CHINA....Archaeologists find Ming Dynasty mummy
Really well preserved for a 700-year old mummy.
Wonder why the liquid in the stone coffin is still intact.
Archaeologists have discovered a well-preserved, 700-year-old,body of a woman inside a stone coffin in China.
The coffin was found on a building site in Taizhou, in eastern China 's Jiangsu Province. Archaeologists carefully lever the lid off with crowbars.
The coffin was one of the three discovered in a tomb two metres underground on a construction site in the city.
Researchers from the Taizhou Museum carefully opened the coffins.
In two they found skeletons, Ming Dynasty clothes and funerary objects.
However, in the third they found the well preserved body of a woman.
The 5-foot-long corpse was tightly wrapped in cerecloth (heavy wax-treated linen cloth used for burying the dead), quilt and clothes.
Ming Dynasty Mummy
Fresh milk in China
Could you think New Zealand or Australia. can beat this milk delivery???
Fresh milk in China - milk on the tap! could not be any fresher.
This is Fresh milk in China............
Never go to China during their public holidays
Never go to China during their school holidays or public holidays. It's no fun.
One has to be warned if you think about travelling or touring China....
Ask the tour or travel agency about the public holidays in China...or you'll be engulfed by the millions of local people... think about the problem of being lost, pick-pocketed, molested and worse... if you need to use a toilet!!!Just view the photographs and you will understand... God help you if you're there!!
What happens during the National Holidays in China ( eg: 1st week of October)
Tell Hollywood "Jesus" is NOT a Swear Word
The Bible says, “For there is no other name under heaven given to men by which we must be saved."
It’s too bad that not all of Hollywood knows this truth!!
Every night on TV and every week in the movie theaters, the name of Jesus is being used not to refer to God’s Son -- but rather as a way to curse and to swear. The Bible says this should not be!
In the USA Network's show "Suits", the name of Jesus is blasphemed and hauled through the sewer constantly. And even ONCE is too much.
Now suddenly in the second season the characters are all gurgling over using Jesus’ name as a swear word! This is typical of current television.
God is never glorified when his Son’s name is taken in vain. You and I cannot let this continue. So we intend to do something about it.
by Christian Film & Television Commission Campaign
Finish The Race - Live without God
A very touching story...
In memory of Dr Richard Teo who finished his race
TESTIMONY OF Dr Richard Teo
Recorded at the Dental Christian Fellowship , on 24 Nov 2011, 8 months after his diagnosis.
Richard would have liked to share this with you. We are doing this to continue his work.
Please have a read and leave it behind for someone else to benefit from his sharing.
If you would like a copy, please let any of his family or close friends know and we will be able to provide both the audio recording as well as the transcript.
Thank you, and may God bless you richly.
Below is the transcript of the talk of Dr. Richard Teo, who was a 40-year-old millionaire and cosmetic surgeon with a stage-4 lung cancer, sharing at a Dental Christian Fellowship Meeting. He would have liked to share this with you too.
HIS BACKGROUND
Hi good morning to all of you. My voice is a bit hoarse from the chemotherapy, so please bear with me. I thought I'll just introduce myself. My name is Richard, I’m a friend of Danny’s, who invited me here.
I’d just begin to say that I’m a typical product of today’s society. Before this, I was talking about how the media influences us etc. So I’m a typical product of what the media portrays. From young, I’ve always been under the influence and impression that to be happy, is to be successful. And to be successful, is to be wealthy. So I led my life according to this motto.
Coming from a poor average family, back in those days, I was highly competitive, whether in sports, studies, leadership. I wanted it all. I’ve been there, done that. But at the end of the day, it’s still about money.
So in my recent last years, I was a trainee in ophthalmology, but I was getting impatient, cos I had friends of mine who were going out into private practise, making tonnes of money. And there I was, stuck in a traineeship. So I said, ‘Enough, it’s getting too long.’ At that time, there was a surge in protégés of aesthetic medicine. I’m sure you’re aware, aesthetic medicine had peaked over the last few years, and I saw good money in there. So much so that I said, ‘Forget about ophthalmology, I’m gonna do aesthetic medicine.’ So that’s what I did.
The truth is, nobody makes heroes out of the average GP in the neighbourhood. They don't. They make heroes out of rich celebrities, politicians, rich and famous people. So I wanted to be one of these. I dived straight into aesthetic medicine. People were not willing to pay when I was doing locum back in those days. Anything more than $30, they would complain that “Wah, this lo kun (doctor) jing qwee (very expensive)”. They made noise and they were not happy. But the same people were willing to pay $10 000 for a liposuction. So I said, ‘Well, let’s stop healing the sick, I’m gonna become a beautician; a medically-trained beautician.’
And that was what I did – liposuction, breast augmentation, eyelid surgeries, you name it, we do it. It was very good money. My clinic, when we started off, waiting time was 1 week; 1 month; became 2 months; became 3 months. There was so much demand that people were literally queuing up to have aesthetic work done on them. Vain women – easy life!
So the clinic grew. I was so overwhelmed, from 1 doctor, I employed 2, then 3, then 4 doctors, and carried on. Nothing is ever enough. I wanted more and more and more. So much so that we set up shop in Indonesia to lure all the Indonesian tai tai’s. We set up shop, set up a team of people there, to get more Indonesian patients to come in.
So, things were doing well. I’m there, my time has arrived.
Around some time in February last year, I said, ‘OK, I have so much spare cash, it’s time to get my first Ferrari. So there I was, getting ready for the deposit. ‘OK! There comes my first Ferrari!’ I was looking for land, to share with some of my friends. I have a banker friend who makes $5 million a year. So I thought, ‘Come, let’s come together. Let’s buy some land and build our houses.’
I was at my prime, getting ready to enjoy. At the same time, my friend Danny had a revival. They were going back to church, some of my close friends. They told me, ‘Richard, come, join us, come back to church.’
I have been a Christian for 20 years; I was baptised 20 years ago, but it was because it was fashionable to be a Christian then. All my friends were becoming Christians then. It was fashionable! I wanted to be baptised, so that when I filled in a form, I could put there “Christian” – feels good. In truth, I had never had a bible; I don’t know what the bible is all about.
I went to church for a while, after some time, I got tired. I said it’s time to go to NUS, stop going to church. I had a lot more things to pursue in NUS – girls, studies, sports etc. After all, I had achieved all these things without God today, so who needs God? I myself can achieve anything I want.
In my arrogance, I told them, “You know what? You go tell your pastor to change your sermon to 2pm. I will consider coming to church.” Such arrogance! And I said 1 statement in addition to that – till date, I don’t know I’ve regretted saying that – I told Danny and my friends, “If God really wanted me to come back to church, He will give me a sign.”. Lo and behold, 3 weeks later, I was back at church.
THE DIAGNOSIS
In March 2011, out of the blues – I was still running around, ‘cause I’m a gym freak and I always go to the gym training, running, swimming 6 days a week. I had some backache, and that’s all I had, but it was persistent. And so I went for an MRI to exclude prolapsed disc. And the day before I had my scan, I was still in the gym, lifting heavy weights, doing my squats. And the next day, they found that half my spine had bone marrow replacement. I said, “Woah, sorry, what’s that?”
We had a PET scan the next day, and they diagnosed that I had terminal lung cancer, stage 4B. It had spread to the brain, half the spine, whole of my lungs were filled with tumour, liver, adrenals…
I said, “Can’t be, I was just at the gym last night, what’s going on?” I’m sure you know how it feels – though I’m not sure if you know how it feels. One moment I was there at the peak, the next day, this news came and I was totally devastated. My whole world just turned upside down.
I couldn’t accept it. I have a hundred relatives on both sides, my mom and my dad. 100 of them. And not a single one has cancer. To me, in my mind, I have good genes, I’m not supposed to be having this! Some of my relatives are heavy chain smokers. Why am I having lung cancer? I was in denial.
HIS ENCOUNTER WITH GOD
So the next day, I was still in a state of denial, still unable to accept what was going on. There I was lying in an operating theatre in a hospital, for a needle biopsy (for histology). There I was, just completed the biopsy, and lying in the operating theatre. The nurses and doctors had left; told me I had to wait for 15 minutes to do a check X-ray to make sure there’s no pneumothorax (a complication).
And there I was, lying on the operating table, staring blankly at the ceiling in a cold, quiet operating theatre. Suddenly I just heard an inner voice; it was not like coming from outside. It was inside. This small inner voice that I had never felt before. And it said very specifically, it said, “This has to happen to you, at your prime, because it’s the only way you can understand.”
I said, “Woah, why did that come from?” You know, when you speak to yourself, you’d say, “OK, what time should I leave this place? Where shall I have dinner after this?” You’d speak from a first person point of view. You don’t say, “Where should YOU go after this?” Whereas the voice that came spoke as a third party. It said, “This has to happen to YOU, at YOUR prime, because this is the only way YOU can understand.” At that time, my emotions just overflowed and I broke down and cried, alone there. And I knew then, subsequently, what it means to understand that why this is the only way.
Because I had been so proud of myself, my whole life, I needed nobody else. I was gifted with things that I could do, why do I need anybody else? I was just so full of myself that there was no other way I could have turned back to God.
In fact, if I were diagnosed with stage 1 or 2, I would have been looking around busily for the best cardiothoracic surgeon, remove a section of the lobe (do a lobectomy), do preventive chemotherapy…The chances of it being cured is extremely high. Who needs God? But I had stage 4B. No man can help, only God can.
A series of events happened after that. I wasn’t sold after that, because of the inner voice, I became believing, prayers, all that. No I wasn’t. To me, it was just ‘maybe there was a voice; or maybe that was just me talking to myself.’ I didn’t buy the story.
What happened next was that I was being prepared for chemotherapy. I started off with a whole brain radiation therapy first; takes about 2 -3 weeks. In the meantime they prepared me for chemotherapy, supplements etc. One of the things they used for chemo was a thing called Zometa. Zometa - they use it to strengthen the bones; once the bone marrow (replacement) is cured of cancer cells, it becomes hollow, so we need Zometa to strengthen the bone to prevent compression fractures.
One of the side effects of Zometa is that it can cause osteonecrosis (bone death) of the jaw, and I had to have my wisdom teeth removed. Years ago, I had my upper wisdom teeth removed, cos it was giving me trouble. The lower ones didn’t give me trouble so I said, “Forget it, just leave it.” So of cause, Danny volunteered to remove it for me.
So there I was, lying there in a dental chair, asking myself, suffering all the side effects of radiotherapy, and now I have to go through wisdom tooth surgery. As if I’ve not had enough to suffer! So I asked Danny, “Eh, bro, is there any other way? Can I not go though this?” He said, “Yes, you can pray.”
I said, “What’s there to lose? Ok lah, pray lah!” And so we prayed. And we did an X-ray after that. Everything was all there, all the appliances and everything. And lo and behold, the Xray showed that there was no wisdom teeth in the lower jaw. I know most people have 4 wisdom teeth, maybe some have none, but to be missing one or 2, as I understand – I’m not too sure, as I understand – is not that common.
Still I was, “Nah, I don’t care about that.” To me, as long as I didn’t have to take out the tooth, I was happy. At that point, I still wasn’t sold on prayers. Maybe it was just a coincidence – for whatever it’s worth.
I continued meeting my oncologist, asking him, “How long do I have?” I asked him. He said, not more than 6 months. I said, “Even with chemotherapy?” About 3 – 4 months, he said.
I couldn’t grasp that. It was difficult to come to terms. And even as I went through radiotherapy, I was struggling everyday, especially when I wake up, hoping that it’s just a nightmare; when I wake up, it’s all over.
As I was struggling, day after day, I went into depression, which is the typical denial, depression blah blah blah that you go through. But for 1 reason, I don’t know why, there was this specific day that I was supposed to meet my oncologist. At about 2pm, I felt this sudden surge of peace, comfort, and in fact, a little happiness. It was just overflowing. For no rhyme or reason, it just came about 2pm, as I was getting ready, dressing up to meet my oncologist. So much so that I whats-apped all my friends that, “Bros, I just feel so good suddenly! I don’t know why, it just came!”
And it was only days, or was it weeks after, that Danny revealed to me that he had fasted for 2 days for me, and he was bargaining with God, and fasted for 2 dyas, and he ended his fast at that exact same point, about 2pm thereabouts, that this surge of sensation came to me for no rhyme or reason. And I didn’t know that he was fasting for me. And when he ended the fast, I felt that sensation!
Whoa, things were getting a bit too coincidental. I was starting to buy a bit of the story, but still I wasn’t sold. As days passed by, I completed my radiotherapy, about 2 weeks plus. Getting ready for chemo, so they let me rest for a few days.
See, the mortality rate of lung cancer : Lung cancer has the highest mortality rate. If you add up breast, colorectal (colon) cancer, and prostate cancer (the top few cancers in Singapore for men and women), if you add up the mortality rate of these 3, it still doesn’t add up to lung cancer. Simply because, you understand, you can remove the prostate, the colon, the breast, but you cannot remove your lungs.
But there’s about 10% of lung cancer patients who do pretty well for some reasons, because they have this specific mutation; we call it the EGFR mutation. And it happens, only 90% of the time, in Asian ladies who never smoked in their lives. Me, first of all, I’m male. 2ndly, I’m a social smoker. I take one a day after dinner; weekends, when my friends offer me, I take it as well. I’m a light smoker, not a social smoker. But still, my oncologist was still not hopeful for me to have this mutation.
The chances of it happening for me was maybe 3-4% for me to get it. That’s why I was being primed to go for chemo. But through all the intense prayers, friends like Danny, people that I don’t even know, it turned out that, during my waiting for chemo, the results came back that I was EGFR positive. I was like, “Woah, good news!” Cos now I don’t have to undergo chemo at that time, because there’s this oral tablet that you can use to control this disease.
Just to share with you some idea – this is a CT scan – thorax – of my lungs, before treatment.
AFTER BEFORE
Every single dot there is a tumour. You can see all the mets (metastasis) there. This is just one single plane. Literally I had it in both lungs, and I had literally tens of thousands of tumour. That’s why the oncologist told me, even with chemo, at most 3-4 months.
But because of this mutation, they have this oral medication. This is what happened after 2 months of treatment. As you can see over here; this is what God can do. And that’s why I’m still here having this opportunity to share with you. As you can see over here, the difference between before and after treatment.
At that point, I said, “Well, it’s to be expected, isn’t it? The medicine is good.” I’m still not buying the story. Well, the guys prayed for me and the tumour markers started to come down. 90% of the tumours were wiped out, and the tumour markers came down to more than 90% over the next few months.
But still, you know, once you have the clinical knowledge, you know the statistics. One year survival, two year survival; having all this knowledge is not a good thing. Cos you live with the knowledge that even with all this, the cancer cells are so unstable, they keep mutating. They will overcome and become resistant to the drugs, and eventually you’re gonna run out of medication.
So living with this knowledge is a huge mental struggle, a huge mental torture. Cancer is not just about a physical struggle, it’s a huge mental torture. How do you live with no hope? How do you live with not being able to plan for the next few years? The oncologist tells you to bear with it for the next 1 – 2 months. So it’s a lot of struggles as I went through: March, then April. April was my lowest point, in deep depression, struggling even as I was recovering.
HIS ACCEPTANCE & PEACE
And one of those days, I was there in bed, struggling in the afternoon, asking God, “Why? Why do I have to go through this suffering? Why do I have to endure this hardship, this struggle? Why me?”
As I fell asleep, in my dreamy state, a vision just came, that says Hebrews 12:7-8.
Now mind you, at this time, I had not read the bible. I have no clue what’s Hebrews, I don’t even know how many chapters there are. Totally clueless.
But it says Hebrews 12:7-8, very specifically.
I didn’t think too much of it. I just continued sleeping. Then I woke up, and I said, “What’s there to lose? I’d just check it out lah!” Danny had bought me a bible; it’s still quite new. I said, “It’s ok, just try.” So I flipped to the Old Testament. Hebrews to me sounds like something ancient, so it should be in the Old Testament right? So I flipped through the Old Testament. No Hebrews there. I was so disappointed.
Then I said, “Maybe New Testament, let’s have a look!”. WOW – New Testament, there’s Hebrew’s!! It says Hebrews 12:7-8. It says, “Endure hardship as discipline as God is treating you as His children.”
I said, “WAH!! Where did that come from?” I was getting goose pimples all over my body. I said, “This can’t be, right?” I mean, what’s the chance of somebody, who has never read the bible, to have a vision of a chapter of a specific verse, that answers my question directly?
I think God called to me directly as I was there sleeping, struggling with it, asking God, “Why do I have to suffer? Why do I have to suffer this?” And God says “Endure hardship as discipline as God is treating you as His child.”
At this point, the chance of that happening is even lesser than my EGFR being positive. There’s just no way; there’s so many millions of thousands of verses in the bible, how can I just conjure up something like that?
So at that point, I was sold I said, “YOU WIN! YOU WIN!!”
Ok , I was convinced. And so from that day onwards, I started believing in my God. And the last time I heard that inner voice was the end of April. And that inner voice, same thing, in the afternoon, as I was sleeping (this time I wasn’t struggling, just going to sleep). In a dreamy state I just heard Him say, “Help others in hardship.”
It was more like a command, rather than a statement. And that’s when I embarked on this journey, helping others in hardship. And I realised that hardship is not just about being poor. In fact, I think a lot of poor people are probably happier than a lot of us here. They are so easily contented with whatever they have, they’re probably pretty happy.
Hardship can happen to rich people; it can be physical hardship, mental hardship, social, etc. And also over the last few months, I started to understand what this true joy is about. In the past, I substituted true joy with the pursuing of wealth. I thought true joy is about pursuing wealth. Why? Cos let me put it to you this way, in my death bed, I found no joy whatsoever in whatever objects I had – my Ferrari, thinking of the land I was going to buy to build my bungalow etc, having a successful business.
It brought me ZERO comfort, ZERO joy, nothing at all. Do you think I can hold onto this piece of metal and it’s going to give true joy? Nah, it’s not going to happen.
True joy comes from interaction with other people. And at a lot of times, it is a short term pride, the past. When you pursue your wealth, Chinese New Year is the best time to do it. Drive my Ferrari, show off to my relatives, show off to my friends, do my rounds, and then you thought that was true joy? You really think that those guys who sold you your Ferrari, they share their joy with you? And your relatives, wow, they share this joy with you? In truth, what you have done is just to illicit envy, jealousy, and even hatred. They are not sharing the joy with you, and what I have is that short-term pride that wow, I have something you don’t have! And I thought that was joy!
So what we have is basically a short-term pride at the expense of somebody else. And that wasn’t true joy. And I found no joy at all on my deathbed, thinking of my Ferrari – to hold on to it, sayang it?!?
True joy I discovered comes from interaction. Over the last few months I was so down. Interaction with my loved ones, my friends, my brothers in Christ, my sisters in Christ, and only then was I able to be motivated, able to be uplifted. To share your sorrow, to share your happiness – that’s true joy.
And you know what makes you smile? True joy comes from helping others in hardship, and because I’ve gone through this, I know what hardship entails. In fact, there’re some cancer patients who tell me a lot of times, people come up to them and tell them, “Stay positive. Stay positive.” Yah, right. You come in my shoes and you try to stay positive! You don’t know what you’re talking about!
But I have the licence. So I’ve been going out to meet other fellow cancer patients, to share with them, encourage them. And I know, because I’ve been through it, and it’s easier for me to talk to them.
And most importantly, I think true joy comes from knowing God. Not knowing about God – I mean, you can read the bible and know about God – but knowing God personally; getting a relationship with God. I think that’s the most important. That’s what I’ve learnt.
So if I were to sum it up, I’d say that the earlier we sort out the priorities in our lives, the better it is. Don’t be like me – I had no other way. I had to learn it through the hard way. I had to come back to God to thank Him for this opportunity because I’ve had 3 major accidents in my past – car accidents. You know, these sports car accidents – I was always speeding , but somehow I always came out alive, even with the car almost being overturned. And I wouldn’t have had a chance. Who knows, I don’t know where else I’d be going to! Even though I was baptised it was just a show, but the fact that this has happened, it gave me a chance to come back to God.
Few things I’d learnt though:
1. Trust in the Lord your God with all your heart – this is so important.
2. Is to love and serve others, not just ourselves.
There is nothing wrong with being rich or wealthy. I think it’s absolutely alright, cos God has blessed. So many people are blessed with good wealth, but the trouble is I think a lot of us can’t handle it. The more we have, the more we want. I’ve gone through it, the deeper the hole we dig, the more we get sucked into it, so much so that we worship wealth and lose focus. Instead of worshipping God, we worship wealth. It’s just a human instinct. It’s just so difficult to get out of it.
We are all professionals, and when we go into private practise, we start to build up our wealth – inevitably. So my thought are, when you start to build up wealth and when the opportunity comes, do remember that all these things don’t belong to us. We don’t really own it nor have rights to this wealth. It’s actually God’s gift to us. Remember that it’s more important to further His Kingdom rather than to further ourselves.
Anyway I think that I’ve gone through it, and I know that wealth without God is empty. It is more important that you fill up the wealth, as you build it up subsequently, as professionals and all, you need to fill it up with the wealth of God.
I think that’s about it. It’s good to share. Thanks.
"Life without God is like an unsharpened pencil - it has no point."
Taiwanese Betel nut beauty Best Uniforms
The saleswoman in Taiwan betel best uniforms
"Bethel", or, in Taiwanese, "binlan" binlan is actually legalized drug (betel leaves, areca nut, tobacco, liquor gaolyanovy) and causes a slight excitement, a sense of euphoria. Helps a long time (days) to stay awake and not lose concentration, for which truckers like (although, of course, with this set of effects - not only them).
The term Betel nut beauty (also betel nut girl - Chinese: 檳榔西施; pinyin: bīnláng xīshī; Pe̍h-ōe-jī: pin-nn̂g se-si) refers to a common sight along roadsides in Taiwan: a young woman selling betel nuts and cigarettes from a brightly lit glass enclosure while wearing revealing clothing (Openshaw). The Mandarin term names the women after Xi Shi, the legendary beauty of imperial China's Spring and Autumn Period. Though betel nuts are chewed in many regions of the Asia-Pacific, the betel nut beauty phenomenon is distinctly Taiwanese.
The original betel nut beauties were the "Shuangdong Girls" who, in the 1960s, brought glamour to the opening of the Shuangdong Betel Nut Stand in Guoxing Township (國姓鄉), Nantou County (Huang Wan-tran, Taipei Times, 2007 March). The success of the marketing strategy led competitors to follow suit, and by the end of the century betel nut beauties and their neon-topped kiosks were a trademark feature of Taiwan's cities and countryside.[original research?] The kiosks appear in urban, suburban and rural settings alike.
As icons of Taiwanese culture, betel nut beauties appear frequently in art and film. Betelnut Beauty is the English title of the 2001 film Ai ni ai wo (愛你愛我, literally "Love you, love me"),and betel nut beauties figure prominently in the 2007 art film Bangbang wo aishen (English title: Help Me, Eros).
The Magnificence of A MOTHER ...
Mother
This is a truly BEAUTIFUL piece.
Please read this at a slow pace,
digesting every word and in leisure....
Do not hurry.....this is a treasure...
For those lucky to still be blessed with your Mom,
this is beautiful.
For those of us who aren't, this is even more beautiful.
For those who are moms, you'll love this.
The young mother set her foot
on the path of life.
'Is this the long way?' she asked.
And the guide said: 'Yes,
and the way is hard
And you will be old before
you reach the end of it..
But the end will be better
than the beginning.'
But the young mother was happy,
and she would not believe
that anything could be better
than these years.
So she played with her children,
and gathered flowers for them along the way,
and bathed them in the clear streams;
and the sun shone on them,
and the young Mother cried,
'Nothing will ever be lovelier than this.'
Then the night came,
and the storm, and the path was dark,
and the children shook with fear and cold,
and the mother drew them close
and covered them with her mantle,
and the children said,
'Mother, we are not afraid,
for you are near, and no harm can come.'
And the morning came,
and there was a hill ahead,
and the children climbed and grew weary,
and the mother was weary.
But at all times she said to the children,
'A little patience and we are there.'
So the children climbed,
and when they reached the top they said,
'Mother, we would not have done it without you.'
And the mother, when she lay down at night
looked up at the stars and said,
'This is a better day than the last,
for my children have learned fortitude
in the face of hardness.
Yesterday I gave them courage.
Today, I've given them strength.'
And the next day came strange clouds
which darkened the earth,
clouds of war and hate and evil,
and the children groped and stumbled,
and the mother said:
' Look up. Lift your eyes to the light.'
And the children looked and saw
above the clouds an everlasting glory,
and it guided them beyond the darkness.
And that night the Mother said,
'This is the best day of all,
for I have shown my children God.'
And the days went on,
and the weeks and the months and the years,
and the mother grew old
and she was little and bent.
But her children were tall and strong,
and walked with courage.
And when the way was rough,
they lifted her, for she was as light as a feather;
and at last they came to a hill,
and beyond they could see a shining road
and golden gates flung wide.
And mother said,
'I have reached the end of my journey..
And now I know the end
is better than the beginning,
for my children can walk alone,
and their children after them.'
And the children said,
'You will always walk with us, Mother,
even when you have gone through the gates.'
And they stood and watched her
as she went on alone,
and the gates closed after her.
And they said:
'We cannot see her but she is with us still.
A Mother like ours is more than a memory.
She is a living presence.......'
Your Mother is always with you....
She's the whisper of the leaves
as you walk down the street;
she's the smell of bleach
in your freshly laundered socks;
she's the cool hand on your brow
when you're not well.
Your Mother lives inside your laughter.
And she's crystallized in every tear drop.
She's the place you came from,
your first home;
and she's the map you follow
with every step you take.
She's your first love and your first heartbreak,
and nothing on earth can separate you.
Not time, not space... not even death !
PASS THIS ON TO ALL THE MOTHERS & CHILDREN YOU KNOW.
MAY WE NEVER TAKE OUR MOTHERS FOR GRANTED...
Pass it on to the men too because they have mothers too
May Your Day Be Blessed My Friends
DANCE like no one's watching; SING like no one's listening; LOVE like you can't get hurt, and LIVE like there's no tomorrow.
A Letter from CEO to his people - US ELECTION
Below is an interesting letter from a CEO to his people about the coming US election
Subject: Message from David Siegel
Date:Mon, 08 Oct 2012 13:58:05 -0400 (EDT)
From: [David Siegel]
To: [All employees]
To All My Valued Employees,
As most of you know our company, Westgate Resorts, has continued to succeed in spite of a very dismal economy. There is no question that the economy has changed for the worse and we have not seen any improvement over the past four years. In spite of all of the challenges we have faced, the good news is this: The economy doesn't currently pose a threat to your job. What does threaten your job however, is another 4 years of the same Presidential administration. Of course, as your employer, I can't tell you whom to vote for, and I certainly wouldn't interfere with your right to vote for whomever you choose. In fact, I encourage you to vote for whomever you think will serve your interests the best.
However, let me share a few facts that might help you decide what is in your best interest.The current administration and members of the press have perpetuated an environment that casts employers against employees. They want you to believe that we live in a class system where the rich get richer, the poor get poorer. They label us the "1%" and imply that we are somehow immune to the challenges that face our country. This could not be further from the truth. Sure, you may have heard about the big home that I'm building. I'm sure many people think that I live a privileged life. However, what you don't see or hear is the true story behind any success that I have achieved.
I started this company over 42 years ago. At that time, I lived in a very modest home. I converted my garage into an office so I could put forth 100% effort into building a company, which by the way, would eventually employ you. We didn't eat in fancy restaurants or take expensive vacations because every dollar I made went back into this company. I drove an old used car, and often times, I stayed home on weekends, while my friends went out drinking and partying. In fact, I was married to my business — hard work, discipline, and sacrifice. Meanwhile, many of my friends got regular jobs. They worked 40 hours a week and made a nice income, and they spent every dime they earned. They drove flashy cars and lived in expensive homes and wore fancy designer clothes. My friends refinanced their mortgages and lived a life of luxury. I, however, did not. I put my time, my money, and my life into this business —-with a vision that eventually, some day, I too, will be able to afford to buy whatever I wanted. Even to this day, every dime I earn goes back into this company. Over the past four years I have had to stop building my dream house, cut back on all of my expenses, and take my kids out of private schools simply to keep this company strong and to keep you employed.
Just think about this – most of you arrive at work in the morning and leave that afternoon and the rest of your time is yours to do as you please. But not me- there is no "off" button for me. When you leave the office, you are done and you have a weekend all to yourself. I unfortunately do not have that freedom. I eat, live, and breathe this company every minute of the day, every day of the week. There is no rest. There is no weekend. There is no happy hour. I know many of you work hard and do a great job, but I'm the one who has to sign every check, pay every expense, and make sure that this company continues to succeed. Unfortunately, what most people see is the nice house and the lavish lifestyle. What the press certainly does not want you to see, is the true story of the hard work and sacrifices I've made.
Now, the economy is falling apart and people like me who made all the right decisions and invested in themselves are being forced to bail out all the people who didn't. The people that overspent their paychecks suddenly feel entitled to the same luxuries that I earned and sacrificed 42 years of my life for. Yes, business ownership has its benefits, but the price I've paid is steep and not without wounds. Unfortunately, the costs of running a business have gotten out of control, and let me tell you why: We are being taxed to death and the government thinks we don't pay enough. We pay state taxes, federal taxes, property taxes, sales and use taxes, payroll taxes, workers compensation taxes and unemployment taxes. I even have to hire an entire department to manage all these taxes. The question I have is this: Who is really stimulating the economy? Is it the Government that wants to take money from those who have earned it and give it to those who have not, or is it people like me who built a company out of his garage and directly employs over 7000 people and hosts over 3 million people per year with a great vacation?
Obviously, our present government believes that taking my money is the right economic stimulus for this country. The fact is, if I deducted 50 percent of your paycheck you'd quit and you wouldn't work here. I mean, why should you? Who wants to get rewarded only 50 percent of their hard work? Well, that's what happens to me.
Here is what most people don't understand and the press and our Government has chosen to ignore — to stimulate the economy you need to stimulate what runs the economy. Instead of raising my taxes and depositing that money into the Washington black-hole, let me spend it on growing the company, hire more employees, and generate substantial economic growth. My employees will enjoy the wealth of that tax cut in the form of promotions and better salaries. But that is not what our current Government wants you to believe. They want you to believe that it somehow makes sense to take more from those who create wealth and give it to those who do not, and somehow our economy will improve. They don't want you to know that the "1%", as they like to label us, pay more than 31% of all the taxes in this country. Thomas Jefferson, the author of our great Constitution, once said, "democracy" will cease to exist when you take away from those who are willing to work and give to those who would not."
Business is at the heart of America and always has been. To restart it, you must stimulate business, not kill it. However, the power brokers in Washington believe redistributing wealth is the essential driver of the American economic engine. Nothing could be further from the truth and this is the type of change they want.
So where am I going with all this? It's quite simple. If any new taxes are levied on me, or my company, as our current President plans, I will have no choice but to reduce the size of this company. Rather than grow this company I will be forced to cut back. This means fewer jobs, less benefits and certainly less opportunity for everyone.
So, when you make your decision to vote, ask yourself, which candidate understands the economics of business ownership and who doesn't? Whose policies will endanger your job? Answer those questions and you should know who might be the one capable of protecting and saving your job. While the media wants to tell you to believe the "1 percenters" are bad, I'm telling you they are not. They create most of the jobs. If you lose your job, it won't be at the hands of the "1%"; it will be at the hands of a political hurricane that swept through this country.
You see, I can no longer support a system that penalizes the productive and gives to the unproductive. My motivation to work and to provide jobs will be destroyed, and with it, so will your opportunities. If that happens, you can find me in the Caribbean sitting on the beach, under a palm tree, retired, and with no employees to worry about.
Signed, your boss,
David Siegel
10,000 times stronger than chemotherapy
Why are we not aware of this? Its because some big corporation want to make back their money spent on years of research by trying to make a synthetic version of it for sale.
So, since you know it now you can help a friend in need by letting him know or just drink some sour sop juice yourself as prevention from time to time. The taste is not bad after all. It's completely natural and definitely has no side effects. If you have the space, plant one in your garden. The other parts of the tree are also useful.
The next time you have a fruit juice, ask for a sour sop.
How many people died in vain while this billion-dollar drug maker concealed the secret of the miraculous Graviola tree?
This tree is low and is called graviola in Brazil, guanabana in Spanish and has the uninspiring name "sour sop" in English, zuurzak (Dutch) The fruit is very large and the subacid sweet white pulp is eaten out of hand or, more commonly, used to make fruit drinks, sherbets and such.
The principal interest in this plant is because of its strong anti-cancer effects. Although it is effective for a number of medical conditions, it is its anti tumour effect that is of most interest. This plant is a proven cancer remedy for cancers of all types.
Besides being a cancer remedy, graviola is a broad spectrum antimicrobial agent for both bacterial and fungal infections, is effective against internal parasites and worms, lowers high blood pressure and is used for depressi on, stress and nervous disorders.
If there ever was a single example that makes it dramatically clear why the existence of Health Sciences Institute is so vital to Americans like you, it's the incredible story behind the Graviola tree.
The truth is stunningly simple: Deep within the Amazon Rainforest grows a tree that could literally revolutionize what you, your doctor, and the rest of the world thinks about cancer treatment and chances of survival. The future has never looked more promising.
Research shows that with extracts from this miraculous tree it now may be possible to:
Attack cancer safely and effectively with an all-natural therapy that does not cause extreme nausea, weight loss and hair loss.
Protect your immune system and avoid deadly infections
Feel stronger and healthier throughout the course of the treatment
Boost your energy and improve your outlook on life
The source of this information is just as stunning: It comes from one of America's largest drug manufacturers, the fruit of over 20 laboratory tests conducted since the 1970's! What those tests revealed was nothing short of mind numbing... Extracts from the tree were shown to:
Effectively target and kill malignant cells in 12 types of cancer,
including colon, breast, prostate, lung and pancreatic cancer.
The tree compounds proved to be up to 10,000 times stronger in slowing the growth of cancer cells than Adriamycin, a commonly used chemotherapeutic drug!
What's more, unlike chemotherapy, the compound extracted from the Graviola tree selectively hunts down and kills only cancer cells. It does not harm healthy cells!
The amazing anti-cancer properties of the Graviola tree have been extensively researched -- so why haven't you heard anything about it? If Graviola extract is as half as promising as it appears to be--why doesn't every single oncologist at every major hospital insist on using it on all his or her patients?
The spine-chilling answer illustrates just how easily our health--and for many, our very lives (!) -- are controlled by money and power.
Graviola--the plant that worked too well
One of Americas biggest billion-dollar drug makers began a search for a cancer cure and their research centred on Graviola, a legendary healing tree from the Amazon Rainforest.
Various parts of the Graviola tree, including the bark, leaves, roots, fruit and fruit-seeds, have been used for centuries by medicine men and native Indians in South America to treat heart disease, asthma, liver problems and arthritis. Going on very little documented scientific evidence, the company poured money and resources into testing the tree's anti-cancerous properties--and were shocked by the results. Graviola proved itself to be a cancer-killing dynamo.
But that's where the Graviola story nearly ended.
The company had one huge problem with the Graviola tree--it's completely natural, and so, under federal law, not patentable. There's no way to make serious profits from it.
It turns out the drug company invested nearly seven years trying to synthesize two of the Graviola tree's most powerful anti-cancer ingredients. If they could isolate and produce man-made clones of what makes the Graviola so potent, they'd be able to patent it and make their money back. Alas, they hit a brick wall. The original simply could not be replicated. There was no way the company could protect its profits--or even make back the millions it poured into research.
As the dream of huge profits evaporated, their testing on Graviola came to a screeching halt. Even worse, the company shelved the entire project and chose not to publish the findings of its research!
Luckily, however, there was one scientist from the Graviola research team whose conscience wouldn't let him see such atrocity committed. Risking his career, he contacted a company that's dedicated to harvesting medical plants from the Amazon Rainforest and blew the whistle.
Miracle unleashed
When researchers at the Health Sciences Institute were alerted to the news of Graviola, they began tracking the research done on the cancer-killing tree. Evidence of the astounding effectiveness of Graviola--and its shocking cover-up--came in fast and furious.
....The National Cancer Institute performed the first scientific research
in 1976. The results showed that Graviola's "leaves and stems were found effective in attacking and destroying malignant cells." Inexplicably, the results were published in an internal report and never released to the public.
...Since 1976, Graviola has proven to be an immensely potent cancer killer in 20 independent laboratory tests, yet no double-blind clinical trials -- the typical benchmark mainstream doctors and journals use to judge a treatment's value -- were ever initiated.
....A study published in the Journal of Natural Products, following a recent study conducted at Catholic University of South Korea stated that one chemical in Graviola was found to selectively kill colon cancer cells at "10,000 times the potency of (the commonly used chemotherapy drug) Adriamycin."
....The most significant part of the Catholic University of South Korea report is that Graviola was shown to selectively target the cancer cells, leaving healthy cells untouched. Unlike chemotherapy, which indiscriminately targets all actively reproducing cells (such as stomach and hair cells), causing the often devastating side effects of nausea and hair loss in cancer patients.
...A study at Purdue University recently found that leaves from the Graviola tree killed cancer cells among six human cell lines and were especially effective against prostate, pancreatic and lung cancers. Seven years of silence broken -- it's finally here!
A limited supply of Graviola extract, grown and harvested by indigenous people in Brazil, is finally available in America.
The full Graviola Story--including where you can get it and how to use it is included in Beyond Chemotherapy: New Cancer Killers, Safe as Mother's Milk, a Health Sciences Institute FREE special bonus report on natural substances that will effectively revolutionize the fight against cancer. This crucial report (along with five more FREE reports) is yours ABSOLUTELY FREE with a new membership to the Health Sciences Institute. It's just one example of how absolutely vital each report from the Institute can be to your life and those of your loved ones.
breakthrough cancer and heart research and revolutionary
Amazon Rainforest herb logy to world-leading anti-aging research and nutritional medicine, every monthly Health Sciences Institute Member's Alert puts in your hands today cures the rest of America -- including your own doctor (!) is likely to find out only ten years from now.
The Phenomenal 2 Letter Word
PHENOMENAL 2 LETTER WORD
I'm sure you will enjoy this. I never knew one word in the English language that could be a noun, verb, adj, adv, prep.
UP
Read until the end ... You'll laugh.
This two-letter word in English has more meanings than any other two-letter word, and that word is ' UP .' It is listed in the dictionary as an [adv], [prep], [adj], [n] or [v].
It's easy to understand UP , meaning toward the sky or at the top of the list, but when we awaken in the morning, why do we wake UP ?
At a meeting, why does a topic come UP ? Why do we speak UP , and why are the officers UP for election (if there is a tie, it is a toss UP ) and why is it UP to the secretary to write UP a report?We call UP our friends, brighten UP a room, polish UP the silver, warm UP the leftovers and clean UP the kitchen. We lock UP the house and fix UP the old car.
At other times, this little word has real special meaning . People stir UP trouble, line UP for tickets, work UP an appetite, and think UP excuses.
To be dressed is one thing but to be dressed UP is special.
And this UP is confusing: A drain must be opened UP because it is blocked UP .
We open UP a store in the morning but we close it UP at night. We seem to be pretty mixed UP about UP !
To be knowledgeable about the proper uses of UP , look UP the word UP in the dictionary. In a desk-sized dictionary, it takes UP almost 1/4 of the page and can add UP to about thirty definitions.
If you are UP to it, you might try building UP a list of the many ways UP is used. It will take UP a lot of your time, but if you don't give UP , you may wind UP with ( UP to) a hundred or more.
When it threatens to rain, we say it is clouding UP . When the sun comes out, we say it is clearing UP . When it rains, it soaks UP the earth. When it does not rain for awhile, things dry UP . One could go on and on, but I'll wrap it UP , for now . . . My time is UP !
Oh . . . One more thing: What is the first thing you do in the morning and the last thing you do at night?
UP !
Did that one crack you UP ?
Don't screw UP .. Send this on to everyone you look UP in your address book . . . Or not . . . it's UP to you.
Now I'll shut UP
How to Know if You're Too Old
'OLD' IS WHEN...
Your sweetie says, 'Let's go upstairs And make love,' and you answer, 'Pick one; I can't do both!'
'OLD' IS WHEN...
Your friends compliment you on your new alligator shoes and you're barefoot.
'OLD' IS WHEN...
Going bra-less pulls all the wrinkles out of your face.
'OLD' IS WHEN...
You don't care where your spouse goes, just as long as you don't have to go along.
'OLD' IS WHEN...
You are cautioned to slow down by the doctor instead of by the police .
'OLD' IS WHEN...
'Getting a little action' means you don't need to take any fiber today.
'OLD' IS WHEN...
'Getting lucky' means you find your car in the parking lot.
'OLD' IS WHEN...
An 'all nighter' means not getting up to use the bathroom.
AND
'OLD' IS WHEN...
You are not sure if these are facts or jokes?
Making Love for Old People
Love Making Tips For Seniors
1. Wear your glasses, to make sure your partner is actually in the bed.
2. Set timer for 3 minutes, in case you doze off in the middle.
3. Set the mood with lighting.
(Turn them ALL OFF!)
4. Make sure you put 911 on your speed dial before you begin.
5. Write partner's name on your hand in case you can't remember.
6. Use extra polygrip so your teeth don't end up under the bed.
7. Have Tylenol ready in case you actually complete the act...
8. Make all the noise you want... the neighbors are deaf too.
9. If it works, call everyone you know with the good news!!
10. Don't even think about trying it twice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Management of Refractory Gout
New Biological Agents for the Management of Refractory Gout
Learning Objectives
After participating in this educational activity, participants should be better able to:
Monitor serum uric acid in order to set and achieve the target levels using all modes of therapies
Anticipate and manage adverse events associated with aggressive urate-lowering therapy (ULT)
Overview of Refractory Gout
With the overall prevalence of gout on the rise and the severity of this disease increasing in many patients, there has been a corresponding rise in the number of patients who are refractory to traditional treatment strategies for gout. Refractory gout refers to patients with persistent gout symptoms such as visible tophi and acute flares of gouty arthritis, and in whom serum uric acid (SUA) concentrations remain stubbornly above 6.8 mg/dL. It is a painful and debilitating condition, and one that affects approximately 30,000 patients in the United States.
There are multiple factors that may lead a patient to become refractory to treatment, including allopurinol intolerance, insufficient escalation of allopurinol, inadequate prophylaxis, multiple comorbidities, lack of follow-up, and poor patient adherence to therapy.[1] The two main pathways to refractory condition are 1) intolerance of conventional therapies, and 2) poor control with conventional therapies. Sensitivity to allopurinol, the first-line drug conventional therapy, is most often associated with side effects ranging from pruritic rash, cutaneous reaction, and/or gastrointestinal symptoms.[2-4] Intolerance to allopurinol can be overcome by switching to febuxostat, another xanthine oxidase inhibitor, or by switching to the off-label combination of allopurinol or febuxostat with probenecid.[5] In cases of poor control with conventional therapies, the pathway to a refractory state is often related to inadequate allopurinol escalation and poor patient adherence to therapy.[1]
Unfortunately, many patients fail to respond to traditional therapies for gout. In the past, there was little alternative for clinicians who care for refractory patients. This changed in September 2010 when the U.S. Food and Drug Administration (FDA) approved pegloticase (8 mg/dL IV q2 weeks) for the treatment of refractory gout.[6] We explore its safety and efficacy in the next section using two patient cases illustrating evidence-based and guideline-based treatment.
Strategies for Treating Gout
Table 1
Treating Gout With Urate-Lowering Therapy
Traditional first-line therapies for gout patients include the urate-lowering strategies outlined in Table 1. It is important for primary care clinicians to note that, as stated in the previous section, the pathway to a refractory state is often attributable to inadequate escalation of allopurinol.[1] Among gout patients, 97% of prescriptions are for 300 mg or less of allopurinol, despite a maximum recommended daily dose of 800 mg.
Effective gout management in the primary care setting includes the titration of allopurinol since 300 mg a day is effective in less than half of patients.[1] Initial doses may be 100 or 150 mg per day, and SUA level should be assessed at two weeks post initiation of ULT. If the value is greater than 6.0 mg/dL, increase the dose by 100 or 150 mg. The uric acid level should be checked again after two weeks. This process should be repeated until the lowest dose that reduces the uric acid level to less than 6.0 mg/dL is determined.
It is important to note that while the recommended SUA target is 6.0 mg/dL for gout patients, it may be necessary and beneficial to target an even lower concentration in some patients, particularly those who are refractory to treatment. Maintaining the SUA at any level less than 6.8 mg/dL will eventually eliminate all the deposited uric acid from the body. However, the lower the SUA, the faster the uric acid will be cleared. Because refractory gout is disabling, it is recommended that the SUA be brought below 4.0 mg/dL to more rapidly clear the crystals.
Treating Acute Gout Flares
Treatment of acute flares is another critical component of gout management, particularly in patients who are refractory to treatment. The choice of agents to use is among NSAIDs, colchicine, and corticosteroids.[8-10] The agent selected should be based on the patient’s comorbidities. For example, a patient with chronic kidney disease, hypertension, diabetes, or congestive heart failure should not take an NSAID. Colchicine is not advised in patients with poor renal function.[11] Regardless of the agent selected, it is essential that patients realize that they must take the medication at the very first hint of a gout flare. If they take the medication soon enough they may be able to abort the attack. If they wait too long, they may have to take medication for days. In addition, since each agent works by a different mechanism, they can be used in combination for severe flares.
Prophylaxis
Achieving optimal outcomes for patients with refractory gout requires that keen attention be paid to prophylaxis, particularly when initiating new therapies. Although it may seem paradoxical, gout flares often occur when initiating ULT. In fact, the lower and faster the serum uric acid drops, the more likely there is to be a flare.[12,13] Using low-dose colchicine or NSAID, beginning two weeks prior to starting the ULT, can significantly decrease this flare rate.[12,13] Once started, prophylaxis should be continued for approximately six months, although this interval may have to be extended in those with chronic tophaceous gout.
Evidence for Biologics for Refractory Gout
Patients with refractory gout often face a life of disability and considerable pain. Effective strategies are needed to control urate crystal deposition in the joints and to minimize tissue damage and loss of function. Biologics can achieve this goal.
Figure 1. Action of Uricase on Uric Acid
Uricase, which catalyzes the conversion of uric acid to allantoin, is the enzyme present in other animals, which prevents them from accumulating uric acid and developing gout. Uricase holds promise as a strategy for managing SUA levels in patients with refractory gout. Previously, a fungal uricase preparation, rasburicase, was approved for the use in patients with tumor lysis syndrome. This agent dramatically lowers SUA but proved to be too antigenic to be used on a repeat basis, as would be needed to treat hyperuricemia in patients with gout.[14]
Pegloticase, a monomethoxypoly (ethylene glycol)-conjugated mammalian recombinant uricase, was FDA-approved in 2010 for the treatment of refractory gout. This agent also dramatically lowers SUA and has been used successfully over longer periods of time.[15,16] Although infusion reactions and anaphylaxis were encountered in clinical trials, it was learned that these occur only after the patients had developed blocking antibodies.[15] Therefore, pegloticase can be used safely as long as it is causing a reduction in SUA levels. If, however, the SUA is not less than 6.0 mg/dL two weeks after the last infusion, then antibodies have formed and the biologic should be discontinued.
Pegloticase in Clinical Trials
The first of the clinical trials was a three-month, open-label randomized controlled study on patients with refractory gout that compared efficacy and tolerability of pegloticase with placebo in lowering uric acid and clinical outcomes. The second study looked at the efficacy of pegloticase for refractory gout patients in a six-month treatment regimen in two replicate, randomized, double-blind, and placebo-controlled trial from June 2006 to October 2007 (n=225). John S. Sundy, MD, PhD, with the Duke Clinical Research Unit, Duke University Medical Center, Durham, North Carolina, and colleagues reported their findings in an August 2011 issue of the Journal of the American Medical Association (JAMA). Patients in the trial have serum uric acid levels of at least 8.0 mg/dL.
These studies show that pegloticase is associated with[14*,15, 17]:
1.Immediate and sustained reductions in SUA levels
2.Tophus resolution in six months
3.Fewer flares
4.Improved pain
5.Improved quality of life
*Urate oxidase had rapid and significantly greater decreases in their blood uric acid levels than historical controls (median maximum level during treatment, 2.3 vs 3.9 mg/dL, P <0 .001=".001" p="p">
Figure 2. Tophi at Baseline, Week 13, Week 19, and Week 25
Case #1: Samuel
Samuel is a 77-year-old male who was diagnosed with gout at age 45. He is now having recurrent flares of gout that last three to four weeks at a time. He has large tophi on his first metatarsophalangeal (MTP) joints, over his Achilles tendons, over his patellae, and on his fingers and forearms. An attempt to surgically remove one of his tophi three years ago resulted in a severe gout flare and was complicated by infection. That tophus has subsequently recurred. Frequent gout flares and the tophi in his hands are significantly disabling. He had a severe cutaneous reaction to allopurinol in the past and refuses to take febuxostat because each time he takes it he gets a severe gout flare. His SUA is 10.4 mg/dL and his serum creatinine is 1.9 mg/dL.
Treating Samuel
Samuel would benefit from education regarding the potential for gout flares while on ULT. Considering his creatinine clearance of 31 ml/min, he should be prescribed colchicine 0.6 mg a day for two weeks before starting ULT and the colchicine should be continued after starting ULT. He should be instructed to take prednisone 20 mg at the first hint that he is developing a gout flare, because if he takes it soon enough after symptoms begin, one dose may be sufficient to abort the attack. If the flare continues, he should take prednisone 20 mg orally twice a day until his symptoms have been completely resolved for at least a week. The choice of ULT for him is between febuxostat and pegloticase. Because of his disabling tophaceous disease, pegloticase would be the first choice since it could eliminate the visible tophi in perhaps three to six months.
Case #2: Marjory
Marjory is a 76-year-old woman who was diagnosed with gout six years ago. She has developed tophi on her fingers and toes. On two occasions the skin over the tophus on her right index finger has broken down allowing extrusion of the contents. Because of the tophi on her feet, she cannot wear shoes. She has had six gout flares in the past year. Her SUA is 8.2 mg/dL on allopurinol 300 mg a day. Her serum creatinine is 1.4 mg/dL.
Treating Marjory
The most important consideration in the management of this patient may be the potential for allopurinol dose escalation, because inadequate escalation of allopurinol is the primary cause of treatment failure for patients with gout. The limitation on allopurinol daily dosing is 800 mg. The most conservative recommended course of therapy in the primary care setting is to increase the dose of allopurinol by increments of 100 mg approximately every two weeks until the dose that lowers the serum uric acid to a level below 6.0 mg/dL has been determined. However, because this patient has disabling tophaceous disease, it would be beneficial to attain an even lower SUA level, since this is the faster pathway to tophi resolution. Thus, pegloticase should strongly be considered for this patient.
Another important consideration for this patient is the use of allopurinol in patients with renal dysfunction. Allopurinol is metabolized in the liver to oxypurinol and has a half-life of four hours. Oxypurinol also is an inhibitor of xanthine oxidase and is eliminated from the body through the kidneys. Thus, as renal function deteriorates, oxypurinol is retained in the body. Therefore, patients with lower creatinine clearance may achieve target serum uric acid levels with lower doses of allopurinol than the doses required when kidney function is normal.
Guidelines for dosing allopurinol in patients with poor kidney function have been published.[18] However, if these are adhered to, a SUA of less than 6.0 mg/dL is attained only 19% of the time.[19] It is also important to note that allopurinol has been safely escalated to reach that target in patients with kidney dysfunction.[20]
Practice Points
Monitor patients closely for signs of refractory gout
When using pegloticase
Rule out glucose-60-phospate dehydrogenase (G6PD) deficiency before initiating pegloticase
Monitor for infusion reactions and side effects
Check SUA levels before each infusion–if not low (eg, less than 6.0 mg/dL), discontinue therapy
When using biologics, stop if little or no result after two infusions
Do not use pegloticase in combination with a xanthine oxidase inhibitor
If an allergic reaction occurred, one would not know which medication caused it
More importantly a xanthine oxidase inhibitor may lower the UA below 6.0 mg/dL, which may encourage the use of a biologic when it is not indicated
Summary/Conclusion
Use biologics to reduce SUA and resolve of tophi in patients with refractory gout
When treating refractory gout patients with biologics, monitor closely and address adverse reactions quickly
Provide prophylaxis against flares when starting biologics for refractory gout0>
The Mayonnaise Jar and the 2 Beers
When things in your life seem almost too much to handle, when 24 hours in a day are not enough, remember the mayonnaise jar and the 2 Beers.
A professor stood before his philosophy class and had some items in front of him. When the class began, he wordlessly picked up a very large and empty mayonnaise jar and proceeded to fill it with golf balls. He then asked the students if the jar was full. They agreed that it was.
The professor then picked up a box of pebbles and poured them into the jar. He shook the jar lightly. The pebbles rolled into the open areas between the golf balls. He then asked the students again if the jar was full. They agreed it was.
The professor next picked up a box of sand and poured it into the jar. Of course, the sand filled up everything else. He asked once more if the jar was full.. The students responded with a unanimous 'yes.'
The professor then produced two Beers from under the table and poured the entire contents into the jar effectively filling the empty space between the sand.The students laughed..
'Now,' said the professor as the laughter subsided, 'I want you to recognize that this jar represents your life. The golf balls are the important things---your family, your children, your health, your friends and your favorite passions---and if everything else was lost and only they remained, your life would still be full. The pebbles are the other things that matter like your job, your house and your car.. The sand is everything else---the small stuff.
'If you put the sand into the jar first,' he continued, 'there is no room for the pebbles or the golf balls. The same goes for life.
If you spend all your time and energy on the small stuff you will never have room for the things that are important to you.
Pay attention to the things that are critical to your happiness.
Spend time with your children. Spend time with your parents. Visit with grandparents. Take your spouse out to dinner. Play another 18. There will always be time to clean the house and mow the lawn.
Take care of the golf balls first---the things that really matter. Set your priorities. The rest is just sand.
One of the students raised her hand and inquired what the Beer represented.
The professor smiled and said, “I'm glad you asked. The Beer just shows you that no matter how full your life may seem, there's always room for a couple of Beers with a friend.”
China telecom giants threaten US: Congress panel
Chinese telecom giants Huawei and ZTE pose a security threat to the United States and should be barred from US contracts and acquisitions, a yearlong congressional investigation has concluded.
A draft of a report by the House Intelligence Committee, obtained Sunday by AFP, said the two firms "cannot be trusted" to be free of influence from Beijing and could be used to undermine US security.
"Based on available classified and unclassified information, Huawei and ZTE cannot be trusted to be free of foreign state influence and thus pose a security threat to the United States and to our systems," the draft document said.
The congressional panel launched its probe over concerns that Beijing could use the fast-growing firms for economic or military espionage, or cyber attacks.
Both Huawei and ZTE have denied any ties with the Chinese government. Top executives of the firms appeared at a hearing held by the panel last month, stressing that they were focused on business, not politics.
Huawei reiterated that position in response to queries.
"The integrity and independence of Huawei's organization and business practices are trusted and respected across almost 150 markets," Huawei vice president William Plummer said in an emailed statement.
photo1
"Purporting that Huawei is somehow uniquely vulnerable to cyber mischief ignores technical and commercial realities, recklessly threatens American jobs and innovation, does nothing to protect national security, and should be exposed as dangerous political distractions."
ZTE did not immediately respond to requests for comment.
The committee said both companies failed to provide adequate answers to lawmakers' questions about their relationship with the Chinese government.
"China has the means, opportunity and motive to use telecommunications companies for malicious purposes," said the report, due to be published Monday on the committee's website.
Based on its investigation, the panel said US authorities "must block acquisitions, takeovers or mergers involving Huawei and ZTE given the threat to US national security interests."
The panel said the US should even consider extending the authority of a super-secret panel that reviews foreign acquisitions to include purchasing agreements.
US government systems, particularly sensitive ones, should not include Huawei or ZTE equipment -- not even component parts -- nor should those of government contractors working on sensitive US programs, it said.
The report also said US private-sector entities "are strongly encouraged to consider the long-term security risks associated with doing business with either ZTE or Huawei for equipment or services."
Because of the lack of clear information on how the companies operate, the committee report said they could be used for "malicious Chinese hardware or software implants" that could serve as "a potent espionage tool for penetrating sensitive US national security systems, as well as providing access to the closed American corporate networks."
The 59-page draft report cited a host of other potential issues with the two firms, including unfair subsidies, allegations of bribery or corruption, dealings with Iran and ties with China's military and Communist Party.
In addition to the concerns cited by the lawmakers, the report said an unpublished, classified annex includes even more.
"The classified annex provides significantly more information adding to the committee's concerns," it said. "That information cannot be shared publicly without risking US national security.
Successor to Concorde
A peek into the future.
Twice as fast as Concorde: The supersonic jet that will fly from London to New York in TWO HOURS!
SonicStar plane will have a top speed of Mach 3.6. Plans for 20-seat craft were unveiled at Paris Air Show.
A jet that can fly from London to Sydney in three and a half hours could rob Concorde of its title as the fastest-ever passenger plane.
Plans have been unveiled for the Hypermach SonicStar, a business jet which will be capable of a top speed of 2,664 mph twice as fast as Concorde.
It will fly at 62,000ft, allowing passengers to see the curvature of the earth.
Hypermach chief executive Richard Lugg wants the plane in the skies within ten years (!) and has already secured funding from the Department of Trade and Industry, which has agreed to support the company in Britain.
Return of supersonic travel: The SonicStar aircraft will be twice as fast as Concorde - so quick that travelling from London to New York will take just two hours. It was unveiled at the Paris Air Show.
Long-range cruise speed - Mach 3.1
High-speed cruise speed - Mach 3.4
Engines - Two SonicBlue S-MAGJET Hybrid Supersonic 4000-X Series
Thrust - Flat-rated to 54,700lb
Wing area - 1,800 square feet
Landing distance - 4,800ft
Range - 6,000 nautical miles
Highest Altitude - 62,000ft
CABIN
Length - 64metres
Height at maximum - 2.6metres
Width at maximum - 2.7metres
Visiting the Paris Air Show, Mr Lugg said: “We have access to revolutionary engine technology and a unique very high speed aircraft design to make this kind of earth-shatteringly fast air travel possible, and we have a date. Our plan is to build and fly the world’s first very high speed supersonic hybrid aircraft by June 2021.
Propulsion for the 20-seat aircraft will come from two hybrid engines which will be 30 per cent more fuel efficient than the Rolls-Royce engines used in Concorde.
It has been eight years since Concorde was retired from service and with it the supersonic dreams of millions around the world.
HyperMach claims its SonicStar aircraft will be so quick that travelling from London to New York will take just two hours.
A trip from New York to Sydney, meanwhile, will be cut by a staggering 75 per cent - from 20 hours on a commercial airliner to just five hours.
It will be able to cruise at Mach 3.1, a speed made possible by S-MAGJET hybrid gas turbine engine technology; nobody has ever travelled that fast before.
Its top speed, however, will be Mach 3.6.
With relatively low fuel consumption, the Sonic Star 'overcomes the economic and environmental challenges of supersonic flight to revolutionise the way we travel and drive air transportation forward into the future,' claims HyperMach.
By using electromagnetic currents across the fuselage to suppress the sonic boom, the plane is able to overcome the noise regulations that constrict supersonic travel.
It has a range of 6,000 nautical miles and its 54,700 thrust class S-MAGJET engine - actually two engines - is optimised to fly the aircraft at 62,000ft.
But it is the reduction in jet engine emissions that HyperMach believes will prove the secret of SonicStar's success.
Tomorrow's world: HyperMach plans to build its SonicStar engine by the end of the decade and to have the plane itself constructed by 2025
SonicStar will be able to cruise at Mach 3.1, a speed made possible by S-MAGJET hybridgas turbine engine technology.
A spokesman said: 'The engine is a true hybrid. It generates massive electrical power on board using proprietary integrated turbine electromagnetic generation technology to segment each engine rotating component stage electrically.
'Every stage from bypass fans to compressor to turbine rotates independently of the other.'
This segmentation will enable the engine to change the operating speeds of its rotating components continually throughout the flight to respond to thechanging conditions of the atmosphere and the flight and performance demands of the aircraft. the HyperMach claims that this, along with the S-MAGJET plasma fuel combustion technology, will result in a 40 to 50 per cent increase in the ability of engine to convert fuel to thrust.
The company said such fuel efficiency would ultimately lead to a 30 to 35 per cent reduction in fuel used as supersonic speeds.
How to Remove Scratches From Plastic Lens Glasses
Remove Scratches From Plastic Lens Glasses
If you have plastic lenses, you may be able to buff out small scratches yourself using common household products. If any of these remedies leaves your glasses clean and scratch-free, you can avoid professional repairs.
1. Use wood cleaner to buff plastic lenses. Spray the cleaner on and wipe it off. Then spray a liquid petroleum jelly on the scratched plastic and wipe that off, as well. The petroleum will fill the scratches, making them more noticeable. Repeat the process until you can't see any scratches after you've wiped the petroleum jelly away.
2. Buff the scratched plastic glasses with brass or silver polish and a soft rag. Rub the polish around on the glasses and wipe any excess off with a clean, soft rag. Repeat until the scratch is gone.
3. Use the cleaning spray that comes with CD/DVD repair kits. The solution is designed to work on scratched CDs or DVDs, but it will work on scratched plastic eyeglasses, as well. Wipe the solution off with a soft rag.
4. Dab a non-abrasive toothpaste on the lens. Rub it on the scratch in a circular motion with a cotton ball and rinse it with cool water. If the scratch is deep, you may need to repeat the process a few times.
5. Make a paste from baking soda and water. Put baking soda in a bowl and mix in small amounts of water until you have a thick paste. Rub the paste on the same way you did the toothpaste, and rinse it off when you think the scratch is gone.
6. Wax your plastic lenses with vehicle wax. Rub the wax around on the plastic lenses in a circular motion for several minutes, or until you see the scratches disappear. Wipe any excess wax off with a soft cloth or cotton ball.
7. Spray the scratched lenses with windshield wash designed to repel water. The wash will buff out very small scratches or blemishes. It also repels water and prevents glasses from fogging up.
8. Try a glass etching abrasive designed for glass art projects. Only do this if you know your glasses do not have an anti-reflective coating. You can buy the abrasive at a hobby or craft store. Use rubber gloves when applying the cleaner to your plastic lenses and wipe off with a soft cloth.
If your glasses are non-reflective, you will ruin them with etching abrasive. At the very least, the glasses will be frosted when you are done with the process. You may need to take these glasses in to a professional to have the scratches fixed if no other home remedies have worked.
World education rankings
World education rankings: which country does best at reading, maths and science?
The OECD's comprehensive world education ranking report, PISA, is out. Find out how each country compares
World education rankings show how countries do atreading, maths and science. A pupil in a science lesson. Photograph: David Sillitoe/Guardian
The world education rankings from the OECD are out. The UK is slipping down in maths, reading and science, and has been overtaken by Poland and Norway, this major study of 65 countries reveals today.
Around 470,000 15-year-olds across the world sat a numeracy, literacy and science test last year, the results of which inform the latest Pisa study by the Paris-based Organisation for Economic Co-operation and Development (OECD).
PISA rankings within OECD PISA rankings within OECD. Illustration: Paul Scruton for the Guardian
The Programme for International Student Assessment (Pisa) is highly respected across the globe, and enables politicians and policy-makers to assess how different country's education systems compare.
It shows the UK's reputation as one of the world's best for education is at risk, and has tumbled several places since 2006.
The UK is ranked 25th for reading, 28th for maths and 16th for science. In 2006, when 57 countries were included in the study, it was placed 17th, 24th and 14th respectively. Poland has stretched ahead of the UK in maths, while Norway is now ranked higher in reading and maths.
Andreas Shleicher, head of the Pisa programme, said the picture for the UK was "stagnant at best". "Many other countries have seen quite significant improvement," he added.
29-year-old Muslim woman named culture minister of Norway
The first ever Muslim minister in the Norwegian Cabinet is Hadia Tajik of Pakistani origin, who was handed the culture portfolio
Minister of Culture of Norway, Hadia Tajik
On Sunday, with no precedent in Norwegian history, Prime Minister Jens Stoltenberg appointed Hadia Tajik, a 29-year-old Muslim woman, as minister of culture, making Tajik the youngest minister in the Norwegian Cabinet and the first ever Muslim in the Norwegian government.
Tajik, of Pakistani origin, anounced that her programme will focus on cultural diversity as part of the Norwegian people's daily lives and how this reflects on Norweigan society as a whole. The programme will delve into the protection of minority rights, whether cultural or racial, including the right of Muslims to wear the veil in public places, among other issues.
The new focus, however, will not be unopposed. Most right wing groups are against these policy changes, considering the increase in diversity in society a challenge to European culture.
Last year Anders Breivik randomly shot 69 people at a summer camp organised by the Workers' Youth League (AUF) of the Labour Party after blowing up a Norweigan state building. During his trial, Breivik reasoned that multi-cultural policies are harming Norway, adding that he considers Islam his enemy.
Born in Strand, Norway, on 18 July 1983, Tajik studied human rights at the University of Kingston in the UK and holds a Bachelor's degree in journalism and Master's in law, the latter awarded by the University of Oslo this year.
An activist from a young age, Tajik led the Young Workers Movement between 1999 and 2002. She also worked as a political advisor to Norway's minister of justice, 2008-2009. During this time Norweigan women members of the police were afforded the right to wear the veil at work. The decision was, however, rescinded due to harsh criticism from conservative parties.
In 2009, Tajik was elected to parliament as a member of the Labour Party in the Oslo constitutency. She was placed on a list of six seats generally considered safe for the party.
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