Masala  [PDF]  

Reduction of dietary sodium is beneficial for all, especially for those with hypertension. The results from two completed Trials of Hypertension Prevention (TOHP I and II) were analysed for the effects of reduction in dietary sodium intake on cardiovascular events in prehypertensive adults. After a follow up of 10–15 years there was a 25%–30% reduction in cardiovascular events including cardiovascular death (BMJ 2007;334:885).
   Extracorporeal shock wave lithotripsy (ESWL) can be used for treatment of painful calcified chronic pancreatitis (Gut 2007;56:545–52). In chronic pancreatitis, obstruction of the main pancreatic duct (MPD) may contribute to the pathogenesis of pain. A randomized trial compared ESWL alone with ESWL and endoscopic drainage of the MPD for treatment of pain in chronic pancreatitis. ESWL alone was found to be equally safe and effective for selected patients with painful calcified chronic pancreatitis while saving the cost of combining systematic endoscopy.
   A novel route for administration of furosemide! Recent evidence suggests that inhaled furosemide relieves dyspnoea in patients and in normal subjects who have been made dyspnoeic. Furosemide sensitizes lung inflation receptors in rats, and lung inflation reduces air hunger in humans. In a study on healthy subjects hypercapnia with constrained ventilation generated substantially less air hunger after aerosolized furosemide treatment (Respir Physiol Neurobiol 2007;156:1–8).
   Physicians, please remain alert when listening to representatives of pharmaceutical companies. In the USA, OxyContin (oxycodone) maker pleaded guilty to falsely promoting the drug as less addictive. According to the US FDA, the company trained its sales representatives to tell healthcare providers that the drug was less addictive than morphine. Also, it was propagated that its active ingredient, oxycodone, was difficult to extract from the tablet, and its delayed absorption will reduce the potential for abuse. The company has been slapped with a fine of more than US$ 600 million (FDA News, 10 May 2007, pp. 7–85).
   In another release the FDA warned consumers about sexual enhancement dietary supplements. It identified that True Man and Energy Max capsules, which were marketed as ‘all-natural’ dietary supplements for erectile dysfunction and sexual enhancement, contained illegal prescription-drug analogs of sildenafil (Viagra) or vardenafil (Levitra)—so much for ‘natural’ medicine. The Indian market is replete with such pills (www.fda.gov/bbs/topics/NEWS).
   Getting close to regular use of a vaccine to prevent genital cancers in females. Two papers have reported on use of quadrivalent human papilloma virus (HPV) vaccine in women. These studies examined prophylactic use of the vaccine in preventing high grade vulval, vaginal and cervical intraepithelial neoplasia associated with HPV-16 and -18. Based on the data  from large cohorts of young women randomized to either the vaccine or placebo it was observed that among women who were naive to HPV-16 and -18 at the time of vaccination, the vaccine was almost 100% effective in preventing high grade intraepithelial neoplastic lesions associated with these virus types. In a mixed population, which included women who could have harboured the virus before vaccination, the efficacy in preventing all high grade lesions was just under 50%. The authors observed that the maximum effect of vaccination is expected in girls who are vaccinated in early adolescence (Lancet 2007;369:1693–702; N Engl J Med 2007;356:1915–27).
   Viewing one’s own surgery reduces the pain associated with the procedure. In a randomized study, patients were allowed to watch their own procedure on the monitor in real time during office-based cystoscopy. Men viewing cystoscopy on the video monitor experienced an approximately 40% decrease in the pain level compared to those who did not view the procedure on the monitor (J Urol 2007;177:1843–5).
   Popping vitamin pills helps the unborn. While prenatal supplementation of folic acid has been shown to decrease the risk of several congenital malformations, the protective role of prenatal multivitamins on paediatric cancers was examined in a systematic review and meta-analysis. There was an apparent protective effect for paediatric brain tumours, neuroblastoma and leukaemia. However, it was not clear as to which constituent(s) among the multivitamins conferred this protective effect (Clin Pharmacol Ther 2007;81:685–91).
   Anger has often been dramatized as a precipitating factor for coronary heart disease events and is actually an independent predictor of such events. The effects of an anger-provoking interview compared with a neutral interview on endothelium-dependent and independent vasodilatation assessed by brachial artery ultrasound was examined in healthy subjects without coronary heart disease risk factors (Am J Cardiol 2007;99:860–3). There were significant decreases in endothelium-dependent and -independent vasodilatation after the anger-provoking interview than after the neutral interview.
   A new role for oxytocin: Mind reading hormone. The ability to ‘read the mind’ of other individuals, that is, to infer their mental state by interpreting subtle social cues, is indispensable in human social interaction. The neuropeptide oxytocin plays a central role in social approach behaviour in non-human mammals. In a double-blind, placebo-controlled, within-subject design, healthy male volunteers were tested for their ability to infer the affective mental state of others using the Reading the Mind in the Eyes Test (RMET). Intranasal administration oxytocin improved performance on the RMET compared with placebo (Biol Psychiatry 2007;61:731–3).

 

GOPESH K. MODI