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The Doctor's Consultation

Care for Dogs

Agony Column

Camera Class by Snap shots

Money Matters

How does your garden grow?

The Doctor's Consultation:  by Dr. Iain Corness

The diet for gout sufferers

A few months ago I covered a diet for dentures. This week it is a diet for those with gout, and there are far more of you than you might imagine. If you are a sufferer, then you join with Henry VIII, Benjamin Franklin and Thomas Jefferson.

It is indicated in around five percent of all cases of arthritis and is present in around three to five percent of the population, with males outnumbering women around nine to one. Afro-Americans and many Asian races also have higher incidence than Caucasians.

Gout is, in its simplest fashion, a recurrent form of arthritis, and which generally affects just one joint - most commonly the joint in the big toe. This arthritis, or inflammation, occurs in association with high uric acid levels in the blood, and is described as ‘exquisitely painful’.

It is a condition that is still being researched, and there is still no complete agreement on the preventive treatment for this condition.

The higher the concentration of serum uric acid (SUA), the more likely you are to get an acute attack. The ‘normal’ range for SUA is taken as less than 0.42 mmol/L (called ‘milli moles’ per liter), but if your concentration is 0.54 mmol/L then you are five times more likely to get gout.

Basically what happens is that with high concentrations of uric acid it crystallizes out into the joint, leaving very sharp, needle-like crystals crunching inside the articular surface of the joint. Very painful!
The typical gout sufferer is male in his 50’s, overweight, with high blood pressure, carnivorous and consumes large quantities of alcohol. Is that you?

Gout affects almost four million men in the USA. It has long been thought that purine-rich foods and a high protein intake are risk factors, and sufferers are advised to avoid meats, seafood, purine-rich vegetables, and animal protein. But this advice was based more on the theory of how excess blood uric acid can occur, rather than actual clinical studies.

One of the newer studies began on over 50,000 men from health professions in 1986. Food-frequency questionnaires were sent out at baseline, and in 1990 and 1994. Weight, medications, and medical conditions were recorded every two years.

The participants were assigned to groups according to the total intake of meat, their consumption of seafood, purine-rich vegetables, dairy products, low-fat dairy products, total protein, and animal protein.

During the study, there were 730 new cases of gout during the 12 years of low-up. Most of them were aged 55 to 64.

When total meat consumption was analyzed, the risk of acquiring gout was 1.41 times greater in the high meat eaters; in other words, eating more meat was a risk factor for gout. Similarly, high seafood eaters were 1.51 times as likely to develop gout. (Grass should be fairly safe to eat!)

In contrast, gout was less common in those taking more dairy products. Men who drank two glasses a day of skim milk, or ate a serving of low-fat yogurt more than twice a week, halved their risk of developing gout.

In this study at least, purine-rich vegetables, and total protein had no influence on the chances of getting gout.

This large study confirmed that a diet high in meat and seafood increases the likelihood that a susceptible person will develop gout. It also showed that milk proteins increase the excretion or uric acid in the urine.

So, to avoid developing gout, try to limit your intake of meat (beef, pork, lamb, and offal) and seafood, while increasing your intake of low-fat dairy produce (skim milk, yogurt).

This is all very important, as the long term outlook is not good for the unrepentant gout sufferer. Constant high levels can lead to uric acid ‘stones’ being deposited in the kidneys (producing renal problems) and even discharging lumps (called ‘tophi’) around joints, on the forearms and even on the outer ears. Really a most bleak and depressing future, and not one I’d like to have.

Note too, that it is low-fat milk that is being proposed, as high fat milk introduces the cholesterol problems again! It really is a fine line that we must all tread!


Susy is special

Susy is blind. She comes under the category ‘Dogs with Special Needs’ but really she just needs a warm bed in cold weather, a shady spot in the hot months, fresh water close by, some nice food, and someone who cares enough to give her all these. Contact the shelter English (08 47 52 52 55) or Thai language (08 69 13 87 01) to make an appointment to meet her.

Heart to Heart  with Hillary

Hi Hillary,
I met my Thai wife in a bar in 2004. We are married and living in the USA. We will move back to Thailand soon. She speaks very good English now, and I speak better and better Thai. She works here in the US as do I. We are, and have been very happy. She has become an expert skier as we live in the mountains. Wonderful girl! She is 31 and I am 68!
R & N

Dear R & N,
Well thank you, Petals. It is good to get the other side of the coin flipped, even if it is generally in the minority. I am glad to see that your Thai wife has also used the six years to learn some new skills, such as English and skiing. However, I hope that you just watch, I think you’re just a little over the limit for snow skiing, even though you are not too old for some of the other exercises! And think of this as an advantage, when she turns 60 and gets the pension, you will only be 97.

Dear Hillary,
I have been married to my Thai wife for eight years and together for 10 years. We don’t live in UK but KSA, in fact my wife loves the Middle East, as I do, and we have worked very well together here. We go on hols to Thailand three times a year and occasionally visit UK and other countries. I am a very happy man and I know I have a diamond.

Dear Homer,
Yours was the second email on this subject to come in on the same day, dealing with the same situation, and at first I wondered if you were the same person as the letter above yours. However, living in KSA you are not likely to do much skiing, other than sand slides. I am pleased to hear that your marriage has been made in heaven, but you did not say how you met your little diamond, who is not a cubic zirconia. Knowing that might be an example for all the love-sick swains who write to me. All the best!

Dear Hillary,
My Thai GF no sooner finishes eating than she’s ready to go again. She’s as thin as a rake, but eats all the time. Her mates are all just the same, finish one round and they’re ready for the next. It gets me, I go out after the third course. What’s the secret, Hillary?

Dear Wondering,
Is that “wondering” or “wandering” I wonder? What do you do between courses four and five? No, Petal, eating is more than just a meal for your Thai GF, it is a very social time when friends can get together and share the food. That can occur at any time of day or night, but the food they eat, such as the favorite som tam is not high in sugar and calories, so that’s why your GF remains thin. The chili also hurries the food through the system. As the TV program warns, “Don’t try this at home!” The real som tam can be far too spicy for foreigners.

Dear Hillary,
Everybody must know by now if they read you column that there is a difference between the girls who work in the bar and the girls who work in regular jobs. What you say is for us to look for female company from the regular job girls. What you don’t say is that the regular jobby ones can’t speak English, are difficult to meet or get to know, while the ones who work from the bars can speak English and are easy to meet and are easy to get to know. For my money, give me the bar girl every time.

Dear Frank,
How astute of you, my Petal! Yes, there are great differences, and even more than the ones you mention, even such things as educational level. If all you are looking for is some female company, then the bar is the right place, but the problem comes when the customer (guys like you) then falls in love with their English speaking, easy to meet and know girl, and forget the fact that they are customers, not boyfriends. Thai girls do not choose to work out of a bar unless they are looking for quick money, without having any necessary qualifications to put them in high salary jobs. They are using their looks, their (presumed) sexuality and their ability to get money from their customers. You are paying for a commodity by meeting the fees demanded. When you fall in love with someone who is used to being fully paid for, the relationship is not really on the emotional plane, but in the financial one. And like all business deals, you can get burned. And many like you do. As you wrote, “For my money, give me the bar girl every time.” And that’s what it is, Petal, your money and you are entitled to spend it any way you please, but don’t complain if you find it has all gone, and the girl’s “affections” with it. There is a phrase in business called ‘due diligence’. Apply it, Petal.

Camera Class:  by Harry Flashman

How to get ‘professional’ pictures

Like all things in this life, practice makes perfect. It is the same for photography - the more photos you take, the better you become as a photographer.

Sometimes I find some old photographs that I took as an enthusiastic amateur, and I am sorry to say that there are very few that I am proud of. The concepts I explored were good. The delivery of those concepts was not.

I have written before about how a friend delivered a very expensive camera outfit to me on his return from an overseas trip. I had asked him to enquire how much the Hasselblad cameras were in the duty free stores, but he decided that I had empowered him to buy one on my behalf. In the long run that was a good decision, but in the short term it was a huge financial drain, just when I didn’t need it. It was at that moment I decided that the Hasselblad was going to have to pay for itself. And if it were to bring in money, it meant I was going to have to become good enough to charge for my photographs.

The next step in my photographic career was to go to all the bookstores and purchase books on photography. Initially I was selecting ‘how to’ books, especially those which gave examples of photo projects. These I devoured until I could reproduce the results that professional photographers like Michael Freeman explained in his instruction books.

After that I began to give myself my own project subjects, imagining, for example, that I had been hired to do the photography for a catalogue of artificial flowers. I had a friend who did import these, so it was not too difficult to borrow some for my own photo shoot.

In this way I learned to shoot to a layout and was able to size the photo illustrations to fit. I also, from the books, learned how to set up a small studio at home in the spare bedroom. Rolls of background papers were found and the catalogue items photographed against them. I had no expensive flash heads, but used internal reflector tungsten lights. I very quickly learned how this changes the overall color of the shot, and how by using blue gels I could correct for the overly warm tones of the tungsten lighting. I also learned to be critical of my own pictures.

By this stage, I began to give myself projects to be photographed outside. These were mainly “advertising” style of shots with models in some physical setting, looking like a fashion style of layout. Fortunately there were enough amateur would-be models wanting to parade in front of the would-be photographer’s lens in return for a few prints. We all learned together!

I also began to learn to use shadow, instead of bathing the models in floodlight (or the sun). All of a sudden, my shots began to have an air of mystery and were starting to look professional, as well as now having a 3D look to them. Shadow is the photographer’s friend!

Eventually I was ready to present my work as a professional, and to do this you place your best shots together, which is called your ‘book’. This is not a real book, but should show your work in the best possible way. The local photographic equipment store showed me some ‘books’ belonging to semi-pro shooters and I made the decision to present only transparencies (slides), but a minimum of 6x6 cm (the Hasselblad size, otherwise known as two and quarter inch square), with the rest 5x4 inch. This made it look as if I had a 5x4 camera, which I didn’t, but the Hasselblad transparencies were sharp enough to be duplicated and enlarged (known as ‘dupes’ in the trade).

I bought a portable light box, mounted all the transparencies on heavy dark card so that they could be thrown on the light box for viewing, and I was ready to meet the art directors - the people from the ad agencies who dole out the work to the photographers. Eventually one gave me an assignment, and I went on from there. Get one and the rest are easy.

Money Matters:  Paul Gambles MBMG International Ltd.

The New World Order, part 1

In times gone by, investors always believed that it the only way to run a portfolio was to have a 70:30 ratio of equities and bonds - in that order. This method of investing should now have gone the way of the dinosaurs. There is a simple but effective way of investing these days and that is going with multi-asset, multi-manager funds. However, what the canny investor needs to also do is see how the manager of these funds decides which funds to use.

Up until recently, the average investor always assumed that the Emerging Markets were very much a large rick area and so only a small weighting of a portfolio should be dedicated to them. However, over time it is these Emerging Markets that have saved portfolios on many an occasion although I am the first to admit the ride could well have been more than a tad bumpy.

It is because of these potential returns that more and more people are now looking at the Emerging Markets with more interest. Up until now, as stated before, these were only a small part of anyone’s investment. However, the problems of the old traditional western markets that have shaken the more established markets to the core have persuaded people to look elsewhere for their returns. As one fund manager at Miton recently said, “Many investors (are looking) to reassess both the absolute risk associated with emerging market investments, as well as the risk relative to other asset classes, especially previously perceived safer developed market assets.” He also went on to state that, “We have been gradually increasing our exposure to emerging markets … over the last 12 months.”

The other piece of good news for new investors is that it is becoming much easier to actually invest in this particular asset class. Also, liquidity is getting better as many funds are no longer asking people to tie their money up for a certain length of time. One caveat to this though is that it is difficult to discern if these Emerging Markets are getting more attention because of the fact they are more accessible or if it is just they are receiving more interest because of more investor demand.

These days there are loads of investment trusts, open-ended funds and Exchange Traded Funds (ETF), etc., which are available to investors. These offer the possibility of investing in index trackers, equities, bonds, commodities, property and currencies which are either hedged or not as the case may be. Also, potential investors can also dip their toes into the Emerging Market scene by putting their money into companies which are in major indices such as the Dow Jones or FTSE. This indirect approach by the more cautious investor will allow them to access what is developing in the world of Emerging Markets whilst at the same time allowing them to deal with companies that use well known, transparent and accepted western business practices.

Why is there this new interest in Emerging Markets as an attractive asset class? Simple. The economic outlook for these places seems to be a lot more favourable than the actual developed markets and good looking economic fundamentals show a healthy state of affairs for risk assets.

Naturally, there have to be some concerns. The politicians and economists in charge of the Emerging Markets must be careful and they have to ensure their countries respective economies do not overheat as this could create pressure on local interest rates. This may create a dilemma for the potential investor as he/she knows the returns could be a lot more than the older markets but then so is the risk. However, there has been a great improvement over the last ten or so years with excellent Finance Ministers like Korn Chatikavanij, who won "Global Finance Minister of the Year" from The Financial Times' Banker magazine last year, leading the way.

So, why are things looking so rosy for the Emerging Markets and developing countries? Two very important factors are population growth and productivity. Much of the developing world is benefitting from the former and good demographic trends - an expanding working age population which has come from urbanization and natural evolution. This means more and more young people are starting to join the workforce. Goldman Sachs have recently calculated that in India, the demographic trends will contribute four percent of annual Gross Domestic Product by 2020.
To be continued…

The above data and research was compiled from sources believed to be reliable. However, neither MBMG International Ltd nor its officers can accept any liability for any errors or omissions in the above article nor bear any responsibility for any losses achieved as a result of any actions taken or not taken as a consequence of reading the above article. For more information please contact Paul Gambles on [email protected]

How does your garden grow?: By Eric Danell,Dokmai Garden

Hog Plum

The hog plum (Spondias pinnata, ’makok’) is a tree native to the dry savanah-like forests surrounding Chiang Mai. It is sometimes called ’Thai olive’, but that is a confusing name. The fruits of the hog plum resemble quail eggs, greenish with dark blotches. They can be seen in the Chiang Mai markets from December-February. The fragrance is quite appealing, fruity, but when you bite a fruit you will have an astringent sensation, not very pleasant, at first. One or two seconds later, the initial flavours degrade, resulting in new flavours, which in turn degrade, resulting in another wave of flavours. There is also a peculiar oscillation between swetness and acidity. The Thai family Seehamongkol like to stock this fruit in the freezer when available, so they can use it in their Esan-style papaya salad all year round. The flowers and the young leaves are edible too. The wood is soft and not termite resistant.
The tree itself is a member of the mango family (Anacardiaceae). It grows quickly, and does not need any special attention, being well adapted to our climate. The bark of young trees is quite lovely, silvery and wrinkled, like the skin of an elephant. The leaves are compund leaves with many leaflets. Without water the tree sheds the leaves like so many other local monsoon trees.
The other member of the Spondias genus native to Chiang Mai is Spondias lakonensis (’maho’ in northern Thai). It has a coppery bark. An American forester visiting Dokmai Garden remarked that of all our trees, this was his favourite, due to the lovely bark. I was happy somebody noticed this tree, because sometimes I fear I dispaly plants without any audience. The fruits of this tree are edible too.