be used for major trade. The creek remains an important port, though it is no longer the dominant port in Dubai (this has fallen to the Jebel Ali Port). Water taxis (known as Abras) shuttle people across the creek, and we took a trip across (for the cost of 1 dirham, about $0.27).

Abra

One thing you notice all around the UAE are pictures of the various sheiks that rule the emirates. Large portraits are on buildings, signs, and posters. Here’s just one example.

Sheiks

Part 1 of my trip to Dubai started with the Burj Kalifa, the tallest building in the world, so it seems appropriate that this post should come full circle. I left Dubai on the morning of the 1^st, after watching New Years fireworks. No picture I took can do them justice, so here’s a video of the show.

The Dubai fountains also featured heavily in the show. I only saw them during the day, but that’s another site worth seeing! (Talk about the land of excess!)

this is seriously worth watching…

Read Full Post »

New Year in Dubai- part 1

Posted in Food, Life on January 17, 2013| 3 Comments »

As I let on in a recent post, I spent Christmas and the start of the New Year visiting my brother in Dubai and touring around the United Arab Emirates (UAE). This isn’t a travel blog, but while I was touring around the emirates and learning some of the history of the region I made some observations that I think are worth sharing- especially since I got a great tour of a part of the world that many will never visit. Apologies if this reads like a blog version of a vacation slideshow!

Dubai is an otherworldly place. Obviously built to be “the city of the future”, the skyline is chock-o-block with architectural masterpieces, though many have been stalled or vacant since the financial collapse of 2009. Put in any other city, many Dubai buildings would be iconic, but standing next to the world’s tallest building, the world’s only 7-star hotel (self proclaimed), and other masterpieces, otherwise stunning buildings start to look commonplace.

The tallest building in the world. It’s almost twice the height of the Empire State Building.

Burj Al Arab by night: Taken from Palm Jumeira- an entirely man made island in the shape of a palm tree (http://en.wikipedia.org/wiki/Palm_Islands). The Burj Al Arab is actually built on its own man-made island in the Gulf. *

Burj Al Arab by night: Taken from Palm Jumeira- an entirely man made island in the shape of a palm tree. The Burj Al Arab is actually built on its own man-made island in the Gulf. *

Old Town: While parts of the city look “authentic” (or what you might expect to see in a Middle Eastern city), the oldest building in Dubai is probably from the 60s or 70s. This complex, known as “Old Town”, was finished in 2007.

Other towers: My brother was able to give me fairly detailed background on many buildings around Dubai, many of which have been stalled or vacant since his arrival in the city 3 years ago. Their vacancy does not hinder their stunning architecture.

On the surface, there seems to be little “traditional living” or “ancestral health” wisdom to glean from Dubai. It is a very modern city with immigrants, corporations, and businesses from around the world. Within a block of my brother’s home you can get Kentucky Fried Chicken, Nando’s (a chicken restaurant originally from South Africa), and Al Tazaj (a chain BBQ chicken restaurant from Saudi Arabia) and that’s just to name the chicken restaurants (Popeye’s chicken is also popular, but there isn’t one within a block of my brother)! You also see The Cheesecake Factory, Texas Roadhouse, PF Chang’s and just about any American or international chain you could name (though I don’t think I saw a Chipotle).

I’m confident that if humans develop an extraterrestrial community, this will be the first chain available in outer space.*

Of course, Dubai only recently became a modern global city. Dubai changed rapidly from a small pearling center and regional trading port to a cosmopolitan global hub fuelled largely by the discovery of oil in the region. Dubai also developed laws and practices that encouraged rapid expansion of business and real-estate on a global scale . Older Emirati have truly seen it all, from the days of very basic living to modern global excess. As someone who is deeply interested in ancestral health, I asked around and read about the traditional ways of living in this part of the county. While no one today lives an “ancestral” lifestyle, the memory of traditional days is not yet forgotten.

The easiest place to start, of course, is food. Until relatively recently, the diet of the Middle East was limited to foods that could be locally produced or transported great distances without refrigeration. While traders would bring spices and rice, which was a staple of the diet, perishable food was limited to what is locally available- which isn’t much. On the shore, seafood was a staple. I was told by a local Emirati (a good friend of my brother) that a generation ago, the main meal of the day would be rice and fish. Fish, readily available from the sea, was relatively cheap, while meat was expensive. Today this has reversed and meat (usually lamb, but sometimes goat and increasingly beef) is cheaper and more commonly eaten while fish is now more expensive and less common.

One of the highlights of my trip to the United Arab Emirates (I spent time in Abu Dhabi, Fujairah, and Sharjah in addition to my time in Dubai) was an evening walking tour around Sharjah led by my brother’s friend Khalid. Khalid is a native Emirati, with a deep knowledge of the area as well as the history and culture of the region. He kindly took us on a tour of some of the markets of Sharjah, and graciously answered my endless questions about the food, history, culture, and religion (and occasional lack thereof) in the area.

The first stop on our tour of Sharjah was the local fish market, where merchants sell fresh catch from dawn until late in the evening (they get two deliveries of fish per day). Here we saw the wide variety of fish that are caught, sold, and eaten in the area.

The fish market in Sharjah**

I recognized a number of fish and marine life on offer. There were shark, rays, and tuna, as well as small reef fish (such as angel fish, parrot fish, and grunts) that I’m familiar with as a SCUBA diver. In Dubai, I saw Tiger Prawns (shrimp) larger than I’ve ever seen: almost a foot long. It appears that this species is on the seafood “red list” as, I’m sure, are other species I spied in the market. An interesting aspect of the fish market was a large station at the end of the market where men would prepare your purchase (fish, squid, or shrimp). It cost 1 Dirham (about $0.27 US) to have a fish cleaned, 2 Dirham to have a kilo of squid cleaned, or 3 Dirham to have a kilo of shrimp cleaned (the most expensive item on the list). As someone that peels her own shrimp, I recognize that ~$0.35/lb is a cheap price for cleaning shrimp!

Traditionally, fish was also dried and used for trading, fertilizer, and animal food. Dried fish would make its way to the oases in the desert (anything fresh from the coast would spoil before it could reach any inland populations) where it could be sold or traded for products of the oases. The #1 product of the oases has traditionally been dates.

The cultivation of date palms (Phoenix dactylifera) has been the most important form of agriculture in the area now known as the UAE. Date palms not only provide their owners with high calorie fruit, but also supply leaves that can be used to make fans and baskets, branches that can be used to make walls and roofs, bark fibers that are suitable for making rope and for stuffing pillows and saddles, and dead trunks that can be used as beams. Date fruits can be eaten fresh, dried, crushed for juice, or boiled and packed in bags made of palm leaves. Fruits stored in this way could be kept for a long time and were used as staple foods for men and animals on long journeys across the desert [1].

Palms of many uses. You can see in this open kitchen in a historical abode that palms trunks were sometimes used as beams and fronds were used as roofing or for walls.

Palms of many uses. You can see in this open kitchen in a historical abode that palm trunks can be used as beams and fronds used as roofing or walls.

This was a small building on the same homestead. Dates were placed on the ridged floor and a large trunk was used to crush them, with the juice running off into the depression where it could be collected.

This was in a small building on the same homestead. Dates were placed on the ridged floor and a large trunk was used to crush them, with the juice running off into the depression where it could be collected.

Today most dates are eaten whole- usually dried, but sometimes fresh when in season. There are MANY types of dates, a number of which I sampled. I’d be lying if I said I weren’t a date enthusiast (though it is a fondness I’ve only developed in the last couple years). Varieties have different characteristics, though they are all incredibly sweet (one shop keeper tried to tell me that a certain variety was lower in sugar and therefore “good for diabetics”. I think not…).

Date Poster: This is an incomplete list, but it gives you an idea of the variety available.

Many types of dates are available from different shops and stands in the UAE, but I definitely didn’t see many of the varieties that are shown above. I did see some unique dates, but there were a few varieties that I saw over and over again. I imagine that the diversity of dates is much like the diversity of apples available in the US. While you can get a good selection from growers and specialty markets, a few types make up the majority of the market. (As far as dates go, in the US I’ve only seen two types for sale in stores: Medjool and Deglet Nour. To me, the Deglet Nour is the Red Delcious of the date world- not worth bothering with- but maybe I’m picky.).

Date alley: Perhaps my favorite part of our Sharjah tour. With the exception of the stand directly on the right that sells coconuts, all of these stands sell dates.

Perhaps my favorite part of our Sharjah tour. With the exception of the stand directly on the right that sells coconuts, all of these stands sell dates.

One of the many date stands. Merchants were keen to tell you the price and source of dates.

The price of dates varied widely. At the street markets, I saw dates from 8-16 Dirham/kg (~ $1-$2/lb), in Waitrose (a nice supermarket) they were 22-35 Dirham/kg (~$3-$4/lb), and at fancy date stores at the Dubai Mall they were 165-240 Dirham/kg ($20-$40/lb)! I tasted dates from all sources and will say that the cheapest and the most expensive were the best- the ones from Waitrose were a disappointment. Lining them all up and having a blind taste test would be fun- I’ll put that on my list for next time!

The third and final local food that played a role in traditional diets is camel products- usually camel milk. If you haven’t seen it already, check out my recent post.

Camel milk of many colors: rose, cardamon, and saffron flavored alongside plain.

Though there has never been enough wildlife to support a population of hunter-gatherers in this part of the Middle East, there is (or was) some game that has historically been hunted. Such sources could not be relied upon, but provided much appreciated variety and sustenance when found. Traditionally, falconry was used for hunting. Falconry remains a deeply loved sport in the Emirates, one that is seen as part of Emirati heritage and supported by the Sheikhs.

Falconry remains a popular sport in the emirates.

Coffee also holds a special cultural significance in the UAE. Arabic coffee, usually spiced with Cardamom, is offered to guests as a sign of hospitality. The hotel where my brother lives (a common choice of housing) has dates and Arabic coffee on offer to guests at all times in the lobby. The coffee (at least to my taste) is rather weak, though the spice is pleasant.

While I’m interested in traditional diets, I’m also interested in what people are eating now. Maybe I’m a weird tourist (or maybe I’m just easily amused), but when I’m traveling I always love to take a trip through a local supermarket to see what people are eating. The Waitrose at the Dubai Mall did not let me down…

First to the meat department:

Grass fed beef from NZ and Grain fed beef from Australia. I really like that you can buy the two side by side. I wish I’d found two comparable cuts so I could compare the prices…

Pork Department: Islam is the national religion in the UAE, and laws are based around Sharia law. Muslims may not drink alcohol or eat pork (amongst other things). That being said, non-Muslims may buy pork at supermarkets and alcohol is served at hotels (though not in Sharjah).

Interesting finds in the pork department: The pork department isn’t just a meat counter- you can also find processed foods that include pork products. The Corn Bread has Pork Fat in it, but I couldn’t find an offending ingredient in the Pop-tarts (though I do find Pop-tarts offensive!). The bacon flavored crackers are obviously taboo!

I didn’t travel halfway around the world just to visit supermarkets. In addition to spending quality time with my brother and his family, I also got to see A LOT of sites in the surrounding emirates, but as this post is already getting rather long, maybe I’ll save that for next time!

Credit where credit due. I took most pics, but the ones marked by a * were taken by a friend Amber, and ** were taken by Khalid.

1. Heard-Bey, F., From Trucial States to United Arab Emirates. 2011, London: Motivate Publishing.

Read Full Post »

An Offal Weekend

Posted in Food, Life, tagged cooking, Food, odd bits, Offal on January 13, 2013| 6 Comments »

As I’ve written before, I’m a fan of eating odd bits. If you’re going to eat meat, and you want to be ethical about it, I think you should make the effort to try and eat all the parts of an animal (or use them in some manner).

I realize this concept is not for everyone. I am one of those people who used to cringe at the thought of eating non-traditional (at least in the current western world) pieces of meat. The disconnect between animals and the plate has become so great that for some, the concept that meat comes from animals is so distant that they won’t eat meat with bones in it. People- meat comes from animals, animals have bones. But I digress…

My family raises cows, so I’m well aware of the importance of “hanging weight”- the weight of an animal’s carcass after it has been killed and eviscerated. If you buy an animal by the whole, half, or any other fraction, it’s likely that the cost is calculated based off of this number. This weight, however, does not include lots of other tasty (and incredibly nutritious) bits that an animal has to offer.

When I buy an animal from a farmer for butchering (or when I send my own animals to slaughter) I make sure I put in a request for lots of odd bits: I want the animal to be fully utilized, I want to get all the tasty bits, I want to get all the nutritious parts, and heck- I want to get my moneys worth! As a result, I sometimes end with a substantial stash of offal in my freezer (especially beef offal, as not everyone who buys beef from us wants the odd bits, though that is changing as we sell more meat to paleo and foodie eaters).

When I came home to my parents this weekend, I thought I’d have a go at eating some of odd bits… My photography is definitely not up to par with many food blogs, but hopefully I do these tasty bits justice (though it takes a better artist/photographer than me to make a raw beef tongue look anything other than kinda weird).

It all started on Friday night, when I decided it was time to experiment with some of the pork skin that I requested from the Berkshire pig I purchased this fall from a local farmer. I found this page and gave their method a try. The result was tasty, though perhaps a danger to my teeth!

Cracklings!

This set in motion a bit of a personal challenge to see how much offal I could put to good use this weekend. Next on the block was a beautiful smoked jowl from the same Berkshire pig as above. Jowl is a really fatty piece of the animal that makes BEAUTIFUL (albeit very fatty) bacon. It can also be cured in other styles such as the Italian Guanciale (which reminds me, I have a piece of jowl from another pig in my freezer that a friend cured into Guanciale at home (<– Worth checking out, if only for the pic of a curing pork jowl hanging from the ceiling). If you don’t request that the butcher save the jowl, I expect it ends up being ground into sausage- a shame for such a delicacy to end in anonymity.

A whole smoked pork jowl

I initially tried to slice this by hand, but quickly realized this was a job for my little deli-slicer.

Jowl bacon, fresh cut

As its winter, I’ve been using quite a bit of stock out of my freezer for soups and stews. It seemed like this weekend was a good time replenish my stores by making some collagen rich pork stock from pork trotters and neck bones.

Trotters and neck bone, to be made into stock.

I shared this pic on my personal facebook page and the general consensus there was “gross”. Although trotters don’t have the same panache as a standing rib roast, they do have a certain je ne sais quoi (and I wouldn’t call them gross).

A number of years ago my parents were visiting Paris. At a restaurant, they were offered a menu in French and English. My father’s grammar school French led him to believe that an item on the menu was “foot of pork”, but the English menu said “leg of pork”. When he inquired, the waiter assured him that it was leg of pork (I think you see where this if going…). When a trotter was brought to the table, my father was less than amused. It is worth noting that my parents are from England, bringing up theories of potential remnants of French-anglo animosity!

As I write this, the trotters have been simmering for almost 24hrs and have made three lovely batches of stock. I have some omnivorous scrap-disposal units that are looking forward to the remnants!

I used some of the stock to make a hearty soup for lunch today, which I paired with a luxurious beef marrowbone.

Marrowbone- I describe it to skeptics as being similar to a savory crème brulee.

I’m one of the few med students on my current rotation who consistently brings lunch. In preparation for this week, and in keeping with the offal theme, I decided to cook up a cow tongue. After it has simmered for a number of hours I’ll shred it and sauté it with an onion and some spices, eventually portioning it out with some mashed sweet potato.

Yes- it’s a tongue.

The final offal of the day is a meaty shinbone that I will stew up with a beef kidney, making the old British standby Steak and Kidney (minus the pudding). Kidneys were one of the last odd bits to make their way into my diet. As a child I would hear of this traditional British meal and cringe- funny how things can change (and how long it can take to get over childhood aversions!).

For those of us used to human anatomy, beef kidneys sure look WEIRD! (It’s important to trim a kidney well, you don’t want to be eating the calyx!)

I realize offal isn’t for everyone, but I hope this might inspire someone to give offal a chance. There are other great things to do with odd bits (imagine a post on offal that doesn’t talk about liver!), and with the help of the internet you can get all kinds of tips and recipes (or you can buy a book). Even if offal isn’t for you, I hope you can recognize that nose-to-tail eating is a responsible decision when thinking about the ethics of eating meat (even if you do find it a little gross).

(Here’s guessing that a number of my friends won’t be looking for dinner invites anytime soon!)

Read Full Post »

Ship of the desert, shaper of human evolution…

Posted in Evolution, Food, Historical, tagged Bedouin, Camel, Camel Milk, desert, Dromedary, Dubai, evolution, human evolution, milk, traditional foods on January 7, 2013| 14 Comments »

Happy New Year!

2012 was a whirlwind year for me. I defended my PhD at the beginning of 2012 and am now almost finished with all the required clerkships of third-year medical school. Phew!

I spent my winter holiday visiting my brother in Dubai, exploring many sites of the United Arab Emirates (UAE). I got to see a lot during my stay, and I’ve been writing a post on some of the interesting things I saw there. As I was writing about the traditional dietary staples of the Middle East, I took a foray through a lot of literature that is available on camel milk. It’s interesting stuff, and I found myself heading off on a tangent that I thought I should post as a stand-alone article.

So here we go…

Ship of the desert
Camels were (and still are, but for different reasons) an important part of life in the Middle East. The Arabian camel (the dromedary Camelus dromedarius) is a one-humped beast, and should not be confused with the 2-humped Bactrian camel (Camelus bactrianus) of central Asia. Dromedaries were the only mode of transportation in the desert before motorized vehicles (walking any substantial distance on foot is out of the question and horses need too much water), and they also were an important form of wealth and source of food. Camel meat was a rare delicacy, while camel milk was a staple of the Bedouin diet. Camel hair was also used to make household necessities and camel dung was often used as fuel (a nice argument against the calories in calories out argument- if biological creatures were bomb calorimeters there wouldn’t be anything worth burning coming out the other end…).

Camel meat was not a staple of the Bedouin diet. In fact, most nomadic people are reluctant to kill their subsistence animals for meat. Female camels were used for dairy and some males were kept for breeding purposes, but extra young male camels would be slaughtered and eaten for special occasions.

Though definitely not a traditional dish- this seems to be the #1 way to eat camel meat today

Though definitely not a traditional dish, this seems to be the most popular way to eat camel meat today

Camels are uniquely able to provide sustenance for humans in an environment that is generally rather inhospitable. Camels are able to not only survive, but thrive, on the limited and harsh forages that are available in the desert. She-camels can produce enough milk to nurse their offspring and provide liters of milk per day for their owner.

Camel in its native environment. These beasts thrive on the course and sparse forage of the desert.

Camel in its native environment. These beasts thrive on the coarse and sparse forage of the desert.

Camels’ milk is interesting stuff. Unlike the milk of cows, goats, and sheep, it cannot be easily made into cheese. It doesn’t coagulate with bovine rennet, however recombinant camel rennet is incredibly efficient at coagulating cow milk and can also coagulate camel milk (there is a difference in the camel kappa-casein that makes it more resistant to cleavage) [1, 2]. With the right enzyme the job can be done, and there is at least one company that makes a camel cheese (nicknamed Camelbert!).

Camel milk isn’t much good for making yoghurt either, being much more resistant to lactic acid fermentation than cow milk. The result of camel milk lactic fermentation is very runny, with little microbial growth [3]. Gariss, a traditional Sudanese fermented camel’s milk product, is made with a mixed culture including Lactobacillus, Streptococcus, and yeast [4]. Here’s how it was traditionally made:

fermentation is carried out in two leather bags of tanned goat skin embedded in green or wet grass carried on the bag of camels and subjected to continuous shaking by the jerky walk inherent to camels. Whenever part of the product is withdrawn for consumption, a portion of fresh camel’s milk is added to make up volume and this continues for months [4].

According to one paper I spotted, food scientists can thicken fermented camel milk with gelatin or alginate (a thickener made from seaweed) in order to make a yoghurt-like product that consumers might find acceptable, but I didn’t spot any on the shelves in the stores of Dubai [5].

It seems to me that when it comes to camel milk it might be best to just keep it simple. Plain old milk.

But camel milk may not be such simple stuff. There is growing research that explores the use of camel milk for medicinal purposes.

I haven’t gone into the research in depth, but there are a number of small studies looking at the benefits of camel milk for people with diabetes (type 1 and type 2), with rather remarkable results. The addition of 500mL of camel milk on top of usual care for patients with type 1 diabetes resulted in significant improvements in a number of parameters in comparison to people who just received standard care. The camel milk group had a decrease in mean blood glucose levels and hemoglobin A1c. The study was small, but 3 of the 12 participants in the camel milk group were able to completely stop using insulin (an almost unheard of occurrence for those with type 1 DM). While the mean amount of insulin used in the control group remained constant, the amount used in the camel milk group dropped rapidly [4].

Abdelgadir et al [4]

It hasn’t been determined how camel milk affects those with diabetes, but there are a number of hypotheses. Some sources think that insulin from camel milk is uniquely able to escape digestion when ingested or that camel milk contains a unique insulin-like small peptide that is bioavailable when consumed [6]. This is unlikely to be the whole story, however, as camel milk is able to increase endogenous insulin secretion in type 1 diabetics (individuals in standard of care + camel milk groups have higher levels of C-peptide, showing an increase in insulin production) [7].

Some readers may know that I have a fondness for fatty liver disease, so I was particularly interested to learn that, in a rat study, camel milk reversed alcohol-induced liver injury. This was seen histologically, where there was minimal fatty accumulation in the livers of alcohol-treated animals supplemented with camel milk in comparison to those just treated with alcohol alone, and serologically, where animals that were treated with ethanol alone had significantly increased liver enzymes in comparison to controls and those fed alcohol and camels milk [8]. I would postulate that it might have something to do with the high levels of carnitine found in camel milk [9], but that’s a story for another day.

Nutritionally, camel milk is unique. As I just mentioned, it has a more free carnitine as a percentage of total carnitine than other species and higher total carnitine than cow or human milk (though lower than sheep and goat milk) [9]. Camel milk has three-times the vitamin C of cow milk, but a similar amount of vitamin E and considerably less vitamin A and riboflavin [10]. Camel milk is low in short chain fatty acids in comparison to other milks and it has primarily long chain fatty acids, a significant portion of which is linoleic acid [11]. I tend to avoid this omega-6 FA, but I suspect that as part of a traditional diet the amount found in camel milk does not cause a problem.
Camels can carry a number of zoonotic organisms, including Coxiella burnetii (which causes Q fever) and Brucella sp. (which causes brucellosis), which can be transmitted through the milk. In fact, there was a recent brucellosis outbreak in Israel caused by raw camel milk [12]. If you’re drinking milk from an untested camel, it’s probably best to have it pasteurized. All the milk that’s available in Dubai supermarkets is pasteurized and homogenized. There are a variety of brands, and you can get milk in an array of flavors!

I spied plain, chocolate, strawberry, saffron, rose, cardamom, and date flavor! In this pic there’s saffron, chocolate, strawberry, date, and plain.

Of course I had to try some… I opted for plain milk, and found it slightly sour in comparison to cow’s milk, with a watery mouthfeel. It’s been at least a decade since I drank skim milk, but as I remember the mouthfeel is similar.

Sculptors of human evolution

Camels have played central roles in the lives of desert dwelling people for millennia. They are the “ship of the desert” and their milk has nourished and sustained generations. Their milk has also shaped the human genome…

The predominance of lactase persistence in populations is a well-known and well-studied example of human evolution. In populations that had access to animal milk, a mutation that allowed for the production of lactase past the age of weaning gave humans access to a rich food source. This was a huge advantage to those that had such a mutation. Those that could easily consume milk were able to have more children, and the mutation spread throughout the population. The advantage of having persistent lactase expression is so advantageous it has occurred independently in multiple populations over time. While some mutations are linked back to the domestication of the cow, there are novel mutations found in Middle Eastern populations that are linked to the domestication of, and subsequent milk consumption from, Arabian camels [13].

The advantage of camel domestication is still present today. A paper from 1996 looked at child health in three populations of Rendille pastoralists in Northern Kenya. Two of the groups had abandoned their nomadic roots to become settled, while one group remained nomadic. In wet years (good years) there was a similar number of malnourished children in the three groups; however in a drought year, the children of the nomadic group faired significantly better. The differences in malnutrition were attributed to food- specifically camels milk. In drought years, the children in the nomadic group consumed three times as much milk as those from the sedentary group, where the children got more starches and sugar. Other studies have found that nomadic groups generally do poorly during drought years (because of decreased production of milk from their herd), but because the Rendille maintain a large number of camels, they faired better during hard times [14].

So there you have it… I went diving into pubmed looking for a few fun facts to incorporate into a blog post on my trip to Dubai and found myself swept up in a mess of Dromedary data… I hope you found it as interesting as I did!

1. Kappeler, S.R., H.J. van den Brink, H. Rahbek-Nielsen, Z. Farah, Z. Puhan, E.B. Hansen, and E. Johansen, Characterization of recombinant camel chymosin reveals superior properties for the coagulation of bovine and camel milk. Biochem Biophys Res Commun, 2006. 342(2): p. 647-54.

2. Sorensen, J., D.S. Palmer, K.B. Qvist, and B. Schiott, Initial stage of cheese production: a molecular modeling study of bovine and camel chymosin complexed with peptides from the chymosin-sensitive region of kappa-casein. J Agric Food Chem, 2011. 59(10): p. 5636-47.

3. Attia, H., N. Kherouatou, and A. Dhouib, Dromedary milk lactic acid fermentation: microbiological and rheological characteristics. J Ind Microbiol Biotechnol, 2001. 26(5): p. 263-70.

4. Abdelgadir, W., D.S. Nielsen, S. Hamad, and M. Jakobsen, A traditional Sudanese fermented camel’s milk product, Gariss, as a habitat of Streptococcus infantarius subsp. infantarius. Int J Food Microbiol, 2008. 127(3): p. 215-9.

5. Hashim, I.B., A.H. Khalil, and H. Habib, Quality and acceptability of a set-type yogurt made from camel milk. J Dairy Sci, 2009. 92(3): p. 857-62.

6. Malik, A., A. Al-Senaidy, E. Skrzypczak-Jankun, and J. Jankun, A study of the anti-diabetic agents of camel milk. Int J Mol Med, 2012. 30(3): p. 585-92.

7. Mohamad, R.H., Z.K. Zekry, H.A. Al-Mehdar, O. Salama, S.E. El-Shaieb, A.A. El-Basmy, M.G. Al-said, and S.M. Sharawy, Camel milk as an adjuvant therapy for the treatment of type 1 diabetes: verification of a traditional ethnomedical practice. J Med Food, 2009. 12(2): p. 461-5.

8. Darwish, H.A., N.R. Abd Raboh, and A. Mahdy, Camel’s milk alleviates alcohol-induced liver injury in rats. Food Chem Toxicol, 2012. 50(5): p. 1377-83.

9. Alhomida, A.S., Total, free, short-chain and long-chain acyl carnitine levels in Arabian camel milk (Camelus dromedarius). Ann Nutr Metab, 1996. 40(4): p. 221-6.

10. Farah, Z., R. Rettenmaier, and D. Atkins, Vitamin content of camel milk. Int J Vitam Nutr Res, 1992. 62(1): p. 30-3.

11. Gorban, A.M. and O.M. Izzeldin, Fatty acids and lipids of camel milk and colostrum. Int J Food Sci Nutr, 2001. 52(3): p. 283-7.

12. Shimol, S.B., L. Dukhan, I. Belmaker, S. Bardenstein, D. Sibirsky, C. Barrett, and D. Greenberg, Human brucellosis outbreak acquired through camel milk ingestion in southern Israel. Isr Med Assoc J, 2012. 14(8): p. 475-8.

13. Enattah, N.S., T.G. Jensen, M. Nielsen, R. Lewinski, M. Kuokkanen, H. Rasinpera, H. El-Shanti, J.K. Seo, M. Alifrangis, I.F. Khalil, A. Natah, A. Ali, S. Natah, D. Comas, S.Q. Mehdi, L. Groop, E.M. Vestergaard, F. Imtiaz, M.S. Rashed, B. Meyer, J. Troelsen, and L. Peltonen, Independent introduction of two lactase-persistence alleles into human populations reflects different history of adaptation to milk culture. Am J Hum Genet, 2008. 82(1): p. 57-72.

14. Nathan, M.A., E.M. Fratkin, and E.A. Roth, Sedentism and child health among Rendille pastoralists of northern Kenya. Soc Sci Med, 1996. 43(4): p. 503-15.

Read Full Post »

principleintopractice

Ramblings of an evolutionary-minded physician

Archive for January, 2013

How did I get here…

This sh*t is bananas…

The evolution of medicine…

New Year in Dubai- part 2

New Year in Dubai- part 1

An Offal Weekend

Ship of the desert, shaper of human evolution…

Happy New Year!

Follow Blog via Email

Recent Posts

Archives

Principle into Practice

Categories

Blogroll