The Elixir of Youth- Telomerase

A few days ago, I began reading a book called 'The Immortal Life of Henrietta Lacks' and so far I am enjoying the book greatly, however there was a  single page which sparked my interest particularly and may hold the secret to eternal youth.

 Henrietta Lacks was a young woman in the 1950's who had cervical cancer. Before she died a sample of her cancerous cells were taken from her cervix and placed in culture. Her cells began to hastily divide quicker than any cells that scientists had ever seen before. The cells managed to outlive any cells that scientists had previously attempted to culture.
Henrietta's cancerous cells or HeLa cells have become one most popular cell lines in the world, purely due to the fact they seem to divide an infinite amount of times without dying like normal body cells, thus achieving the status of immortality. I find it shocking that Henrietta's cells have lived for far longer in culture,  74 years, than they ever did in the mere 30 years when she was alive.

This made me begin to question:
Why do cancer cells divide an infinite amount of times whereas body cells would simply die after a finite amount of divisions?

The Telomere at the end of each chromosome

Later in the book I managed to find a brief answer to my question.

In 1961, Leonard  Hayflick found out that cells divide a set amount of times, around 50 divisions, before dying. This limit is imaginatively named 'The Hayflick limit'. The hayflick limit is determined by a small mechanism found at the end of every chromosome, inside every single cell in our body. Each time a cell divides through mitosis, this telomere shortens until it can shorten no more and the cell dies. You can almost imagine it as a ticking time bomb. This shortening is proportional to the age of a person: the older we get, the shorter our telomeres and the shorter the amount of time  our cells have to divide before they die.
With cancer cells, they produce a enzyme called 'telomerase' which actively rebuilds their telomere's, meaning that they can carry on dividing for an infinite amount of time.

After finding out this piece of information, it made me wonder:
If we could artificially produce the enzyme 'telomerase' and administer it to ourselves, would we have found secret to living forever and staying young? 

In 2010,  Dr Robert DePinho of Harvard University conducted a study which solved the answer to this question. He conducted his experiment on mice, whose organs resembled those of an 80 year old person. He gave the mice a drug which switched on the production of telomerase. Surprisingly, after just two months of being given the drugs the mice regained their youthfulness and  even their fertility. This hints that one day humans may be able to reverse the effects of aging and become youthful again. This could put an end to age related illnesses such as Alzheimer's disease and save the NHS millions of pounds. With these drugs, we could become real life versions of Scott Fitzgerald's Benjamin Button. It could also mean that women past child bearing age, could once again become fertile and produce a child without the use of in vitro fertilisation.

As good as this sounds, there are many ethical implications with humans having eternal youth, which will most likely mean that telomerase drugs for human use will remain a fragment of science fiction. These implications include the fact that if these drugs were available to everybody, the world would be left with an unsustainable population and there simply wouldn't be enough space for everybody to live on. If these drugs were rational, who would qualify to use them?

Could telomerase inhibiting drugs cure cancer?
As previously  explained, telomerase is the element in cancer cells that causes them to divide an infinite amount of times without death of the malignant cell. In theory, this could mean that if we could stop the production of telomerase then this could stop cancerous cells from dividing and cause them to die. When this theory was tested, anti-telomerase drugs did in fact cause cancer cells to die. However, it was found that cancer cells quickly adapted to the loss of telomerase by producing a resistant mechanism which lead again to the lengthening of telomeres. Therefore, in order for this theory to work, drugs need to be developed which will inhibit both telomerase and it's resistant mechanisms.

In conclusion to my research, telomerase has the potential be a very useful component in anti-aging drugs, however due to ethical complications it is unlikely that it would ever be a legal substance. In addition to this, studies into telomerase and how itself and it's resistant mechanisms can be inhibited could provide hope in the future for a cure to cancer. Telomerase is truly an amazing yet harmful substance (due to its cancer progressing nature) and I'm sure there will be many further scientific studies in order to uncover it's mysteries...

Strange Diseasapolobrewy Syndrome

Auto-brewery syndrome, or gut fermentation syndrome, is an incredibly rare medical condition that causes the body’s own digestive system to produce intoxicating amounts of alcohol.

The cause:
A strain of yeast called saccharomyces cerevisiae stuck in the small intestine produces pure ethanol which is then quickly absorbed into the bloodstream. After a high carbohydrate meal, the yeast will break down the carbohydrates found in foods like bread of pasta and turn them into ethanol. This yeast is the same yeast used in winemaking, baking and brewing. This yeast is also considered one of the most studied eukaryotes in cell biology.

The condition cannot be cured, but can be effectively controlled by taking anti fungal drugs such as fluconazole and by administering a low carbohydrate diet.
The most notorious case of Auto-brewery syndrome is that of a sixty one year old Texas man, whose story made it to the International Journal of Clinical Medicine and other media outlets. The man complained of dizziness and other alcohol related symptoms, it was not until he underwent a gastroenterology test that doctors discovered yeast was producing the ethanol in his gut.

 Although it sounds like this particular disease could have certain pros, they are definitely far outweighed by the cons, which include a constant hangover and often being five times over the legal driving limit despite not touching a drop of beer.

First Aid Fridays - Blisters

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.

Blisters are injuries where the top layer of skin has created ‘bubble’ of tissue fluid or blood; this is a method in which the body protects its self from further damage. Blisters are mostly caused when the skin is repeatedly rubbed against another surface or when exposed to heat; the most likely scenarios which lead to blisters are when people are walking for long distances or when a hot pan is touched. As blisters can occur due to common minor accidents, it is likely that most people have either seen or experienced blisters; as they are so frequent, this blog post is highly important to gain an insight into how to treat a blister. The main aspect to focus on is to not burst the blister as this hugely increases the risk of infection.

Recognition Signs:
-    - A ‘bubble’ shape where the top layer of skin has swollen. The blister may appear skin coloured or may be red due to blood being trapped inside.

      1. Wash the area with clean water and rinse. Pat the blister and surrounding area dry using sterile gauze. This step is to reduce the risk of infection.
2. Cover the blister using a plaster; when applying this, ensure that the adhesive dressing is larger than the blister to offer sufficient cushioning to the wound. The ideal dressing would be a blister plaster as these are cushioned to provide extra protection and comfort.
-     3. If the person is to continue with their activities (such as walking), it may be a good idea to apply Vaseline  on top of the plaster in order to reduce the amount of friction between the plaster and shoe.

For more information, see page 121 of the DK First Aid Manual.

A blister on the arm.

First Aid Fridays - Heat Exhaustion

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.

Salts and water are lost from the body when sweating; during hot weather, excessive sweating can occur. This condition occurs gradually over time and can affect those who are not acclimatised to hot and humid conditions; those who are unwell with illnesses that include vomiting and diarrhoea are more susceptible to developing heat exhaustion. Heat exhaustion can also develop as a result of the body producing more heat than it can cope with - this can be caused by some recreational drugs, such as Ecstasy, which alter the body's temperature regulation system.

Recognition Signs:
- Headache, dizziness and confusion.
- Loss of an appetite.
- Sweating with clammy skin.
- Cramps in the arms, legs and abdomen.
- Rapid and weakening pulse.

1. Help the casualty to reach a cool and shady place. Encourage the casualty to lie down and elevate their legs in order to improve the blood flow to the brain.
2. Give the casualty water to drink to rehydrate them. If an Oral Rehydration Solution (ORS) is available, use this as this will restore the lost salts and ions.
3. Monitor the casualty and record any vital signs (such as pulse). Even if the casualty appears to improve quickly, encourage them to seek medical help.
4. If the vital signs of the casualty worsens, call for emergency help using 999 or 112. Wait with the casualty until help arrives.

For more information, see page 192 of the DK First Aid Manual.

The position to encourage a casualty to rest in - this increases blood flow to the brain.

Staying Hydrated This Heatwave

Following the warning of a heatwave to hit the UK within the next few days, I felt it fitting that an article regarding the risks of hot weather was to be written; especially as around 2000 people a year in the UK die due to heat!

What Is Dehydration?

Dehydration is the condition which occurs when the amount of fluids lost by the body are not replaced to maintain a suitable level; during hot weather, this fluid is most commonly lost through sweating. Sweating is a mechanism in which the body attempts to cool itself by evaporation, however this process causes fluid, salt and ion levels to fall. Children, the elderly or those with prolonged periods of activity are particularly at risk.

How to Prevent Dehydration:

In order to avoid dehydration, it must be ensured that enough fluids are consumed in order to restore those lost through sweating and urine. It is advised by the Food Standards Agency (FSA) that residents of the UK should aim to consume 6-8 glasses (1.2 litres) of fluid a day; this fluid can be water, semi-skimmed milk, diluted squash and diluted juice.

As well as taking in enough fluids, it may be advised that the amount of fluids lost could be reduced by decreasing the amount of physical activity performed - as well as dehydration, strenuous activity in the heat can result in heat exhaustion.

Monitoring Hydration Levels:

There are multiple ways in which you can roughly monitor whether you are staying hydrated enough during the hot weather. For each test, I have listed the possible results and what they mean.

Urine Colour Test:

The colour of the urine passed is a good indicator of whether you are staying hydrated enough. Following the chart displayed in the image; if the colour of the urine is light then you are well hydrated, whereas if it is a dark yellow or brown colour then you are heavily dehydrated. If you show to be well hydrated, continue to drink the amount of fluids you are currently taking in; whereas if you are dehydrated, begin to consume more fluids than you currently are - tackling dehydration at this early stage may prevent other symptoms of dehydration from developing.

Skin Turgor Test:

This is another simple test which can be conducted to test whether you are dehydrated or not. Pinch the skin on your hand then pull it up; if the skin then lowers and returns to original position, you are hydrated and should continue to consume the amount of fluids you currently are taking. However if the skin remains elevated, this would suggest that you are dehydrated and have lost too many fluids - you should increase your amount of fluids consumed.

Recognition Signs of Dehydration:

If dehydration has developed before you have managed to control it, the following symptoms may be present. Different people react differently to the condition so not all of the symptoms may be present.

- Dry mouth and dry eyes.
- Dry and/or cracked lips.
- Headaches, dizziness or confusion.
- Dark coloured urine.
- A reduced amount of urine passed.
- Cramping may occur in muscles (such as the calves).

Treatment Procedure:

1. Reassure the casualty and encourage them to sit down.
2. Give the casualty water to consume in order to restore the lost fluids. If an Oral Rehydration Solution (ORS) is available, this may be used in order to restore any lost salts and ions.
3. If the casualty is encouraging cramping, advise them to stretch and massage the affected muscles.
4. If the casualty remains unwell or worsens, seek medical advice immediately.

Dehydration In Babies:

Dehydration can be harder to spot in babies/young children as they may not necessarily display the symptoms as listed above.  In order to determine whether they are dehydrated, there are some extra tests and recognition symptoms which can be observed.

A sunken Fontanelle.
Firstly, babies and young children may show pale skin or sunken eyes; as well as this, young babies may have a sunken Fontanelle (the soft spot on the head). If any of these signs are present, they could be indicating dehydration so follow the treatment procedure as above.

Further tests include checking of the nappy (if there is a lack of excretion this could suggest dehydration), monitoring of any crying (tearless crying is a sign of a lack of fluids) and monitoring of respiration rate - some children may have rapid breathing if they are dehydrated.

If the child remains unwell or the condition worsens, seek medical assistance immediately.

As long as you consume sufficient fluids and avoid strenuous physical activity, all should be ok! Stay safe this summer and enjoy the beautiful weather!

Recognition Signs and Treatment Procedure have been sourced from the DK First Aid Manual Revised 9th Edition - for further information, read page 190. The information above is given as advice and has been written by a prospective medical student using various resources - if you are worried about the welfare of any casualty, seek medical attention.

Symptomless But Deadly: Aneurysms

In September, I will be starting my AS level biology (exciting) and on induction day, as part of my summer homework, I was asked to produce a poster on aneurysms. As part of my research into this condition, I thought I might as well post some of my findings on here.

Aneurysms are defined as 'an abnormal swelling of a weakened arterial wall', which causes the artery to bulge out like a balloon. If this balloon ruptures it can cause extensive internal bleeding and a complete collapse of the circulatory system . If an aneurysm bursts, you will loose consciousness within seconds. I personally find the fatality rates shocking- 50 percent die even with medical attention. What I find scary is that small aneurysms often go unnoticed as they tend to be symptom-less and in many cases your problems won't become apparent until its too late...

Who gets aneurysms and how do they develop?
Aneurysms can run in your family or they may develop due to plaque building up on the walls of arteries, causing them to harden (atherosclerosis). Having high blood pressure and/or being a smoker can also increase your chances of developing an aneurysm. The most common type of aneurysm develops in the main artery from the heart (aorta); when the muscle fibres of the tunica media layer of the artery wall become weak or deficient, the power of the high blood pressure against the wall can cause it to bulge forming an aneurysm.

Types of aneurysm
To tell the truth, I wasn't surprised to find out there are many variations of aneurysms:
  • Abdominal Aortic Aneurysms- the most common type of aneurysm, found in the abdominal portion of the aorta. Thankfully, these are found fairly easily due to CT scans. However, they can grow very large, but they rarely rupture.
  • Thoracic Aortic Aneurysms- occur in the chest portion of the aorta. Only 50 percent of people develop symptoms. These are significantly more serious as they can allow blood to leak back into the heart.
  • Cerebral Aneurysms- Occur in the brain and rarely produce any symptoms before the rupture. I personally judge this as the most serious type of aneurysm because when they rupture it leads to an extremely severe condition called a  subarachnoid haemorrhage which produces life threatening symptoms such as a sudden unbearable headache and vomiting. I find it startling that 3 out of 5 people will die within two weeks of having a subarachnoid haemorrhage and half of those who survive will be left permanently brain damaged. 
How are they treated?
 - A doctor may prescribe medicines such as beta blockers or calcium channel blockers in order to help reduce blood pressure on arteries and lower the risk that an aneurysm will rupture.
- Doctors may recommend surgery if the aneurysm is growing at an alarming rate. There are two types of surgery available to treat aneurysms: open chest/abdominal surgery or endovascular repair.
- Open chest/abdominal surgery involves making an incision into the area and removing the aneurysm. The section of artery will be replaced with a material such as Teflon or Dacron.
-With Endovascular repair the actual aneurysm isn't removed; instead a graft is inserted into the aorta to support it. Surgeons perform this using catheters inserted into the arteries, so no opening of the chest is required. The recovery time for endovascular repair is much less than that of open chest surgery, however not all aneurysms can be treated in this way.

In my opinion, I find it unfortunate and shocking that such a serious condition can go unnoticed due to the lack of symptoms. If you wish to further your reading on this condition, here are a few sites I would suggest:

The Battle Between Antibiotics and Bacteria

Antibiotic is a powerful medicine commonly used to fight against some life-threatening bacterial infections. The first antibiotic, penicillin, was discovered by Scottish scientist Alexander Fleming in 1928. It has made a huge impact on medical care and significantly reduced illness and death from infectious diseases. About 35million prescriptions for antibiotics are dispensed every year by GPs in England. The number has increased by 30 per cent since 2000, according to NHS figures. However, there are still as many as 5,000 people die from antibiotic-resistant infections in England every year.

What are Antibiotics?
Antibiotics are chemicals that can destroy or inhibit the growth of microorganisms (commonly pathogens). Antibiotics are used inside the body; they can be used in such way because they selectively target infecting bacteria, and then either stops them from growing or terminates them. They achieve this at concentrations that are not usually harmful to our cells and tissues. Some people however are allergic to some antibiotics and as a result can affect our cells if used at too high a concentration. Like all drugs they can have side-effects.

Why are bacteria becoming resistant to antibiotics?
The numbers of antibiotic-resistant bacteria have increased, partly due to the misuse of antibiotics. In some countries and over the internet, antibiotics can be sold and purchased without a doctor's prescription and this leads to over-use. As a result, bacteria can become immune to such antibiotics when they are over-used.
GPs hand out antibiotics to placate demanding patients. Patients sometimes take antibiotics unnecessarily, to treat viral illnesses like the common cold. This promotes the antibiotic resistance and makes the spread of resistance become hard to control because mutant strains of bacteria can form as a result of this practice. Antibiotic Resistance is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country. It has become a major threat to public health.

How do bacteria become resistant?
Some bacteria are naturally resistant to certain types of antibiotics.
Bacteria may also become resistant in two ways.

By a genetic mutation:
  • Over time, bacteria can become resistant to certain antibiotics through natural selection. A mutation in the base sequence of a bacterial DNA changes the protein and causes a different characteristic. Some mutations in bacterial DNA mean that the bacteria are not affected by a particular antibiotic any more (they’ve developed antibiotic resistance) or can possess an enzyme called Penicillinase which destroys the antibiotic penicillin and prevent it from working and destroying other bacteria.These survive and reproduce, creating more bacteria that are resistant to the antibiotic.

       By acquiring resistance from another bacterium:
  • Bacteria can pass on their mutated, resistant genes which pass on antibiotic resistance to the next generation by Vertical Gene Transmission and also through a process Horizontal Gene Transmission where mutant, resistant plasmids are passed from one bacterium to another via a conjugation tube. During Horizontal Gene Transmission the mutated plasmids can be passed on to many different species of bacteria and this is why the process is such an issue.

      Methicillin-resistant Staphylococcus Aureus (MRSA)
This vicious infection often referred to superbug, is caused by bacteria strain of Staphylococcus Aureus. The symptoms of MRSA infection may commence as a minor skin sore, pimple or boil; and it can become serious and sometimes fatal for patient who suffers from an immune deficiency.
Through the process of natural selection over years, the bacteria has developed resistance to Penicillin, Methicillin, Dicloxacillin, Nafcillin, Oxacillin etc.

The treatment of MRSA
Although MRSA are resistant to many drugs, most remain susceptible to the antibiotics Vancomycin and Teicoplanin (Targocid). Infections due to MRSA are therefore often treated with one or the other of these drugs. Both must be administered by infusion or injection, and for this reason, they are used for treatment only in hospitalised patients.

Why don't we have enough new antibiotics?
The search for new antibiotics is an expensive venture to fund. The course of antibiotic treatment is usually short and the amounts of antibiotics that are allowed to give to the patients are small in order to avoid resistance developing. If major resistance does occur, the drug would be a write-off for the pharmaceutical company that developed it. Many of the "newer" antibiotics are chemical variants of older agents and this means resistance development can occur quickly.

Common diseases and treatment
  • Pneumonia  -Amoxicillin, Roxithromycin or Doxycycline
  • Pharyngitis   -Phenoxymethylpenicillin (Penicillin V), Amoxicillin
  • Conjunctivitis  -Chloramphenicol 0.5% eye drop, Fusidic acid eye gel

What can we do?
  • Using antibiotics only when prescribed by a doctor.
  • Completing the full prescription, even if a person feel better.
  • Never share antibiotics with others or use leftover prescriptions.
  • Basic hygiene - hand washing and taking care when preparing food.
  • Never take an antibiotic for a viral infection like a cold or the flu

How can GPs pharmacists help tackle resistance?
  • Only prescribing and dispensing antibiotics when they are truly needed-unnecessary prescription of antibiotics can contribute to the acceleration of antibiotic resistance.
  • Prescribing and dispensing the right antibiotics to treat the illness.
  • Family doctors could prescribe placebo treatment to patients –the placebo effect can result in an improvement in a patient’s condition psychologically. This however triggers an ethical debate which will be reviewed in another blog post soon.

First Aid Fridays - Cuts and Grazes

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.

Cuts and grazes are common injuries which most people are likely to encounter and therefore need to first aid. Most people will know that these wounds are easy to treat by elevating, applying pressure and possibly dressing; however these people may not necessarily know how to reduce the risk of infection whilst treating these injuries. Infection of a wound occurs when the wound is dirty and micro-organisms trigger an immune response in this area; common recognition symbols of infection include yellow pus, swelling and increased pain + soreness around the wound. In order to avoid infection, we must aim to clean the wound as much as possible.

Recognition Signs of a Cut/Graze:
-     - A cut or graze to an area of the body – wounds vary in size so the wound may be large with a lot of blood escaping or it could be small puncture wounds.

Recognition Signs of Infection:
-      - Yellow pus oozing from the wound.
-      - Increased pain and tenderness around the wound.
-      - Swelling and redness around the injury.
-      - A feeling of heat around the cut/graze.
-      - If the infection is advanced, the casualty may have symptoms of a fever.

     1. Clean the wound by washing it under running water or by using an alcohol-free wipe. Pat the wound dry using a gauze swab.
     2. Place a sterile gauze over the wound and then apply pressure. Elevate the injury above the level of the heart (if possible). This elevation is to reduce the blood flow to the wound and therefore the amount of blood loss should reduce.
     3.  Keeping the gauze on the wound, use soap and water to clean around the injured part. Clean the surrounding area using sterile swabs, using a new swab for each stroke. Pat the area dry.
     4.  Remove the wound covering and then apply a sterile dressing (a bandage or plaster dependent on the size of the wound).
     5. If there is a worry of infection, advise the casualty to seek medical attention and advise them on the recognition signs of infection. 
     6. If the wound is likely to have come into contact with soil, you should advise the casualty to seek medical attention as the bacterium which causes Tetanus may have infected the injury.

For more information, see page 120 of the DK First Aid Manual.

Applying pressure to a bleeding wound.

First Aid Fridays - Shock

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.

Shock is a life threatening condition which occurs as a result of the circulatory system not supplying vital organs with sufficient oxygen; this deprivation of oxygen causes the body to begin to ‘panic’. As this condition affects vital organs, immediate medical assistance is required.
Shock can be caused by multiple factors however the two largest causes are fluid loss and the inability of the heart to pump the blood around the body. The loss of fluids is most commonly through severe bleeds however other causes include severe burns, diarrhoea, vomiting and bowel obstructions. Other factors which may lead to shock include an overwhelming infection, hypothermia and anaphylactic shock.
Due to the large variety of causes, shock also has many recognition signs. As shock is a condition which develops over a period of time, there are different symptoms for the different sections of time.

Initial Recognition Signs:
- A rapid pulse as the heart attempts to recover and supply enough oxygen to the vital organs.
- Pale cold and clammy skin.
- Sweating as the casualty begins to panic.

Developing Recognition Signs:
- Rapid, shallow breathing as the casualty panics due to the lack of oxygen.
- Weakness and Dizziness.
- Nausea and possible vomiting.
- Thirst (due to the loss of fluids).
- Grey-blue coloured skin in the lips and fingernails/earlobes will not regain colour immediately.

As the Oxygen deprivation starts to affect the brain:
- Restlessness and aggressiveness.- Yawning/gasping for air.
- Unconsciousness and finally the heart will stop.
- As the time period progresses, it can be seen that the symptoms become more severe and can even lead to death.


  1. Treat the injury which has caused the shock; such as bandaging a bleeding wound (follow the relevant procedure for the specific injury).
  2. Ensure that you constantly reassure the casualty in order to make them more comfortable and to help calm them down.
  3. Encourage the casualty to lie down and raise their legs above their head – this is to increase the blood flow to the head (this is the most vital organ which must be kept with a good blood supply in order to preserve life). Do not let the casualty sit on a chair or raised surface as this can cause further injury if they were to fall unconscious and fall off onto the floor.
  4. Loosen any clothing such as tight ties or shirts which may be restricting breathing or the neck.
  5. Keep the casualty warm using blankets and call for emergency medical assistance on 999 or 112.
  6. Observe and record any vital signs such as pulse rate, blood oxygen saturation, respiration rate and alertness. If the casualty becomes unresponsive and unconscious, place them into the recovery position and ensure the airways are maintained open. If the heart stops, start the procedure for CPR and using a defibrillator.
For more information, see page 116 of the DK First Aid Manual.

Elevated legs position.

Useless Organs: Why did we get them, why do we still have them?

To begin to answer this question we must first create a list of the ‘useless’ organs in the human body. This is not quite as simple as it sounds as some parts of the human body serve some minute purpose, and of course there are some organs that we do not understand, but this does not mean they do not serve some secret function that is hidden from us; for example the Appendix has long been labelled as serving little or no purpose but a 2009 study claims that the Appendix is used to store beneficial bacteria.

The list:

     Male Nipples - an undisputedly useless piece of the male anatomy, and often the first to come up when discussing a topic like this. Male Nipples appear in the womb due to the fact that all foetuses start off as female and some become male after an influx of testosterone in the first few weeks of pregnancy.

     Extrinsic Ear Muscles – these are the muscles that allow some people to wiggle their ears. It is believed these muscles were useful when we more ape like so we could move our ears independently of our head.

     Fenestra – Temporal Fenestra (openings in the skull) cannot really be classed as organs as such, but are anatomical features of the human body nonetheless. Fenestra date back to the days of dinosaurs, these openings in the skull meant that large dinosaurs such as T-rex could have a larger skull with less weight due to less of the skull being made of bone. Humans still have one of these openings where T-rex would have had multiple. The openings in a human skull are tiny and are of little use.

     Sinuses – Sinuses are not completely understood by doctors, there are multiple theories as to the function they perform: to act as an airbag in the event of a severe trauma to the face, to insulate the eyes, to moisten the air we inhale. However no one is quite sure and whatever function they perform it is irrelevant enough to go dismissed. It is often reported that our ancient ancestors would have used them to greatly improve their sense of smell; however the sinuses have no such effect on us. Infection of the Sinuses (known as sinusitis) can cause a blocked nose, headaches, facial pain and a reduced sense of smell.

     Adenoids – The Adenoids are masses of lymphatic tissue that act as part of the immune system; they protect the body from bacteria that we inhale. Whilst this organ seems quite useful, it is only useful during childhood, in adulthood the lymphatic tissue shrinks and is no longer of any use.

Now we have a few examples to work with we can begin to answer the questions posed in the title: 

Why and how did we acquire such organs? 

This depends on the organ; for organs like the Fenestra, ear muscles and Sinuses we know that these are due to our evolutionary past and although we have no use for them, our ancestors certainly did; organs like the male nipple and Adenoids are still with us because they are necessary at some point in our growth. 

Why do we still have the organs that serve no use in our development?
This is a point often made in reference to the Appendix or Tonsils, those that have them removed suffer no negative impacts as a result of their removal as far as we know so why are they still with us if they are of no benefit? 
As you probably know, evolution naturally selects the organisms most suited to survive and reproduce, the appendix for example is absolutely harmless to around fourteen out of fifteen members of the population and even then, if Appendicitis develops after sexual maturity then the affected person is still able to pass on their genes. 

We can assume the same for other ‘useless’ organs, if they do not effect a person’s ability to pass on their genes, then the genes for these organs will continue to be passed on, and so we retain these anatomical relics.