Smoking shisha; is the WHO right?

I have decided to write an article because I had once been asked to smoke shisha, being insisted that there were no health implications involved and shisha was essentially the perks of smoking without the drawbacks, such as the continuity of use being able to possibly cause lung cancer! My decision to write this article was also perhaps encouraged by the growing market of shisha, which to has seen roughly a 210% rise in the number of cafes offering in since the smoking ban was implemented in 1 July 2007, as reported by the Independent. Moreover, there were 179 shisha bars in 2007 but there were 556 in 2012. So I now will begin writing a little bit of what I know to do with this subject.

“An oriental tobacco pipe with a long, flexible tube that draws the smoke through water contained in a bowl” describes ‘hubble-bubble’, ‘hookah’, ‘waterpipe smoking’ and any other alias the infamous shisha tends to spread under. First discovered by Abul-Fath Gilani according to popular belief, the upcoming craze originated from the humble, and likewise, booming country that used to be Persia; India – though this is said to be a disputed merit.

Shisha, often written under as a safer alternative to cigarettes, is a ‘glass-bottomed waterpipe’ which emits radiant fruity smells of your desires. But, surprisingly, for such a simple task of smoking, shisha requires a rather sophisticated device, inclusive of many components from grommets to diffusers. Thus, there is already a physical distinction from its cigarette counterpart. However, it is from the water jar where, unsurprisingly, most of the common misconceptions about shisha arise.

So the misconceptions, which are often seen as a major contributor to why shisha has become increasingly popular since the noughties, become intriguing as a blur between fact and fiction becomes visible. The first main myth to this tobacco craze would be the bubbling water creates the illusion of the smoke being cleansed and purified thus apparently being made healthy. Although, in reality the water, bubbling it may be, does not filter out all the toxins and the fruity smell is only the guise for the smoke which contains the otherwise cancer causing chemicals. Dr Sellehudin Abu Bakr even goes as far as to call the water ‘filter’ a ‘gimmick’. Additionally, passive smoking can be dangerous as it can be the smoke and its composition which causes harm. In the smokes composition exist an addictive substance: nicotine, which can cause a dependence upon this social commodity which increasingly seems harmful. Unfortunately, this is not where the problems end, as sharing a mouthpiece increases the risk of infection with TB or hepatitis, both of which come with disastrous implications.

As a result of public unawareness, the World Health Organisation (WHO) had, from their research published as ‘Waterpipe Tobacco Smoking’ in 2005, which found that, contrary to ancient lore and popular belief, the smoke of shisha contained many toxicants which can cause lung cancer, heart disease and can have other detrimental effects to your body. The WHO also came to the conclusion that 1 hour of smoking shisha is equivalent to up to 200 cigarettes worth of smoke, and this isn’t particularly ‘good’ smoke as the heat sources for shisha are often cinders or charcoals. These are dangerous as they release carbon monoxide.

Additonally, shisha delivers nicotine which as many of you may know, is an addictive substance. Despite the water absorbing some of it, it still enters your body in substantial amounts, so much so, that it can cause addiction, like other tobacco products. The study also highlighted the dangers of second-hand shisha smoking. So by even entering a shisha bar where others are smoking, even by not smoking yourself, you can still be endangered. Also, another important note to focus on is that in this research, they had showed shisha, like cigarettes to contain the capacity to have an adverse effect on the unborn baby during pregnancy. So by smoking shisha, one can potentially harm their baby.

Therefore, one must ask the question on whether smoking shisha is really as harmless as others advocate. In light of the WHO research, it becomes increasingly clear that there are dangerous aspects to this craze, but the research isn’t conclusive enough, many seem to argue. Thus, in order to really clear the misconceptions surrounding shisha, more research needs to be carried out.

Ultrasound Scan Objective

I would like to start by saying that I am sorry for having disappeared for the past couple of months due to exams and UCAS, but hopefully I can write more often now .

On my recent work experience at BRI I was fortunate to be able to shadow a sonographer and so thought I’d share my experience.

Ultrasound is a form of energy using high frequency soundwaves to produce an image. During my time in ultrasound many abdominal cases and a madible case was seen. These involved gall stones, mass, focal lesions and lymph node in the mandible.

A gel medium was required in order to improve transmission of soundwaves. The speed of this sound varies depending on the medium density and compressibilty. Without the gel the soundwaves would have to travel through different densities; through air and then through soft tissue.

Even though ultrasound does not give off radiation, it still may not be as safe. The bioeffects of ultrasound are heating and cavitation. The beam is attenuated as it passes through tissue therefore energy is lost. This energy is absorbed and converted into heat. This can cause over heating of any microbubbles which may be present within organs. Changes in pressure of the beam may cause the microbubbles to oscillate in size and cause tissue damage. However, ultrasound has not yet been proven to be unsafe.

Ultrasound soundwaves cannot pass through bone so only the outer surfaces of bones will be shown, and what is within the bony structures will not be shown. Another limitation is large body habitus and if there is more gas than bone present. Because of these limitations other modalities such as CT, general X-RAY and MRI have to be used.

idoctor says hello!

Well where do I begin…. this is my first post on the blog so I just want to say a little hello an introduce myself to those who read this blog and other writers. A lot like many of you I am an aspiring medic. I applied last year with one interview which was unsuccessful so without a doubt will be trying again for 2013. Received my a level grades 2 weeks ago, big smilees 🙂 🙂 🙂 which also showed me how much I want to study medicine. Being quite an academic person I have always been told that I can do whatever i want and that ‘the world is my oyster’. easier said than done 😉 well ill keep it short and simple… hoping to try new things during my gap year, and blogging being one of them, i thought this would be a great way to write about things that interest me whilst trying something new. I’ll try to post every week and talk about different topics in the medicine world that I find most interesting and most important and i’ll also keep you upto date on my application to medicine ..take two 😉

Getting into Med School

So, I’m a bit confused about the system and its effectiveness. I know many people who received amazing A-Level results, you may be one, but have not got a place at Med School. We have experience, grades, volunteering all under our belt yet every year it seems average student nick the exceptional students places.
This was recently in the news as well, how this system is not effective. Other countries operate in that students apply after receiving their grades, as university begins later. Surely this is a better system.
But none the less, every opportunity should be seized. If like me you’ve found yourself on a gap year, lets make the most of it and gain as much as we can from it.
– Rabia

Medicad’s first post

Hi everyone,

This is my first post as a contributor to the Valuemed blog. I am a mature student about to embark on a pre-medical course, hoping for entry to medical school in 2013. I have always been in awe of the ability doctors have to diagnose and treat patients. Being brought up in a family with a history of depression and autistic spectrum disorders was challenging, but it made me appreciate how illnesses can affect patients in different ways. I’ve always made it my aim to try and change the lives of people suffering, because I can understand how difficult it is for themselves and their loved ones.

I have experience of working with a wide range of people in different settings – I am a keen volunteer. I’ve previously been a trustee for a youth organisation, and I’ve more recently become involved with St John Ambulance and King’s College Hospital. In addition, I have undertaken clinical placements at the National Society for Epilepsy and at the Ophthalmology department of Stoke Mandeville Hospital.

The branches of medicine that interest me and will feature in my future posts, alongside current medical news and my experiences as an applicant, include neurology, psychiatry, infectious diseases, preventative medicine and medical genetics. I am hoping that my posts will inform, engage and perhaps inspire, as I set out to expand my knowledge of such a dynamic field.

Until next time,


Hello Everyone

My name is Rabia and this is my first post. I hope to build a relationship with all of you so here’s some information about me. I am 18 years old and have just left school after completing my A-Levels and attaining A*A*A (Biology, Chemistry and Geography.) Like many others on here, I too am a prospective Medical student. After failing to gain a place in the 2012 cycle I am about to embark on a gap year and then re-apply. Why do I want to study Medicine? Is the trickiest question for me. It’s something I can’t put into words. Maybe its the rush and excitement I’ll get every single working day. Or maybe the fact that I am genuinely helping and saving people. Or maybe its the fact that I’ll be applying my favourite subject, Biology, every day.

Joining this blog is my way not only to share what I feel but to indulge in research, in the latest medical topics or areas of interest to me to hopefully put across my excitement and enthusiasm to the readers. What better way to learn than to teach others?

I have followed Doctors in a Hospital where I observed the workings of a ward round, basic examinations conducted and of course key skills and qualities such as teamwork with other doctors and nurses, politeness towards patients and the ability to always have a smile on your face. I was lucky enough to be involved in a private consultation informing a family member of a patients severely deteriorating health and almost confirmed death, which I will always remember. Similarly I have had experience in clinics, pharmacies and a dental practice. (The dental placement however, I can say was my least favourite…)

So what about my gap year? I’m going to continue with my voluntary work which I’ve been doing for 2 years now at a local Hospital which goes to patients in wards to sell newspapers and items. I’m also beginning another volunteering opportunity with disabled people. More work experience is to come but first and foremost I need to re-take the dreaded UKCAT and find a job!

– Rabia

Introduction from a guest blogger applying for medical school

 Hi everyone its hanifz here,

I am a new guest blogger on this site and thought I’d introduce myself. I am currently studying a Biomedical Science Degree at university and am planning to apply for medicine this year. I hope to study medicine as I have always been fascinated by the human body and how intricate a system it is. I have chosen to write for this blog so that I can talk about the medical world and all that intrigues me about it. As well as allowing me to gain a greater insight into it.

In medicine the area of most interest to me is oncology, in particular working in paediatrics. The idea of helping people with one of the most life threatening diseases is a huge draw for me. In addition, the fact that there are so any variations of cancer means it is an area that will continuously test me. In preparation I have undertaken work experience in a local hospital and nursing home to gain an understanding of how medicine works in reality.

I hope to write many more posts in the future. Thanks

Applying to Medical School -CRB checks, entrance exams, work experience & A level grades

Applying to medical school these days is so much more complicated than it was in my day and more costly.

I have just been chatting to an A level student who is hoping to go to medical school this autumn and is currently sitting his A levels. He was tellling me he has two offers from UK medical schools that he has accepted and that both have asked for a CRB check to be performed (this is routine for all medical schools in UK now I think) and that he has already had one done for his first choice medical school at a cost of £44, and that he has asked the second medical school if they will accept the first CRB check performed about a month ago, but they have advised him that it must be done again as they like to have their own CRB done. So he has to stump up another £44. Last year he also had a CRB check done for his voluntary work-so in last 12 months he will have had three CRB checks.

Prior to applying to medical school he also sat several medical school entrance exams all iniated & funded by himself, attended multiple open days under his own steam & funding, attended for interviews and bought books to help him prepare for these exams. I heard recently on the news that the government was trying to make medical school more accessible to students from comprehensive schools. The costs to him of all this has run into several hundreds of pounds. If he was not incredibly determined and supported by his family I think he may well have given up. The state school he attends does not take students to open days nor help them prepare for entrance exams.

In my day it was so much simpler for students from state schools. I attended our local comprehensive school.Then you simply got reasonable O levels, studied science A levels& decided to apply for medical school. If you were really keen you did a bit of voluntary work or work experience ,but this was not obligatory as it seems to be now. I attended no open days nor sat any entrance exams. You were called for interview and if successful you got an offer & as long as you got reasonable A levels you got in. My offer from medical school was an A and 2 Bs , my husband also coming from a comprehensive school got an offer from same medical school of  3C’s. Medical schools seemed to have far more discretion in our day on what they offered students. They must have been realy impressed by my husband at interview as 3C’s was a very good offer although not uncommon-a friend of mine who applied from the same comprehensive school as me got a 3C’s offer from a London medical school). These sort of offers from medical schools in UK are unheard of now and the 3 As seems to be the lowest offer you are likely to get with many now asking for at least one A* this year.

Now you have to get outstanding GCSE’s (ideally all A’s and A*) and be predicted to get all A’s and even some A* at A level. You also have to attend open days, do voluntary work, gain work experience in medicine,  sit entrance exams for many , write an amazing personal statement, attend for interviews, all the while making sure you get outstanding AS levels and work for your A levels. Talk about pressure ! How many students in the state sector are actually going to be able to achieve all this under their own steam and with no help or funding from their schools. How will students from low income families afford to do it ?

Applying to medical school – Where do I start?

Both of my parents went through UK medical school and went on to become GPs and their accounts of the application process made it seem frankly easy, indeed my dad got in with A level grades: BCC. So I relaxed myself on the notion that I would get in with no trouble at all – what could have changed in just 30 years?

How wrong we were. Competition for places has increased so dramatically, with nearly all applicants with at least AAA at A level and a long and impressive list of both work experience and voluntary work in the medical related field. Ive been told that they don’t even consider you unless you`ve done a lot of voluntary work.

Im currently in Year 12 so will be entering university in September 2012 and applying in a couple of months. I have at present done no work experience or voluntary work in the field, except for the work experience I did through school which was at the local dentists – so slightly related. So I went onto the  – which is an absolutely fabulous website and Iive now got an interview tomorrow to see whether I’ll be suitable for a voluntary placement with a charity that looks after people who have just been discharged from hospital. So all smiles on that front.

As for work experience im hopefully going to do some over the summer holidays. My parents are no longer GPS but my uncle is a consultant at Edinburgh hospital. So theres a possibility I might be able to go there. If not I might just go to our local general practice.

Now onto another aspect of application – entrance exams. The medical schools I wish to apply for are: Oxford (would be absolutely lovely to get into this one), Imperial, UCL, Durham and Liverpool. I was going to apply to Warwick but I dont think they accept undergraduates for medicine. Now for Oxford, Imperial and UCL I need to sit and do well in the BMAT, whilst for Durham I need to sit the UKCAT and Liverpool mercifully requires no entrance exam. When researching this I thought for a while that I was also goiug to have to sit the 6 hour GAMSAT exam, but thankfully thats for graduate entry only. The BMAT seems quite easy, but the UKCAT has some really bizarre sections in it, one requires you to interpret codes and the other is abstract reasoning. Anyway I’m sitting that in July and have bought a practise book.

I havn`t even considered interviews yet – that will be a future hurdle.