GOUT

• Typically, gout patients are about 95% men, 5% women. An initial attack of gout (50% of initial attacks involve the big toe) may last several days and disappear even if untreated. Subsequent attacks may not occur for weeks, months, years, or not at all. In severe cases, repeated attacks occurring over a long period may cause damage to the joints and loss of mobility. The big toe is eventually affected in 90% of cases. Knowing how to treat gout is important for preventing attacks.
• Gout is often related to an inherited abnormality in the body to process uric acid. Uric acid levels can become elevated by eating a lot of purine-rich foods such as meats, by the overproduction of uric acid by the body, or if the kidneys do not eliminate excess uric acid.
• Treatment goals include terminating acute gout attacks, rapid and safe relief of pain and inflammation, preventing future attacks, and avoiding complications (formation of tophi, kidney stones, and joint destruction).
• Though gout treatment is most often treated successfully and without complications, it becomes more of a challenge if other conditions exist along with gout or if there is poor patient compliance to recommended lifestyle changes or a medication regimen.
• Dietary alterations are recommended, such as avoiding a purine-rich diet. Other preventive measures include maintaining adequate fluid intake, weight reduction, reduction in alcohol consumption, and medications to reduce hyperuricemia.
• Medications for gout include:
• non-steroidal anti-inflammatory drugs (NSAIDS)
• colchicine
• corticosteroids
• adrenocorticotropic hormone (ACTH)
• allopurinol
• probenecid
• sulfinpyrazone
• NSAIDS, specifically indomethacin, are commonly the first medication prescribed to treat acute gout. Other NSAIDS may be equally effective. NSAIDS are initially prescribed at maximum dosage and reduced as symptoms subside. The medication should be continued until pain and inflammation are non-existent for at least 48 hours. NSAIDS which are COX-2 inhibitors may be useful for patients with gastrointestinal concerns but their use for acute gout has not been specifically reported yet.
• Colchicine is used to treat acute flares of gouty arthritis and to prevent recurrent acute attacks. Colchicine does not cure gout or take the place of other medicines that lower the amount of uric acid in the body. It prevents or relieves gout attacks by reducing inflammation. Colchicine may be used in 2 ways: some people take small amounts of it regularly for months or years, while others take large amounts of colchicine during a short period of time (several hours).
• Corticosteroids or adrenocorticotropic hormone can be used for patients who cannot take NSAIDS or colchicine. Patients with acute gout typically receive daily doses of prednisone (20-40mg) or its equivalent for 3 to 4 days, then it is tapered gradually over one to two weeks. ACTH is administered as an intramuscular injection (an initial dose and subsequent doses over several days as needed).
• Allopurinol (brand name - Zyloprim) is prescribed for chronic gout or gouty arthritis and works by affecting the system that manufactures uric acid in the body. It is used to prevent gout attacks, not to treat them once they occur.
• Probenecid (brand names - Benemid, Probalan) is prescribed for chronic gout and gouty arthritis. It is used to prevent attacks related to gout, not treat them once they occur. It acts on the kidneys to help the body eliminate uric acid. Probenecid is known as a uricosuric agent.
• ColBenemid (other brand names are Col-Probenecid and Proben-C) is a gout medication that contains Probenecid, which is a uricosuric agent, and Colchicine, which has anti-gout properties.
• Sulfinpyrazone (brand name - Anturane) is also known as a uricosuric agent and is used to treat gouty arthritis. It works by lowering the amount of uric acid in your blood, preventing gout attacks. The drug helps prevent attacks but is not used to treat an attack once it has started. Sulfinpyrazone is not currently available in the U.S.
• Losartan, (brand names - Cozaar and Hyzaar), is not specifically a gout medication but is an angiotensin II receptor antagonist, antihypertensive drug that may help control uric acid levels. Fenofibrate, (brand name - Tricor), is not a specific gout medication but it a lipid-lowering drug that may help uric acid levels.
• Analgesic painkillers are also used to relieve the intense pain of gout. All of the aforementioned drugs can be used in combination, to control symptoms, prevent future attacks, and maintain healthy uric acid levels.

THE BEATLES

Paul McCartney's song 'Yesterday', which was recently voted the most popular song of the century by a BBC poll, had music written before the lyrics. Paul used the working words 'scrambled eggs' before coming up with 'yesterday' while composing this song.

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The song 'strawberry fields forever' is actually two versions of the song mixed together by George Martin. One was a half-tone higher and slightly faster. When it was slowed down it somehow fit together with the other version perfectly. The Beatles liked both versions and couldn't decide on one and asked Martin if he could put them together somehow. When he tried it - it worked!

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The Beatles featured two left handed members, Paul, whom everyone saw holding his Hoffner bass left handed, and Ringo, whose left handedness is at least partially to blame for his 'original' drumming style.

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Paul McCartney wrote the song Lovely Rita, Meter Maid for the album Sergeant Pepper's Lonely Hearts Club Band after getting a parking ticket from a female warden in Abbey Road.

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The Beatles, with Pete Best on drums, made the group's TV debut performing Roy Orbison's 'Dream Baby' on the BBC show 'Teenager's Turn' in 1962.

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'Hey Jude' was written by Paul in his car. Paul was on his way to visit Julian, John Lennon's son, who was disturbed by his parents' divorce. Paul wrote this song to cheer him up.

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The Beatles got their name from a line in the movie 'The Wild Ones'. Lee Marvin's character said the motocycle gang wanted Marlon Brando's charcter back, even the beetles (he was referring to the women in the gang). They changed the 'ee' to 'ea' so it was like the musical term 'beat'.

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The Beatles song "Dear Prudence" was written about Mia Farrow's sister, Prudence, when she wouldn't come out and play with Mia and the Beatles at a religious retreat in India.

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In a contest held by Mersyside Newspaper to see who was the biggest band in Liverpool, 1962, one of the main reasons that The Beatles won was because they called in posing as different people voting for themselves.

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'We don't like their sound, and guitar music is on the way out.'
Decca Recording Co. rejecting the Beatles, 1962.

PROUDLY SOUTH AFRICAN

1. Table Mountain in Cape Town is believed to be one of the oldest mountains in the world.

2. The world is divided into six floral kingdoms. All these kingdoms encompass several countries, and in some cases, several continents. South Africa, which has a floral kingdom wholly contained within the country, is the one exception. The Cape Floral Kingdom has 9,600 plant species, 70% of which are not found anywhere else in the world.

3. Table Mountain alone has over 1,500 species of plants, more than the entire United Kingdom.

4. South Africa is the second largest exporter of fruit in the world.

5. South Africa has the longest wine route in the world.

6. Kruger National Park supports the greatest variety of wildlife species on the African continent.

7. South Africa, Zimbabwe, and Mozambique are tearing down fences between the countries' game parks to create a 13,500 square mile game park, which will become the largest conservation area in the world. It will be bigger than Switzerland, Belgium or Taiwan.

8. South Africa has a penguin colony, which thrives thanks to the cold Antarctic currents on the west coast near the Cape.

9. South Africa is rated 3rd in the world in supplying safe, drinkable tap water.

10. The Palace of the Lost City resort hotel is the largest theme resort hotel in the world as well as the largest building project undertaken in the southern hemisphere.

11. Walt Disney serves South African wine exclusively at its 73-acre Animal Kingdom Lodge in the United States.

12. South Africa has the cheapest electricity in the world.

13. The deepest mine is a gold mine in South Africa. in 1977 the Western Deep Levels Mine reached a depth of 11,749 feet. Most mines descend to about 3,300 feet.

14. South Africa is the only country in the world to voluntarily abandon its nuclear weapons program.

15. South Africa has 19,004 miles of railway track - 80% of Africa's rail infrastructure.

16. South Africa generates two-thirds of Africa's electricity.

17. The Tugela Falls is the second highest waterfall in the world, where the water tumbles down 2,789 feet. First place goes to the Angel Falls in Venezuela at 3,212 feet.

18. Blyde River Canyon is the third largest canyon in the world - and the largest green one. The Grand Canyon in the U.S. is the biggest, and the Fish River Canyon in Namibia the second, but both are very dry.

19. South Africa is home to the world's smallest succulent plants (less than 0.39 inches) and the largest (the baobab tree).

20. Kimberley may have the biggest man-made hole in the world, but did you know that the southern Free State town of Jagersfontein has the deepest vertical man-made hole?

21. The only street in the world to house two Nobel Peace prizewinners is in Soweto. Nelson Mandela and Archbishop Desmond Tutu both have houses on Vilakazi Street in Soweto.

22. South Africa is the world's largest producer of macadamia nuts.

23. South Africa has the third highest level of biodiversity in the world.

24. South Africa is the world's leader in mining and minerals. It has nearly 90% of the platinum metals on earth, 80% of the manganese, 73% of the chrome, 45% of the vanadium and 41% of the gold.

25. South Africa is the first country in Africa to host the prestigious FIFA World Cup (will take place in 2010).

26. South Africa has the oldest meteor scar in the world, just across the Vaal River near Parys, called the Vredefort Dome. This is a UNESCO World Heritage Site.

27. South African grasslands have approximately 30 species per square kilometer, greater than the biodiversity of rainforests.

28. South Africa is the sole producer of the Mercedes Benz C Class, right-hand drive vehicles .

29. General Motors South Africa will be the only manufacturing site outside of the United States to build the Hummer H3 vehicle.

30. South Africa is one of the most generously endowed geographic solar hotspots in the world, soaking up just over half of the world's highest category of solar wattage per square yard of land.

31. South Africa has deserts, mountains, escarpments, plateaus, grasslands, bush, wetlands and subtropical forests.

32. Most of the world's proto-mammalian fossils are found in the Karoo region.

33. Dr. Christiaan Barnard, at Groote Schuur Hospital in Cape Town, performed the first human heart transplant in the world in 1967. He was also the first to do a "piggyback" transplant in 1971, and he was the first to do a heart-lung transplant.

34. The vast majority of South African coal exports are shipped through the Richards Bay Coal Terminal (RBCT). With the capacity to export 79.4 mmst annually, RBCT is the world's largest coal export facility.

35. The world's largest diamond was the Cullinan Diamond, found in South Africa in 1905. It weighed 3,106.75 carats uncut. It was cut into the Great Star of Africa, weighing 530.2 carats, the Lesser Star of Africa, which weighs 317.40 carats, and 104 other diamonds of nearly flawless color and clarity. They now form part of the British crown jewels.

36. There are about 280,000 windmills on farms across South Africa, second in number only to Australia.

37. Three of the five fastest land animals live in South Africa - the cheetah (63 miles per hour), the wildebeest, and the lion.

38. The oldest remains of modern humans were found in Klasies River Cave in the Eastern Cape. They are well over 100,000 years old.

39. In eastern South Africa, scientists have found traces of blue-green algae dating back 3,500 million years. This is some of the earliest evidence of life on Earth.

40. There are more than 2,000 shipwrecks, dating back at least 500 years, off the South African coast. More than one of these, including the Waratah, simply vanished without a trace.

41. The Karoo region is home to some of the best fossils of early dinosaurs.

42. Although Pretoria is considered to be the capital of South Africa, the country actually has three capitals: Pretoria (executive), Cape Town (legislative), and Bloemfontein (judicial).

43. In its eastern part, South Africa entirely surrounds another country - Lesotho, an independent constitutional monarchy.

44. Approximately 900 bird species are found in South Africa alone, which represents 10% of the worlds total bird species.

45. South Africa has the most luxurious train in the world, The Rovos Rail.

46. South Africa has the highest commercial bungi jump in the world (710 feet).

47. Mossel Bay is in the Guinness Book of records as having the second most moderate climate in the world.

48. Pietermaritzburg's city hall is the largest red brick building in the Southern Hemisphere.

49. Hippos are susceptible to sunburn, and spend most of their days with just their noses out of water. Their noses have special flaps that close when submerged, and they can stay under water for 25 minutes.

50. South Africa has the oldest wine industry outside of Europe and the Mediterranean, featuring Chardonnays, Pinot Noir, Merlot, Cinsault, Riesling, Shiraz, Sauvignon Blanc, Cabernet Sauvignon and Pinotage varietals.