Zulfiqar Rana, MD, MPH, FACP

Board Certified in Internal Medicine

Is Sitting a Lethal Activity?

A growing body of research suggests that watching your diet and exercising a few times a week is not enough to offset sedentary time.


Leading Health Indicators for Healthy People 2020: Letter Report

Cover imageStarting in 1990, the Department of Health and Human Services (HHS) has issued a national agenda aimed at improving the health of all Americans over the 10-year span. At the request of HHS, the IOM identified a set of leading health indicators that could be used by Healthy People 2020 and developed a conceptual framework within which the topics, indicators, and objectives would be developed or selected…


Hunger and Obesity

Cover imageResearchers have long observed food insecurity- difficulty providing food for all one’s family members, known as hunger in its most severe form -and obesity occurring together in the same communities, families, and individuals. But the relationship of these two problems is not well-understood. The IOM held a workshop November 16-18, 2010, to explore the relationship between food insecurity and obesity, the current state of the research, and the data and analyses needed to better understand their relationship…


Breathing Dirt

In the PARSIFAL study (6843 participants), researchers analyzed mattress dust samples for environmental bacteria via DNA signatures, which detect bacteria that cannot be measured by culture. In the GABRIELA study (9668 participants), researchers used culture techniques to evaluate bacterial and fungal taxa in dust from children’s rooms. Both studies showed that farm-dwelling children had a lower incidence of asthma and atopy and were exposed to a larger variety of environmental microorganisms than non–farm-dwellers. Microbial diversity was inversely related to asthma risk. An inverse relationship was seen between asthma incidence rates and exposure to certain fungal and bacterial species…



“How to Conquer Your Fear of Doctors”

The term “content farm” describes a company that employs large numbers of often freelance writers to generate large amounts of textual and/or video content which is specifically designed to satisfy algorithms for maximal retrieval by search engines. Their main goal is to generate advertising revenue through attracting reader page views (source: Wikipedia).

This is what the content farms are producing nowadays:

How to Conquer Your Fear of Doctors (). A mix of good and bad advice, don’t take it seriously:

Average time patients spend waiting

The average time patients spend waiting to see a health-care provider is 22 minutes. Orthopedists have the longest waits, at 29 minutes; dermatologists the shortest, at 20.

Patient satisfaction dropped significantly with each 5 minutes of waiting time. Even the term “waiting room” has a bad connotation. Many offices prefer “reception area” instead.

“I live my life in seven-minute intervals,” says Laurie Green, a obstetrician-gynecologist in San Francisco who delivers 400 to 500 babies a year and says she needs to bring in $70 every 15 minutes just to meet her office overhead.

Measures the health-care industry is trying to minimize waiting time include:

– “Open-access” scheduling
– Minimize office visits
– Advance preparation
– Huddling up: “Mr. Jones is in a 15-minute slot, but we know he’s a 45-minute guy”
– Teamwork
– Cutting “cycle time”
– Keep patients informed
– Survey patients

References:The Doctor Will See You Eventually. WSJ..


More Physicians Say No to Endless Workdays

Days of house calls and night calls over? See the NYT article.
Many physicians prefer predictable hours that allow for family time, a change that is transforming the way patients get care.


Prescribing of Fibrates

Comment: In large trials published in 2005 and 2010, fenofibrate did not improve cardiovascular outcomes significantly in patients with type 2 diabetes (JW Cardiol Jan 5 2006 and Mar 14 2010). Although gemfibrozil lowered rates of cardiovascular endpoints in older trials involving high-risk nondiabetic patients conducted largely before the statin era — for example, the Helsinki Heart Study (JW Gen Med Nov 17 1987) and VA-HIT Trial (JAMA 2001; 285:1585) — most such patients would now receive statins as first-line therapy. Thus, the recent rapid expansion of fenofibrate prescribing is unwarranted. One reason for this phenomenon is aggressive marketing of fibrates; another is confusion among clinicians about the lack of hard evidence to support add-on triglyceride-lowering therapies in patients receiving statins.

Prescribing of Fibrates Is Booming in the U.S. – General Medicine.

Nine Dead In Ala. After IV Treatment

A pharmacy that produces intravenous solutions is the potential common source for an outbreak of blood infections that has sickened 19 people at six hospitals. The products have been recalled.


Self-strengthening polymer

Check out: “Self-strengthening polymer nanocomposite works best under pressure” – www.engadget.com


No one keeps carbon nanotubes down — especially not these ones. The always popular allotropes have been enlisted by researchers at Rice University to create a composite material that gets stronger under pressure. When combined with polydimethylsiloxane, a rubbery polymer, the tubes form a nanocomposite that exhibits self-strengthening properties also exhibited in bones. During testing, the team found the material increased in stiffness by 12 percent after 3.5 million compressions. Apparently, the crew is stumped on why it reacts this way, but is no less eager to see it working in the real world — discussion is already underway to use the stuff as artificial cartilage. And here we thought aerogel was cool…