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Dr Bhiku Pattni appointed on the Primaray Care Trust Board

Congratulation to our ‘in house’ Doctor Bhiku Pattni on his appointment as the member Primary Care Trust,  the think tank body that advices the National Health Service in UK. The Professional Executive Committee (PEC) is an important part of a Primary Care Trust. The function of the PEC is like a think tank. It is there to assess needs, examine practice and formulate policies for the PCT around clinical development. These are then put to the Trust Board for approval.

Dr Bhikhu Ladhabhai Pattni is originally from Kenya where he studied his Medical Doctorate. He came to United Kingdom for his Post Graduate training. He is now residing in Birmingham, UK where he is a General Practitioner for past 15 years.

Apart from his several hobbies and interests, he is very active in Community projects.  On the broader front, he had been invited several times by the local BBC radio to talk in Gujarati about various current medical topics.Members will find his first article on Meningitis informative and educational.

Pran C. Arjan
Editor for

Following are Dr Bhikus Articles:


Diabetes or to call it by its proper name, Diabetes Mellitus, is a rising public health issue. There is now evidence that we are in the throngs of a rising incidence of diabetes in the population and in particular the rise in the south Asian community is exponential. There are numerous reasons for this and we shall go into this in due course.

However the important message for this first article is identifying those at risk of developing diabetes. This is the first step. Evidence suggests that even to this date a significant number of diabetics are not being diagnosed. It is now known that early diagnosis and control by proven treatment and advise can significantly reduce the complications of the disease.

So who should be screened and who should consider themselves at risk of developing diabetes?

If you are of South Asian origin, the risk is multiplied ( figures vary from fivefold to tenfold as compared with Caucasians or north Europeans). Current data suggests that the incidence in South Asian community may be as high as 10 to 15 percent of the adult population!

If you have a first degree relative who has already been diagnosed with diabetes.

If you are overweight (in the next article I will go into how to calculate something called Body Mass Index or BMI which can tell whether one is overweight or not)

If your girth (that is the waist circumference) is greater that your chest circumference particularly in the male or the waist circumference exceeds 36 inches.    

Remember the above are pointer to determine risk of developing diabetes. If any of the above applies to you then consider asking your doctor or your practice nurse to screen you for diabetes. Do not delay. The test is free under the NHS and most doctors would oblige if you fall into the above category.

In subsequent article I shall discuss and highlight a condition recognised as pre diabetic or sometimes called "Abnormal glucose tolerance test".

The next article we shall look at the general lifestyle issues that are contributing to the rising incidence of diabetes.

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Flu- Avian Flu

Influenza or “flu” has been in the news lately. Its not that flu is a new disease that is threatening the mankind. Indeed we have known the flu virus for many centuries!

This short article is an attempt to shed some light on the current worries about the so called bird or “Avian” flu. Importantly for most people the flu that they are most likely to come across is the seasonal flu that we see in this country in winter (namely October to March every year). We know a lot about the seasonal flu virus that affect us every year.

The following information will help to answer some of the questions you may have about flu.

Influenza is a virus which causes a severe form of respiratory tract infection with generalised bodily symptoms. It spreads around the world in epidemics and is responsible for much ill health as well as many deaths.

Symptom of seasonal human Influenza

If you start to develop cold symptoms but starting more rapidly and rather more violently, with higher fever and severe aches and pains, often in the back and muscles, then you may well be developing influenza. This may be associated with severe headache, cough, and, as a result of the fever, intermittent sweating and shivering. Sometimes there is a gastrointestinal element, with vomiting and/or diarrhoea.

Many people think they have had "flu" when all that they have suffered is a bad cold. When you have influenza you will know the difference. Most people will find it impossible to leave their bed and feel terrible and feel very ill.

The worst symptoms usually last for three to five days, and then should begin to improve. It is common to need two to three weeks off work as there is considerable debility left after the feverish illness is over. Do not be surprised to be quite depressed, this is a natural after-effect of the condition.

Influenza makes everyone feel terrible, but most people recover. However it does have a small but significant mortality, especially in the very young, the very old, and those with poor immunity.


Influenza is caused by a virus which attacks our body's cells, resulting in various effects depending on the strain of the virus.

The virus mutates all the time and new variations (strains) arise. Unfortunately immunity against one strain (which is conferred by exposure or immunisation) does not protect against other strains. In the era of rapid air transport the worldwide spread of a new type of influenza can be extremely fast.


Diagnosis is largely based on the severity of the condition and the way in which it affects you (symptoms). It is possible to test body secretions for the influenza virus, but this is not usually of practical value as the test takes some time to show a result.


Until recently there was no specific treatment for influenza, and for most people it is still best to treat the symptoms in the old fashioned way:

Stay at home.
Drink plenty of fluids.
Take symptom relief with:paracetamol, aspirin (not in children under the age of 16),ibuprofen or other anti-inflammatory drugs to help with fever and aches and pains.If you are still hot, sponge down (or be sponged down!) with tepid water. Await natural recovery.

New Developments

There are very few treatments that work on viruses. Those that do work on influenza need to be given within 48 hours of the onset of the attack, before it is possible to be absolutely sure of the diagnosis, and only shorten and reduce the severity of the condition.

The other aspect of this is that they are only available on prescription, and if everybody with influenza were to see their doctor within two days of developing symptoms the healthcare systems in most countries, already stretched by an epidemic, would probably grind to a complete halt. Prevention, with influenza vaccine, is a far better option.

When to call the doctor

You should consult your doctor if symptoms such as clouded/altered consciousness, breathlessness, or severe chest pain occur, and if you are concerned. Try not to call just because of the temperature, aches and pains, and cough, as there is nothing your doctor can do that you can not, and what is more, there are likely to be many other people with similar symptoms, stretching family doctor, nursing and hospital services to the limit.

If symptoms continue unabated for more than a week, or if you seem to be improving for a few days then get much worse again, it is worth asking your doctor's advice.

Sometimes, during 'flu, a secondary infection gets in while the body's defences are down. This is most commonly a chest infection and can be a pneumonia. The secondary infection is often caused by bacteria, and as a result is likely to respond to an antibiotic.


This is the current preferred defence against the influenza virus. There are many influenza viruses, often named after places where epidemics have occurred. There tend to be only one or two which reach epidemic proportions each year. By monitoring the progress of these worldwide, the World Health Organisation (WHO) each year decide on the best "cocktail" of influenza types to be included in that year's influenza vaccine.

It is advised that people belonging to the following risk categories consider annual influenza vaccination. In the UK this is available free of charge from your doctor from October onwards.

High risk groups

There are various groups who are more at risk during influenza epidemics. These include:

people aged 65 or older

people who have poor immunity

people with conditions such as diabetes, lung disease (asthma, bronchitis), kidney disease, heart disease, or liver disease.

Other people who are not at such risk from influenza might choose to have the vaccination, but in the UK this is not routinely covered the National Health Service. Your employer may offer this as occupational health service or alternatively you can make a private arrangement with a doctor.

Avian Flu (H5N1 strain)

The link below lists the answers from the Chief Medical Officer of the department of health (DOH) given to the BBC and I feel anwers most of the questions.


1) Be aware of flu in general. Avian flu is not yet a worry in this country at present. Steps are being taken by the government and the health service to be prepared rather than take a wait and see attitude.

2) If you are not at risk and get the seasonal flu treat it as described above with symptom control medications.

3) If you belong to a group at risk make sure you have received your vaccination. If not get one as soon as you can.

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Mouth, Throat and Voice Box (laryngeal) Cancer -By Dr Bhiku Pattni


In this article I wish to bring to the fore an illness that seems to be increasingly diagnosed amongst the Asian community. The condition is Oro-pharyngeal Cancer. Its incidence (the rate at which new cases are diagnosed) is increasing. Worryingly, the increase is particularly high amongst younger members of the population.

Worldwide the incidence of mouth, throat and voice box (laryngeal) cancer is increasing. The increase is particularly worse in some south Asian countries including India, Bangladesh, and Sri Lanka. Worse still, the cancers are being diagnosed at a later stage when the disease has spread.

There is a general consensus by experts that while there is a genetic element that determines if an individual is susceptible, the risks of developing mouth and throat cancer increase substantially in those who smoke and drink alcohol. The risks are further increased in individual who smoke and drink alcohol at the same time. Many experts say that this is a disease linked to lifestyle.

Being of south Asian origin increases the risk. One of the reasons for this seems to be the habit of chewing paan and betel nuts. Betel nut (sopari) amongst others, contains a known group 1 carcinogen (substance which have been proven to be cancer causing).

Mouth and the throat area of the human body have many important and vital structures. So when this form of cancer spreads it can cause havoc and devastating results.

In this article my message is to try and prevent the cancer in the first place by adopting sensible lifestyle. If one is unfortunate, then the second message is to try and get early diagnoses so that the outcome from treatment is better. Because the mouth and the upper end of the throat is directly visible it is possible to be vigilant and by following the advise in the box below early professional opinion is recommended if you notice any of the symptoms mentioned.

The following lifestyle advice is particularly recommended to minimize the risk of getting oropharyngeal cancer:

1. Not smoking or chewing tobacco, gutkha or paan, particularly, not on a regular habitual daily use basis.

2. Limiting alcohol consumption and in particular not drinking alcohol at the same time as smoking.

3. Having a healthier, balanced, "low meat, low fat" diet, rich in vegetables and fruit with servings of cereals or beans everyday. Include nuts and seeds in your diet. 

The table below lists symptoms that you should take particular notice and consult a health professional (i.e. your doctor or dentist)

1. A sore or ulcer in the mouth that does not heal within three weeks

2. A lump or overgrowth of tissue anywhere in the mouth

3. A white or red patch on the gums, tongue, or lining of the mouth

4. Difficulty in swallowing

5. Difficulty in chewing or moving the jaw or tongue?

6. Numbness of the tongue or other area of the mouth

7. A feeling that something is caught in the throat


8. A chronic sore throat or hoarseness that persists more than six weeks, particularly smokers over 50 years old and heavy drinkers

Swelling of the jaw that causes dentures to fit poorly or become uncomfortable

10. Neck swelling present for more than three weeks

Unexplained tooth mobility persisting for more than three weeks - see a dentist urgently

12. unilateral nasal mass / ulceration / obstruction, particularly associated with purulent or bloody discharge

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Nutrition and Health: Articles coming soon.

Health & Nutrition and Education pages are added to this site, please send your articles as the page is regurarly updated.

We will be introducing Youth Newsletter soon, therefore if you are interested then please submit your full details with articles that you would like to appear on youth newsletter to the Editor.



©Pattni Connection International January 2007.