A woman in Australia died after being attacked by one of her roosters, according to a new case report—and as highly unlikely as it sounds (and, honestly, is) the incident will leave you paying a little more attention to some veins on your legs.

The case report, detailed in the journal Forensic Science, Medicine, and Pathology, tells of a 76-year-old woman who was collecting chicken eggs on her property when a rooster started pecking at her lower left leg. That pecking caused a "significant hemorrhage," that caused the woman to collapse. She eventually died of her injuries.

According to the case report, an autopsy conducted after her death found that the woman had two small cuts on her leg, including one that was over a large varicose vein. As a result, doctors said she died from "exsanguination," or severe blood loss, from bleeding from the varicose vein after the rooster attack.

“This case demonstrates that even relatively small domestic animals may be able to inflict lethal injuries in individuals if there are specific vascular vulnerabilities present,” the authors of the report wrote.

While dying from a varicose vein injury is rare (that's why it ended up in a medical journal), the incident raises some important questions about varicose veins. Here's what you need to know. 

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What are varicose veins, again?

Varicose veins are a common condition caused by weak or damaged vein walls and valves, the National Heart, Lung, and Blood Institute (NHLBI) says. Your veins have one-way valves inside them that open and close to keep blood flowing in your heart. But weakened or damaged valves or walls in the veins can cause blood to pool and flow backwards, the NHLBI explains. When this happens, the veins might grow larger and become distorted, causing varicose veins.

“Varicose veins are veins you already have that stretch out over time,” explains Mounir Haurani, M.D., vascular surgeon at The Ohio State University Wexner Medical Center. “Think of a balloon that you make animals out of: They start out straight and small but after they get blown up they are longer, wider, and thinner walled.”

Varicose veins typically form when your blood pressure increases inside your veins. That can happen due to a range of things, including pregnancy, constipation, a tumor, or being overweight or obese, the NHLBI says.

As far as treatment options go, lifestyle changes (reaching a healthy weight, avoiding sitting or standing for long periods of time, being more physically active—can help, as can compression therapy, says Dr. Haurani. Medical procedures like endovenous ablation (which uses lasers or radiofrequency energy to heat the inside of the vein and close it off), sclerotherapy (where your doctor injects liquid or foam chemicals into the vein to seal it closed), or surgical removal of the varicose veins are also an option, the NHLBI says.

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Okay, but are varicose veins ever harmful?

If this case study is any indication, yes, they can be—but on the whole, varicose veins are not directly a sign of any major systemic illness, Dr. Haurani says, so they’re pretty harmless on their own.

But back to the case study: It should be noted that bleeding from varicose veins is not overly common, Dr. Haurani says. Still, people do go to the emergency room for varicose vein injuries “because it can be hard to stop the bleeding on your own,” he says.

If you have varicose veins and you happen to injure them, apply pressure to the wound and then lay down with your legs up on a chair, Dr. Haurani says. And, if the bleeding doesn’t stop, seek medical care ASAP. But, aside from injuring varicose veins, if you have them at all and are bothered by them (or you're concerned about you have varicose veins and they bother you, or you’re concerned about your future risk of injury, talk to your doctor, who should be able to guide you on next steps. 

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It has been scientifically proven that just 60g of nuts can improve sexual function and that nuts have a positive effect on cholesterol.

To add to the list of benefits, research presented at the ESC Congress 2019 has revealed that eating nuts twice a week is associated with a 17% lower risk of death from cardiovascular disease. 

Food frequency questionnaire

The study looked at the link between nut consumption and risk of cardiovascular death and disease in the Iranian population. 5 432 adults who were 35 and older and who had no history of cardiovascular disease were selected randomly from both urban and rural areas of Isfahan, Arak and Najafabad.

The intake of nuts such as walnuts, hazelnuts, almonds, pistachios and seeds were assessed in 2001 by means of a food frequency questionnaire. Every two years until 2013, participants were interviewed for the occurrence of cardiovascular events and death. The outcomes investigated included:

• Coronary heart disease
• Total cardiovascular disease
• Stroke
• Death from cardiovascular disease
• Death from any cause

A median 12 year follow up concluded that there were 751 cardiovascular events, of which, 594 were coronary heart disease and 157 were strokes. There were also 179 cardiovascular deaths and 458 all-cause deaths. Eating nuts twice a week or more was associated with a 17% lower risk of cardiovascular mortality in comparison to eating nuts once every two weeks.

Even after adjusting factors which could have influenced the relationship such as age, sex, education, smoking and physical activity, the connection was still robust. Nuts were inversely associated with other outcomes, but that proved to be insignificant after adjustments.

Dr Noushin Mohammadifard, study author from Isfahan Cardiovascular Research Institute in Iran said, “Nuts are a good source of unsaturated fat and contain little saturated fat. They also have protein, minerals, vitamins, fibre, phytosterols and polyphenols which benefit heart health.”

According to ESC guidelines, 30g of unsalted nuts per day is listed as one of the characteristics of a healthy diet, and the energy density of nuts is high. “Raw and fresh nuts are the healthiest,” Dr Mohammadifard added. “Nuts should be fresh because unsaturated fats can become oxidised in stale nuts, making them harmful. You can tell if nuts are rancid by their paint-like smell and bitter or sour taste.”

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Deeanne Daniels

However, the benefits to the heart seem to outweigh the risks to the brain.

Many people suffering from mental disorders such as anxiety, depression and schizophrenia turn to traditional doctors because there’s no accessible treatment for 90% of mental health patients in state hospitals.

The World Health Organisation (WHO) estimates that more than 33% of countries allocate less than 1% of their total health budgets to mental health. This means that the magnitude of mental health across the world is not matched by the size and effectiveness of the response it demands. It’s a concerning finding, considering one-third of South Africans experience at least one mental disorder during their lifetime.

African Traditional Medicine Day

With very limited access to psychiatric treatment in the South African public health sector, “Western” doctors are trying to close the treatment gap by combining conventional and traditional treatments.

Speaking ahead of African Traditional Medicine Day – an initiative of WHO – that took place on 31 August, Specialist psychiatrist Dr Lerato Dikobe-Kalane, a member of the South African Society of Psychiatrists (SASOP) called for cooperation between conventional Western medicine and traditional health practitioners to improve access to mental healthcare.

Dikobe-Kalane believes that traditional healers can play an important role in the frontline of treatment for mental disorders such as depression and anxiety, as well as substance abuse.

“We have an estimated 200 000 traditional healers in South Africa – they have intimate knowledge of traditional medicine and cultural and spiritual practices and beliefs. They are respected in the community and their advice is sought out and respected, and they are able to offer culturally appropriate treatment.”

According to Dikobe-Kalane, there is evidence that the psychosocial role of traditional healers can help to relieve distress and mild symptoms of common mental disorders. Some of the treatment includes informal counselling and support in improving family, community or work relationships. 

A beneficial collaboration

Reportedly South Africa has only 915 practising psychiatrists, and the majority of them work in the private sector and in urban areas. Because of this shortage, a staggering 75% of South Africans with mental disorders do not receive the treatment they need. 

Since traditional healers play an influential role in providing health information in both rural and urban settings, a collaboration between conventional, Western health practitioners and traditional healers can educate traditional healers on common mental disorders and treatment options, and also refer people for more specialist treatment, Dikobe-Kalane said.

A South African Stress and Healthy study in 2009 was the first to research mental disorders on a nationally-representative scale and showed that alternative, or traditional, medicine is commonly used by South Africans. This is especially the case for those suffering from anxiety or battling substance abuse. 

Traditional healers – a misconception

Traditional healers primarily use natural herbs in their practice. They are trained to be mindful, but are not experts, traditional healer trainee Choco Nkosi explained to CNN.

The calling to become a healer starts with an “initiation illness”. It is believed that the sickness will persist until the chosen individual heeds the calling and seeks out a trainer to initiate them into becoming a healer. 

Traditional healers are not to be confused with witch doctors, a Johannesburg-based traditional healer, Dzonga told CNN. “They do not cure. The witch doctor actually brings negative energy.” 

Severe mental disorders require Western medical treatment

Educating traditional healers about common mental disorders and treatment options could have a significant impact on people living with untreated mental health problems, said Dikobe-Kalane, especially considering our country’s limited public sector psychiatric facilities. However, she cautioned that treatment for severe mental illness should be left to Western practitioners.

“There is little evidence that traditional healers have an impact on treatment of severe mental illnesses such as bipolar and psychotic disorders. This is why collaboration between traditional and Western practitioners is needed – to ensure that they understand each other’s roles and cultures, and are able to refer treatment-resistant patients to alternative modes,” she said. 

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Compiled by Zakiyah Ebrahim

The US research contradicts previous findings and recommends other steps to reduce the risk of STIs.

Driving while high on marijuana can be as dangerous and illegal as driving drunk, but unlike alcohol, there’s no way to detect dagga on your breath.

That could change, however, as University of Pittsburgh scientists are working hard to develop a breathalyser that can measure the psychoactive ingredient in marijuana. Although the technology may work, many questions must be answered before police start checking drivers.

Stoned behind the wheel

“We envision that this sensor can be produced as a breathalyser like an alcohol breathalyser,” said lead researcher Alexander Star, a professor of chemistry and bioengineering.

As more US states legalise marijuana, it’s likely more drivers will get behind the wheel stoned.

Since Washington state legalised marijuana in 2012, the number of drivers involved in fatal crashes who tested positive for marijuana rose from 8% in 2013 to 17% in 2014, according to the National Conference of State Legislatures.

Since current testing relies on blood, urine or hair samples, it can’t be done in the field when a driver suspected of being high is pulled over.

Using carbon nanotubes, however, Star’s team has found a way of detecting tetrahydrocannabinol (THC), the ingredient in marijuana that creates a high, in a user’s breath.

These hollow nanotubes are 100 000 times thinner than a human hair. The electrical components of molecules in the breath bind to the tubes. Since different molecules bind at different speeds, the type of substance, including THC, can be detected.

Tests need to be done

Star said these sensors can detect THC with the same accuracy as mass spectrometry, the gold standard for detecting it.

So far, the device, which resembles a breathalyser used to test for alcohol, has only been tested in the lab, using breath samples that also contained carbon dioxide, water, ethanol, methanol and acetone.

Before the device can be made available for use by police, it will have to be tested on hundreds, if not thousands, of people, Star said.

Right now, unlike alcohol, no standard for THC intoxication exists or is written in any state driving laws. Setting a standard for how much THC is too much is a job for medical professionals, not chemical engineers, Star said.

So don’t expect to have your breath tested for marijuana anytime soon.

Paul Armentano, deputy director of NORML, which advocates for the legalisation of marijuana, said establishing a standard for THC intoxication is no simple task.

Levels of impairment

“There is zero scientific data addressing the question of correlating the detection of THC or its metabolites in breath with psychomotor impairment, nor am I aware of any serious scientific investigations that have sought to do so,” he said.

Experts, such as AAA and the National Highway Traffic Safety Administration (NHTSA), oppose imposition of such a per se limit, Armentano said.

“Some researchers and the NHTSA have observed that using a measure of THC as evidence of a driver’s impairment is not supported by scientific evidence to date,” he said.

Moreover, studies haven’t been able to consistently correlate THC levels with levels of impairment, Armentano said.

“Ultimately, if law enforcement’s priority is to better identify drivers who may be under the influence of cannabis, then the appropriate response is to identify and incorporate specific performance measures that accurately distinguish cannabis-influenced drivers from those who are not, and to prioritise greater officer training in the field of Drug Recognition Evaluators,” he said.

The report was published in the journal ACS Sensors. Star is its editor-in-chief.

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