AMERICA AT LARGE: For the benefit of Dr Vladimir Klitschko, here's this morning's medical school factoid: An elevated blood-sugar level can be caused by several different things, and some of them are even dangerous. But it can also be caused by, well, sugar.

After wilting before Lamon Brewster's fifth-round onslaught in their April 10th World Boxing Organization heavyweight title fight in Las Vegas, Klitschko tried to explain away the loss by claiming somebody slipped him a mickey. Now he's trying to make a federal case out of it.Citing an elevated blood-sugar level, Klitschko's representatives have suggested their fighter was "poisoned" or "drugged".

Two weeks after Vladimir's loss to Brewster his brother Vitali stopped Sanders to win the World Boxing Council version of the title. You'd think one belt would be enough for any household, but last Wednesday, boxing attorney Judd Burstein, who represents both Klitschkos, posted a letter demanding a federal investigation into the circumstances surrounding the Brewster-Vladimir Klitschko fight.

Dr Margaret Goodman is the chairwoman of the Nevada State Athletic Commission's medical advisory board and Nevada's chief ringside physician. She was in the ring and attending to Klitschko seconds after Byrd stopped the fight.

Burstein's letter to the US Attorney claims that: "Mr Klitschko has also confirmed that his head was completely clear after the Brewster fight was stopped; yet he could not speak or move his body with ease. It is also important to note that Mr Klitschko's blood sugar level after the fight was 230 - almost twice the normal level. Medical experts have confirmed to the Klitschko team that such an elevated count may well indicate that Mr Klitschko was given a foreign substance." But Dr Goodman's recollection of events paints a different picture.

"When I got to the ring Vladimir initially seemed alert and responsive," recalled Goodman, "but then back in the corner he began to exhibit changes. He seemed increasingly lethargic, and within a few minutes became less responsive to questioning." Dr Goodman ascribed this to a "transitory loss of consciousness" - in layman's terms, Vladimir was "out on his feet".

Burstein's letter also claims that Klitschko's "pupils were dilated," which isn't precisely correct, either. "There was an inequality in the pupils," said Goodman, who recognized this as another cause for concern.

"My immediate concern was that there might be a cerebral injury - either bleeding or swelling on the brain," she said.

Under Goodman's instruction, Klitschko was immediately transported by ambulance to the trauma centre at the University Medical Center in Las Vegas. He was accompanied on this journey by his brother, Vitali, sundry EMTs, and a neurologist, Dr Albert Capanna.

On the short trip Klitschko was fitted with an IV, a standard precautionary measure in emergency-room situations like this. Under normal circumstances the standard IV would be a D5½NS, which includes a glucose solution. If the EMTs feared a hypoglycaemic reaction, they might even have pushed an ampule of an even more heavily concentrated glucose substance called D50 to replenish Klitschko's blood sugar. Either would certainly explain the subsequent - and temporary - elevation in his blood sugar. "We don't know what was in the IV," said Dr Goodman, who wasn't in the ambulance.

At the hospital, Klitschko was administered a battery of tests, including a CAT scan, and the pupil inequality resolved on its own. To Goodman's relief her initial diagnosis of a Grade 3 concussion was confirmed.

Following the brain scan, several other routine tests were administered. All were normal save the blood-sugar level, which was 232, which physicians uniformly agree was "elevated, but not dangerous". Despite having ruled out their gravest fears, attending physicians wanted Klitschko to remain in the hospital overnight for observation - for the concussion, NOT for the blood sugar, which at that point wasn't even a concern - but he decided to check himself out of the hospital. He was obliged to sign a form that he was doing so "against medical advice".

The next morning the Klitschkos had contacted Quest, an independent lab, and had repeat blood work done. Everything was normal, including the sugar level. The independent lab work done by Quest tested for over 100 substances. Between Quest's tests and those done at UMH after the fight, the only remotely abnormal result was the blood sugar level drawn after the CAT scan had been completed, and that had resolved by the next morning. The 232 level - again, "elevated but not dangerous" - could have several possible explanations, but the IV in the ambulance remains the most likely one.

"What is it," Dr. Goodman asked us last weekend, "that they THINK he was given?"

Although blood work and lab specimens which have yielded positive results would be preserved, samples whose results were unremarkable and normal would routinely be disposed of in a week to 10 days. The Klitschko camp was provided with phone numbers and ample warning, but in the absence of a response from them the samples were destroyed.

Burstein apparently sees this as evidence of a conspiracy. "One of those possible explanations - and an eminently reasonable one - is that those specimens were destroyed in order to hide the truth of what happened to Mr Klitschko," he said. But "the truth of what happened to Mr Klitschko" is that he got beat silly by Mr Brewster.

Vladmir Klitschko should be grateful for the medical assistance with which he was provided and thankful for his physical safety. Instead he continues to whine like a child.