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Arthritis drug withdrawn
October 1 - The arthritis drug Vioxx has been removed from use because of new findings linking it to heart attack and stroke, it was announced yesterday.

Made by the drug company Merck and available since 1999, the painkiller Vioxx is used by some 400,000 people in the UK alone.

However, a three-year trial has now shown an increased risk of heart problems, beginning 18 months after starting to take the drug, Merck said.

The manufacturers are now withdrawing the drug worldwide.

Dr Mayur Lakhani of the UK's Royal College of GPs says that there is no cause for alarm but if people are worried they can switch to a safer pain-killer. He added that the next step is to consult their GP for an alternative prescription.

The US's Food and Drug Administration said that other drugs in the same class as Vioxx (rofecoxib) would be monitored for similar risks. The group of drugs are thought to be a better alternative to the traditional non-steroidal anti-inflammatory drugs (NSAIDs).

The European Committee for Proprietary Medicinal Products looked into the safety of these drugs following several adverse events. It concluded in 2003 that the benefits outweighed the risks, but recommended strengthening existing warnings about use in patients with cardiovascular risk factors.

Chairman of Merck, Raymond Gilmartin, said: "Although we believe it would have been possible to continue to market Vioxx with labelling that would incorporate these new data, given the availability of alternative therapies, and the questions raised by the data, we concluded that a voluntary withdrawal is the responsible course to take."

The chairman of the Medicines and Healthcare Products Regulatory Agency, Professor Sir Alasdair Breckenridge, said: "Patients taking Vioxx should contact their doctor by phone or at the next convenient appointment to arrange an alternative prescription.

"The Committee on Safety of Medicine has looked at this issue this morning and agreed that this message should be communicated widely to health professionals and patients without delay."


Fasting during Ramadan could affect medications
October 1 - Patients who fast during Ramadan may alter their intake of medicines, often without consulting a doctor.

The Islamic holy month of fasting begins on 15 October. During this time, adult Muslims abstain from eating, drinking or taking oral drugs between dawn and dusk. Islamic rules say that those with chronic diseases are not required to fast, but many insist on doing so. Patients with acute diseases are also allowed to stop fasting.

A group of Moroccan doctors have now published an article in the British Medical Journal to point out that fasting could cause problems for Muslim patients taking prescribed drugs.

Dr Nadia Aadil and colleagues of the University of Casablanca, Morocco explain that "several studies have shown that patients arbitrarily modify the times of doses, the number of doses, the time span between doses, and even the total daily dosage of drugs during the month of Ramadan, often without seeking any medical advice."

The experts say that this could alter the activity of drugs in the body, reducing their effectiveness.

They write: "Studies have found delayed absorption, problems with side effects, and drug-food interactions during Ramadan. Further studies should be carried out to provide more guidelines about the ways in which the administration of drugs should be modified."

"In the meantime, doctors and scientists in the Muslim world should be encouraged to follow up their patients with chronic diseases during Ramadan, in order to establish optimal dosage regimens.

"Consensus on these issues would allow health professionals to provide accurate and standardised advice on the appropriate use of drugs during the holy month of Ramadan," they conclude.

BMJ Volume 329, pp 778-82


Web viagra is counterfeit
September 30 - Viagra is widely sold on the internet - and as many as half the pills are counterfeit, a new analytical technique has revealed.

Researchers used 'near infrared microscopy' to identify the contents of Viagra tablets purchased from web sites.

Their findings were revealed to the British Pharmaceutical Conference in Manchester to help highlight the new technique.

Researchers said NIR microscopy gave another "layer of information" to the established technique of NIR spectroscopy.

In spectroscopy a sample of a drug yields a single spectrum while the microscopy technique enables as many as 10,000 spectra to be obtained from a tablet.

Dr Nic Wilson, of the School of Pharmacy, University of London, said the technology could be used to identify added ingredients in counterfeit drugs.

She said: "This will help to link different sources of counterfeit tablets and to monitor the movements of batches of counterfeit tablets.

"It will therefore help the regulatory authorities and the pharmaceutical companies in the fight against the counterfeit medicine trade."

Dr Wilson said of the Internet Viagra: "On our initial estimate, around half of these Viagra samples could be counterfeit."


Books on Diabetes

Future treatments for diabetes?
September 30 - An extract from a curry tree and a new skin cream could be two potential treatments for diabetes, researchers told the British Pharmaceutical Conference in Manchester UK this week.

Egyptian scientists are studying the use of a drug called glipizide used as an ointment or cream to treat type 2 diabetes.

Professor Hussein Ammar from Cairo's National Research Centre said giving the drug through the skin avoided the unpleasant gastrointestinal side effects of diabetes drugs, leaving many patients reluctant to take their medicines.

It is hoped the skin cream alternative could address this problem, ultimately reducing long-term vascular complications of the disease.

Professor Ammar's study showed the skin cream had a sustained effect on glucose levels for about 48 hours when applied to rats.

"The results lead us to believe that topical administration is possible," Professor Amman said.

Researchers from King's College London reported on a study into the use an extract from the curry-leaf tree (Murraya koenigii) from India, one of the traditional Indian plants with reputed benefit in diabetes.

Katie Bawden-Tucknott and colleagues believe the plant to could have an 'antidiabetic' effect.

Once they isolate its active component, they hope to compare it with antidiabetic drugs that interfere with starch digestion.

The conference also heard of studies on plants used by the Ashantis, one of the largest ethnic groups in Ghana.

The researchers interviewed traditional healers to identify plants that are used to help wound healing.


Iron lung veteran praises nurse care
September 29 - A man in an iron lung has told how the care of "thousands" of nurses has kept him alive.

John Prestwich has spent 50 years on artificial respiration - much of the time in an old-fashioned iron lung - after contracting polio as a teenager.

Mr Prestwich, from Hertfordshire, tells the Nursing Standard today: "I have experienced the care of many thousands of nurses. For the first 16 years I was permanently in hospital, the first seven in an iron lung.

"The expert skills and total dedication of the nurses undoubtedly saved my life."

He added: "I remember once having a painful and traumatic procedure carried out on my trachea. A nurse was with me and she saw my distress, opened a porthole in the iron lung, slipped her arm through and took hold of my hand.

"That was all of 47 years ago and I have not forgotten that nurse and I never will."

Mr Prestwich's story was one of several collected by the journal as part of its 'Nursing the Future' campaign.

Practice nurse Amandine Everett, from Leeds, tells how she discovered first hand the caring nature of her profession when her husband David contracted myeloma.

She said: "I remember the sheer frustration and sadness that I felt when the diagnosis arrived in January 2003. I am indebted to these nurses who have really helped me to continue. Without their dedication and care who knows would have happened? As a nurse I felt helpless."


Pine is more than just a scent
September 29 - The popular scent of pine found in many household cleaners may have more significance than just being a pleasant smell, researchers have discovered.

The pine cone may contain the secrets of combating the hospital superbug, MRSA, the British Pharmaceutical Conference in Manchester was told.

Researchers at London University's school of pharmacy, said they stumbled across the properties while testing immature cones for anti-bacterial properties.

The cones came from a common pine, Chamaecyparis lawsoniana, studied by student Eileen Smith.

Researcher Dr Simon Gibbons said the first application for the discovery might well be to use the compounds as antiseptics, included as additives in hospital soap and cleaners.

The discovery includes a compound, called a diterpene, that was found to block the growth of multi-drug resistant strains of the bug at very low concentrations.

Dr Gibbons said: "Plants need some protection against bacteria in their environment and there is an ecological rationale for protective compounds to be synthesised in a part of the plant essential for its reproduction, i.e. the cones.

"There is no reason to assume that any plant antibacterial compounds will be active against human pathogens but we felt that it was worth investigation."


Books on Healthy Eating

Parents struggle to keep children healthy
September 28 - Most British parents know they are "struggling" to get their children to eat healthily, researchers reported today.

The research shows children blame their parents for their unhealthy lifestyles - while the parents claim they cannot motivate their children.

The findings were unveiled as part of a launch of a new project by the Doctor Patient Partnership and the National Obesity Forum.

Researchers found that 45 per cent of parents said it was difficult to work out which foods were healthy for their children.

And 65 per cent said they struggled to motivate their children. Among children, 70 per cent said they would be active and eat healthily if their parents did also.

More than 1,000 children and 756 parents took part in the survey.

The DPP launched a "Get Sussed, Get Healthy Family Challenge" including a family card game.

Dr David Wrigley, of the DPP, said: "The power of parents to influence their children’s behaviour simply by doing it themselves is clear from these findings.

"In order to get their family on track to a healthy lifestyle parents need support and tools to help them.

"By providing information in a fun format which engages the whole family we hope to encourage more parents and children to get together and see healthier lifestyles as something achievable."

Dr Ian Campbell, of the National Obesity Forum said: "This kind of support is crucial for parents if we are to see a reduction in the escalating rates of obesity.

"A range of factors can contribute to adults and children gaining weight. Parents, schools, health professionals, the media, food manufacturers and the government all have an important role to play in reducing the risk to children’s lives from obesity. This campaign is an important step in the right direction."


Epidemic of heart disease and stroke revealed
September 27 - A global epidemic of stroke and heart disease is revealed in the World Health Organisation's new 'Atlas of Heart Disease and Stroke.

The report shows the spread of the leading single cause of death worldwide, coinciding with World Heart Day on yesterday (26th September).

Heart disease and stroke kill 17 million people a year, and by 2020 the number is predicted to increase to 20 million a year, and over 24 million a year by 2030, the atlas says.

Aiming to encourage action and constructive decision-making by governments, policymakers, and national and international organisations, WHO hopes the Atlas will prove a powerful advocacy tool. It contains updated data for each country, depicted through maps, photographs and images together with risk factor statistics.

Dr Robert Beaglehole, WHO Director of Chronic Diseases and Health Promotion, said: "The old stereotype of cardiovascular diseases affecting only stressed, overweight middle-aged men in developed countries no longer applies.

"Today, men, women and children are at risk and 80 per cent of the burden is in low- and middle-income countries.

"Heart disease and stroke not only take lives, but also cause an enormous economic burden. The Atlas should be a significant new resource for global advocacy and education activity."

Dr Judith Mackay, co-author of the Atlas, added: "No matter what advances there are in high-technology medicine, the fundamental message is that any major reduction in deaths and disability from heart disease and stroke will come primarily from prevention, not just cure.

"This must involve robust reduction of risk factors, through encouraging our children to adopt healthy lifestyle habits and by introducing appropriate policies and intervention programmes."


Tamara, the ovarian transplant baby, and her proud parentsCelebrations and questions over Tamara birth
September 27 - The birth of a baby to a woman who had an ovarian transplant has created hope for dozens of others - despite some scientific scepticism.

Tamara Touriat was born to her mother Ouarda in Belgium on Thursday - seven years after Ouarda was judged to have been made infertile by cancer treatment.

In Edinburgh, Scotland, British scientists were bracing themselves to perform the first procedure of its kind.

The Medical Research Council's human reproductive science unit has been storing ovarian tissue for women for some time - but so far has had no requests for transplant operations to take place.

Scientist Richard Anderson told the Independent on Sunday: "We have offered it to women but many have declined. Until now, it was unproven and it does involve going through an operation.

"For many women coming to terms with a cancer diagnosis, it was not what they wanted. But I expect to get a different response from women in the future."

Ouarda said: "I was crying at first, it's a dream, a big miracle.

"I am very happy, it's what I always wanted."

But the Times quoted Dr Kutluk Oktay, of Cornell University, New York, who said the chances that the baby was the result of the ovarian transplant were just 50 per cent.

He said the mother had ovulated several times spontaneously - and it was possible her fertility had returned naturally.

He said: "I am cautiously optimistic, but there are parts of the research that need explaining before I'm 100 per cent convinced. We think there's no reason it can't be done, and it is very possible that this has worked."

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