Showing posts with label Medical Information. Show all posts
Showing posts with label Medical Information. Show all posts

Sunday, 29 July 2012

Observations about Modern History of Lebanon


With the so called wave of Arab Spring having since about March 2011 reached the Syrian coastline and crossed to the mainland the fallout of either the ripple effect or the peaks and troughs of this wave will impact on Lebanon and other neighbouring countries especially Jordan and Israel.  Given the close historical, geographical and economic ties between Syria and Lebanon dating back to the Ottoman Empire from about 1516 until the defeat of the Empire toward the end of World War I in 1918 it is easy to appreciate the fact that however and in whatever way the cookie crumbles in Syria Lebanon may have to pick up a piece or two and watch its own cookies.  If the Lebanese cookies crumble or even crack there will be direct and indirect ramifications that will send chills to the State of Israel and makes lots of its people nervous.

Arguably what had taken place and continues to take place in all the countries in the Middle East, including the so called Arab Spring is both direct and indirect result of Versaille Treaty signed by the victorious powers mainly England and France in 1918.  Under the Treaty England and France split the Middle East between them in accordance with what each country could obtain to pay for some of its own war debts. That is obtain by hook or crook the treasures, and whatever of value, present and/or contingent.  This is so regardless of whatever preamble or justification the wording of the Versaille Treaty provided for the loot.  You can bet the 'welfare and future and best interest of the people in the Middle East' are included in the Treaty.

The current map of the Middle East is but arbitrary line drawn to suit England and France.  Shortly after that arbitrary line is drawn the Foreign Ministers of  England and France, Sykes and Picot met and signed agreement promising the Jewish diaspora/Zionists homeland in Palestine right in the heart of the Arab World.

The arbitrary line resulted in the creation of new smaller countries better described as Sheikdoms that are effectively run exclusively by tribal families.  The territory making such countries were part and parcel of bigger territory.  Tribal Families that were subsequently elevated to the status of Emirs bestowing on those countries various names including the exclusive title of  'Royalties' that was once exclusive to the English now better described as Monarchs.  Some of those countries became effectively under the 'protective umbrella, of England. The countries forming of the Gulf States and Kuwait are creations of the English arbitrary line.  The history of conflicts in those countries after they became independent speaks for itself - Perhaps topic for another blog.

Syria/Lebanon

 The presence of Christians in Syria and Lebanon pre dates Islam by  several hundred years.  The Christian community in Syria and Lebanon was forgotten by Christian Europe and Rome and only came to the fore when the Crusaders of the First Crusade passed through Lebanon on their way to Jerusalem in 1097.  The main reason for the Crusade was the destruction of the Church of Holy Sepluchre on the order of the Sixth Fatimad (hakim fi amr Allah).  The Lebanese/Syrian Christian suffered under the various Islamic dynasties - Ummiads/ Abbasaid/ Mamlukes and Ottomen - The Ottomen of course were non Arabs and the conversion or adoption of the Turkomen Sultan of the Islamic faith made him take on the Caliphs role as official protector of the faith.

In the nineteenth century the Christian communities in Syria and Lebanon witnessed number of massacres that caused the European powers who were squabbling over colonies in Africa at the time to send or threaten to send troops to help the Christian communities.  This was especially so after the massacres of 1842, 1844 and 1860 when France and Russia sent troops to Lebanon.  The British simply spoke with the Sultan in Istanbul and played political role without sending troops.  This could be also due to the fact the countries under the English protection were exclusively Moslem.

As mentioned above after World War 1 France took over control of Syria/Lebanon.  At the time there was a call for one Arab country and ruler covering the entire Middle East.  This call started in Saudi Arabia and saw advocates of this call come in drove from Saudi Arabia to Syria in preparation after the last Turkomen left. This call for one Arab nation had lots of popular support amongst the  people including the intellectuals of both the Moslem and Christian communities in Syria and Lebanon.  Britain and France would not have a bar of it.  Likewise the overwhelming majority of the Maronite community in Lebanon and Syria.  At the time, in theory at least the geography of Lebanon was limited to Mount Lebanon.  Lebanon as it now exists as independent country incorporated additional territory added by the French to make it into Greater Lebanon.  This additional territory included Tripoli which as at 1918 regarded itself as part of Syria.  Likewise the Bekka and Hirmal region.  Lebanon gained its independence in 1943 and some three months later Syria gained its independence.

Curse of Lebanon's Presidential Post


In the near future my next blog entry will be dedicated to families/people who played a role in the independence of Lebanon and whose offspring are still playing dynastic role in Lebanese politics.  For variety of reasons those families had been and continue to be jinxed.  Let us take a look.  Camille Shamoun who had been successful lawyer with Bishara El Khoury (first President of Lebanon before independence) was elected President of Lebanon in 1952.  His opponent for the position was Hamid Franjieh.  Shamoun became President at a time when Pan Arabisim euphoria was sweeping the Middle East and when the Cold War was at its peak England having handed over control to America after the Second World War.   Shamoun presidency saw the very same colonial powers - England and France - send troops to stop nationalisation of the Suez Canal by President Nasser of Egypt.  In 1958 US Marines landed in Beirut to protect Shamoun and Lebanon being engulfed by the wave of Pan Arabisim. Whatever chance Shamoun' dynasty had surviving to make it again to the presidency that chance was cut short.  His eldest son Danny was assassinated in 1992.


Pierre Jummeil is the founding father of the Phalange (Katieb) Party that had played significant role representing the Christian Community interest in Lebanon from the late 1930's onwards opposing the Nahda Party which was the non Christian Party wanting unity with Syria.  Although Pierre got off on the wrong side of the French after the outbreak of World War II his dynasty played its part and continues to do so in modern day Lebanon.  However the curse of the Lebanese Presidency did not spare the Jummeil Family.  In fact the curse is most prominent in that family.  Pierre younger son, Bashir took over as leader of the Phalange Party and was at its helms at the official  start of the Lebanese civil war on 25 April 1975.  Bashir was elected President of Lebanon in 1982 when Israel was occupying the country.  Before he could be formally sworn or make any formal or official  decision as President of Lebanon he was assassinated.  His eldest brother Amin became President and served full six years term.  Amin is a lawyer and a businessman he is still involved in Lebanese politics and is very much alive.  However his eldest son Pierre who was elected member of Parliament was assassinated in 2006.  It would be brave Jummeil to think of making effort to occupy the Presidential Chair any time soon.




 The word Marada is the name of the tribal fighters in Syria who came to the assistance of the Maronite Community fleeing persecution of other Christians and later Moslems as they made their way to the relative safety of the Lebanese Mountains.  The Orontes River (Nahr El Assi) and the valleys that depended on the flow of that river provided sanctuary and were historically the bread basket of the various civilizations that crossed that part of the Middle East  including the  Romans and in latter days the various Christian communities now incumbents in Lebanon and Syria.  The exclusive heartland of the Marada Party is the village of Zhogarta in North Lebanon located in the mountains above Lebanon' second largest city Tripoli.

The Franjieh Family (claims its descendency to date back to the Crusades some of whom decided to make Lebanon/Syrian and Palestine their homeland) became involved in Lebanese politics and is one of the Christian families that did not escape the Presidential curse.  Hamid Franjieh' brother  Sulieman, is highly respected intellect opposed Shamoun for the presidency in 1952 and had leaning towards Syria.  Hamid was highly respected politician the calibre of Bishara Khoury, Emil Eddie, Riad El Solh, Shamoun and Ors.  Sulieman was elected President of Lebanon in the early 1970's his tenure as President saw the outbreak of the civil war in 1975.  His heir apparent son, Tony, was assassinated in 1978.  Tony's son, Suleiman is still in the Lebanese Parliament and hold position as Minister.  Suleiman is a potential future Presidential candidate and his name was touted as a candidate during the last two presidential elections.  Should Sulieman make it as President he is certainly not immune from the Presidential curse. In recent times some of the Lebanese Presidents, including the current incumbent, Michel Suleiman, hailed from the ranks of the army.  Thus far they had been immuned from the Presidential curse.  May be the curse is presently cautious of arsenals or more likely taken holiday.  Let us hope holiday for good.  

 The curse that jinxed the Christian families that made it to the presidency did not exactly spare the non Christian families including Prime Ministers and leaders of other sects that played and continue to play prominent role in Lebanese politics.  This will be the subject matter of future blogs about Lebanon.




Saturday, 13 August 2011

ECG explained for no apparent reason

I just thought I'd brag about how smart I am ...
Hello Dear Readers,

Since I started my first blog by writing about the world most famous cardiologist, the Late Michael Dabaghy (by sheer coincidence I might add) I thought it would be appropriate if I were to continue my second blog by writing about the heart and attempt to explain the tracing of ECG (ElectroCardioGram) which is heavily relied upon by General Practitioners and cardiologists to diagnose arrythmia (abnormal rhythm), flutter (fast heart rate), fibrilation (beats from abnormal sources than SA Node), infarcts (heart muscle cells that had been damaged or died) both past and present.
The main leads of the ECG machine are placed on the body in the form of a triangle in which the heart is in the middle. The other leads that labelled V1 to V6 ar placed in different positions on the spaced of the ribs. The ideas being to observe the hear from different angles. Lead V4 provided important information useful to tell whether there had been damage to the muscle of the ventricles from previous infarcts (heart attacks). Some of the tracing from the V leads are inverted images of the main leads in which the heart is in the middle of the triangle.
In brief the heart is a pump that is split into two halfs. Each half has upped chamber and lower chamber. The upper is known as the auricle and the lower is known as the ventricle. The opening between the auricle and ventricle is controlled by one way valve. On the right hand side the valve is known as the mitral valve (from the Bishop collar) and on the left is the pulmonary valve which allow the passage of blood to the lungs. On the question of valves it is interesting to note that the mitral valve is damaged in childhood diseases such as rheumatic fever. Australia's former Prime Minister, Kevin Rudd, who suffered rheumatic fever as a child had last week undergone surgery to replace the mitral valve and is now recovering in Queensland hospital. The right side of the heart receive cifrculating blood that had shed its oxygen content (not the full content). This blood is pumped to be oxygenated by the air we breath and is then pumped by the left side of the heart to nourish the body and return back after releasing its oxygen for bodily metabolism. The pumping by the left ventricle requres much greater energy than the pumping of the right ventricle. As a result the mucscle mass of the left ventricle is significantly greater than that of the right ventricle. Depending on their severity heart attacks (myocardial infarcts) normally leave damaged areas in the left venticle. This often show on lead V4 and the 'T' wave of the tracing in which the heart is at the centre of the triangle.
The above diagram shows normal ECG tracing taken from the three leads in which the heart is at the centre of the triangle. The letters are P, QRS, and T. Every cell of the heart could potentially fire a signal which could be picked up by ECG. However, in a normal heart the firing begins with the Sino Atrial Node (SA Node) located in the right atrium. This is a collections of cell with a firing threshold lower than the rest of the myocardial cells. When the SA node fires it gives the 'P" wave of the ECG. As this wave travels in the atrium it triggers the firing of cells that allows the left ventricle to fire giving the QRS wave of the ECG. As the heart comes back to rest the 'T' wave records the resting electrical activities of the myocardial cells. The 'T" wave is important in picking upand diagnosing prior heart attacks. Elevated blood potassioum level could also give you abnormal 'T' wave.

I realised that I may have written too much for a blog I will attempt to briefly summarise the essentials of what i have written:
If you listen to the heart you will hear the sound "Lubb" "Dubb", "Lubb" "Dubb" etc... The "Lubb" is the sound of the right side of the heart filling with blood coming from the body. The "Dubb" is the sound of the firing of the left ventricle pushing the oxygenated blood to the body. The 'P' wave is the firing of the SA Node. The distance between the 'P' wave and rthe 'QRS' wave is measured in milliseconds. If there is anorther wave that means some cell is firing on the pathway of the wave. A road block or a pump on the road. It could suggest damage or ectopic beat (arrythmia). The width and the height of the 'QRS' wave is important reflection of the state of the muscle cells of the left ventricle. The height of the 'T' wave is an indicator of prior damage to the heart muscle. The reading is normally confirmed by the V leads to which I referred earlier.
      
So dear Readers if you find what I have written about is interesting and you wish me to continue writing about the drugs that is norally prescribed to treat heart ailments you may care telling me.   I will be happy to write about drugs that doctors normally prescribe to treat either chronotropic conditions (rates and rythems) and ionotropic conditions (weakened heart muscles).

If you are mad I wasted your time with this information, please feel free to kick me in the nuts...

Cheers for now