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Tetanus

Tetanus
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* Tetanus is an acute, often-fatal disease of the nervous system that is caused by nerve toxins produced by the bacterium Clostridium tetani. This bacterium is found throughout the world in the soil and in animal and human intestines.

* Contaminated wounds are the sites where tetanus bacteria multiply. Deep wounds or those with devitalized (dead) tissue are particularly prone to tetanus infection.

- Puncture wounds, such as those caused by nails, splinters, or insect bites, are favorite locations of entry for the bacteria. The bacteria can also be introduced through burns, any break in the skin, and injection-drug sites. Tetanus can also be a hazard to both the mother and newborn child (by means of the uterus after delivery and through the umbilical cord stump).

- The potent toxin that is produced when the tetanus bacteria multiply is the major cause of harm in this disease.

- All children and adults should be immunized against tetanus by receiving vaccinations. A tetanus booster is needed every 10 years after primary immunization or after a puncture or other skin wound which could provide the tetanus bacteria an opportunity to enter the body.

* The tetanus toxin affects the site of interaction between the nerve and the muscle that it stimulates " This region is called the neuromuscular junction ". The tetanus toxin amplifies the chemical signal from the nerve to the muscle, which causes the muscles to tighten up in a continuous ("tetanic" or "tonic") contraction or spasm. This results in either localized or generalized muscle spasms. Tetanus toxin can affect neonates to cause muscle spasms, inability to nurse, and seizures.
This typically occurs within the first two weeks after birth and can be associated with poor sanitation methods in caring for the umbilical cord stump of the neonate

* The incubation period between exposure to the bacteria in a contaminated wound and development of the initial symptoms of tetanus ranges from two days to two months, but it's commonly within 14 days of injury.

* During a one- to seven-day period, progressive muscle spasms caused by the tetanus toxin in the immediate wound area may progress to involve the entire body in a set of continuous muscle contractions. Restlessness, headache, and irritability are common.

The tetanus neurotoxin causes the muscles to tighten up into a continuous ("tetanic" or "tonic") contraction or spasm. The jaw is "locked" by muscle spasms, giving the name "lockjaw" (also called "trismus"). Muscles throughout the body are affected, including the vital muscles necessary for normal breathing. When the breathing muscles lose their power, breathing becomes difficult or impossible and death can occur without life-support measures. Even with breathing support, infections of the airways within the lungs can lead to death.

* Active immunization ("tetanus shots") plays an essential role in preventing tetanus. Preventative measures to protect the skin from being penetrated by the tetanus bacteria are also important. For instance, precautions should be taken to avoid stepping on nails by wearing shoes. If a penetrating wound should occur, it should be thoroughly cleansed with soap and water and medical attention should be sought. Finally, passive immunization can be administered in selected cases (with specialized immunoglobulin).

Dialysis

Niceness may be predicted by our genes

DNA may help explain why some people are nicer than others.

A person’s niceness may have a lot more to do with their nature than previously thought. A recent study conducted by researchers at the University at Buffalo and the University of California in Irvine reveal that at least part of the reason behind why some people are kind—and generous—is because their genes push them towards it.

The study was co-authored by Anneke Buffone and E. Alison Holman, who observed different versions of the receptor genes for two hormones: oxytocin, which promotes maternal behaviour and is also known as the ‘cuddle chemical,’ and vasopressin. According to Michael Poulin, assistant professor of psychology at University at Buffalo and principal author of the study, both hormones have been linked to the way we treat one another and to greater amiability.

The researchers used some of the previous findings to establish whether the chemicals cause other prosocial behaviour such as the urge to donate to charity, report crimes, gives blood or participate in jury duty. Study subjects took part in an online survey where they were questioned on how often they did these activities, and were also asked how they felt about the world and humanity in general. Of the participants, 711 provided saliva samples for DNA analysis, which revealed what form of oxytocin and vasopressin receptors they had.

Those who said they considered life threatening were less likely to help others, unless they had versions of the ‘nice’ receptor genes—that is, individuals with G/G genotypes of one oxytocin receptor and long alleles for a vasopressin receptor. “The ‘nicer’ versions of the genes allow you to overcome feelings of the world being threatening and help other people in spite of those fears,” said Poulin.

“We aren’t saying we’ve found the niceness gene, but we have found a gene that makes a contribution,” said Poulin. “What I find so interesting is the fact that it only makes a contribution in the presence of certain feelings people have about the world around them.” Which means, disappointingly, that we may never be able to inject all the unfriendly people we know with some sort of ‘niceness’ serum.

Source: University at Buffalo, Psychological Science

Genetic link to fractures found

A large number of genetic variants have for the first time been linked to the risk of osteoporosis and bone fracture, according to a major new international study.
Osteoporosis is a silent but devastating age-related disease that kills half of those who fracture their hip after the age of 80 within 12 months.  Women aged over 65 are at greater risk of death after hip fracture than from breast cancer.
Researchers around the world, including from The University of Western Australia, found that variants in 56 regions of the genome influenced bone mineral density, while 14 of these variants increased the risk of bone fracture.
Bone mineral density is the most widely used measurement to diagnose osteoporosis and assess the risk of fracture, with higher density associated with lower risk of fracture.
In the largest genetic study of osteoporosis to date, investigators from more than 50 studies across Europe, North America, East Asia and Australia studied more than 80,000 individuals.
The study, led by researchers from Holland's Erasmus University Medical Centre in Rotterdam, was published in the leading international journal Nature Genetics.
Co-author Professor Richard Prince, from UWA's Bone and Vascular Research Group, said osteoporosis was strongly related to gene variation.
"We have found new genes strongly related to bone structure.  This latest research has helped pinpoint many factors in critical molecular pathways that may lead to therapeutic treatments.
"This research also leads to better understanding of the biology of skeletal health and fracture susceptibility."
Researchers also found that women with an excess of bone mineral density-decreasing genetic variants had up to 56 per cent higher risk osteoporosis and a 60 per cent higher risk of all types of fractures.
The Bone and Vascular Research Group, within UWA's School of Medicine and Pharmacology, is focused on bone and joint disease, including genetic epidemiology, using a longitudinal study of 1500 elderly West Australian women.

CHLAMYDIA

What is chlamydia?
Chlamydia (Chlamydia trachomatis) is a bacterium that causes an infection that is very similar to gonorrhea in the way that it is spread and the symptoms it produces. It is common and affects approximately 4 million women annually. Like gonorrhea, the chlamydia bacterium is found in the cervix and urethra and can live in the throat or rectum. Both infected men and infected women frequently lack symptoms of chlamydia infection. Thus, these individuals can unknowingly spread the infection to others. Another strain (type) of Chlamydia trachomatis, which can be distinguished in specialized laboratories, causes the STD known as lymphogranuloma venereum(LGV; see below).
Symptoms of chlamydia
The majority of women with chlamydia do not have symptoms. Cervicitis (infection of the uterine cervix) is the most common manifestation of the infection. While about half of women with chlamydial cervicitis have no symptoms, others may experiencevaginal discharge or abdominal pain. Infection of the urethra is often associated with chlamydial infection of the cervix. Women with infection of the urethra (urethritis) have the typical symptoms of a urinary tract infection, including pain upon urination and the frequent and urgent need to urinate.
Chlamydia is very destructive to the Fallopian tubes. It can also cause severe pelvic infection. If untreated, about 30% of women with chlamydia will develop pelvic inflammatory disease (PID; see above). Because it is common for infected women to have no symptoms, chlamydial infection is often untreated and results in extensive destruction of the Fallopian tubes, fertilityproblems and tubal pregnancy.
Chlamydial infection, like gonorrhea, is associated with an increased incidence of premature births. In addition, the infant can acquire the infection during passage through the infected birth canal, leading to serious eye damage or pneumonia. For this reason, all newborns are treated with eye drops containing an antibiotic that kills chlamydia. Treatment of all newborns is routine because of the large number of infected women without symptoms and the dire consequences of chlamydial eye infection to the newborn.
Diagnosis of chlamydia
Chlamydia can be detected on material collected by swabbing the cervix during a traditional examination using a speculum, but noninvasive screening tests done on urine or on self-collected vaginal swabs are less expensive and sometimes more acceptable to patients. While culturing of the organism can confirm the diagnosis, this method is limited to research laboratories and forensic investigations. For routine diagnostic use, newer and inexpensive diagnostic tests that depend upon identification and amplification of the genetic material of the organism have replaced the older, time-consuming culture methods.
Treatment of chlamydia
Treatment of chlamydia involves antibiotics. A convenient single-dose therapy for chlamydia is oral azithromycin (Zithromax, Zmax). Alternative treatments are often used, however, because of the high cost of this medication. The most common alternative treatment is doxycycline (Vibramycin, Oracea, Adoxa, Atridox, and others). Unlike gonorrhea, there has been little, if any, resistance of chlamydia to current antibiotics. There are many other antibiotics that also have been effective against chlamydia. As with gonorrhea, a condom or other protective barrier prevents the spread of the infection.

GONORRHEA

What is gonorrhea?
Gonorrhea is a bacterial infection caused by the organism Neisseria gonorrheae (also known as gonococcus bacteriae) that is transmitted by sexual contact. Gonorrhea is one of the oldest known sexually transmitted diseases. It is estimated that over one million women are currently infected with gonorrhea. Among women who are infected, 25%-40% also will be infected with chlamydia, another type of bacteria that causes another STD. (Chlamydia infection is discussed later in this article.)
Contrary to popular belief, gonorrhea cannot be transmitted from toilet seats or door handles. The bacterium that causes gonorrhea requires very specific conditions for growth and reproduction. It cannot live outside the body for longer than a few minutes, nor can it live on the skin of the hands, arms, or legs. It survives only on moist surfaces within the body and is found most commonly in the vagina, and, more commonly, the cervix. (The cervix is the end of the uterus that protrudes into the vagina.) It can also live in the tube (urethra) through which urine drains from the bladder. Gonorrhea can also exist in the back of the throat (from oral-genital contact) and in the rectum.
Symptoms of gonorrhea
Over 50% of infected women have no symptoms, especially in the early stages of the infection. Symptoms of gonorrhea include burning or frequent urination, a yellowish vaginal discharge, redness and swelling of the genitals, and a burning or itching of the vaginal area. If untreated, gonorrhea can lead to a severe pelvic infection with inflammation of the Fallopian tubes and ovaries. Gonorrhea can also spread through the body to infect joints to cause gonococcal arthritis. Gonorrheal infection of the Fallopian tubes can lead to a serious, painful infection of the pelvis known as pelvic inflammatory disease or PID. PID occurs in 10% to 40% of women with gonorrheal infection of the uterine cervix. Symptoms of pelvic infection include fever, pelvic cramping, abdominal pain, or pain with intercourse. Pelvic infection can lead to difficulty in becoming pregnant or even sterility. Occasionally, if the infection is severe enough, a localized area of infection and pus (an abscess) forms, and major surgery may be necessary and even lifesaving. Gonorrhea infection in people with conditions causing serious abnormal immune function, such as AIDS, can also be more serious.
Diagnosis of gonorrhea
Testing for gonorrhea is done by swabbing the infected site (rectum, throat, cervix) and identifying the bacteria in the laboratory either through culturing of the material from the swab (growing the bacteria) or identification of the genetic material from the bacteria. Sometimes the tests do not show bacteria because of sampling errors (the sampled area does not contain bacteria) or other technical difficulties, even when the woman has an infection. Newer tests to diagnose gonorrhea involve the use of DNA probes or amplification techniques (for example, polymerase chain reaction, or PCR) to identify the genetic material of the bacteria. These tests are more expensive than cultures but typically yield more rapid results.
Treatment of gonorrhea
In the past, the treatment of uncomplicated gonorrhea was fairly simple. A single injection of penicillin cured almost every infected person. Unfortunately, there are new strains of gonorrhea that have become resistant to various antibiotics, including penicillins, and are therefore more difficult to treat. Fortunately, gonorrhea can still be treated by other injectable or oral medications.
Uncomplicated gonococcal infections of the cervix, urethra, and rectum, are usually treated by a single injection of ceftriaxone or by oral cefixime(Suprax). For uncomplicated gonococcal infections of the pharynx, the recommended treatment is ceftriaxone in a single IM dose.
Alternative regimens for uncomplicated gonococcal infections of the cervix, urethra, and rectum include spectinomycin in nonpregnant women (not available in the United States) or single doses of other cephalosporins such as ceftizoxime or cefoxitin, administered with probenecid (Benemid), 1 g orally; or cefotaxime.
Treatment for gonorrhea should always include medication that will treat chlamydia [for example, azithromycin (Zithromax, Zmax) or doxycycline(Vibramycin, Oracea, Adoxa, Atridox and others)] as well as gonorrhea, because gonorrhea and chlamydia frequently exist together in the same person. The sexual partners of women who have had either gonorrhea or chlamydia must receive treatment for both infections since their partners may be infected as well. Treating the partners also prevents reinfection of the woman. Women suffering from PID or gonococcal arthritis require more aggressive treatment that is effective against the bacteria that cause gonorrhea as well as against other organisms. These women often require intravenous administration of antibiotics.
It is important to note that doxycycline, one of the recommended drugs for treatment of PID, is not recommended for use in pregnant women.
Gonorrhea is one of the easier STDs to prevent because the bacterium that causes the infection can survive only under certain conditions. The use of condoms protects against gonorrhea infection. Since the organism can live in the throat, condoms should be used during oral-genital contact as well.

What are sexually transmitted diseases (STDs)?

Sexually transmitted diseases (STDs) are infections that can be transferred from one person to another through any type of sexual contact. STDs are sometimes referred to as sexually transmitted infections (STIs) since they involve the transmission of a disease-causing organism from one person to another during sexual activity. It is important to realize that sexual contact includes more than just sexual intercourse (vaginal and anal). Sexual contact includes kissing, oral-genital contact, and the use of sexual "toys," such as vibrators. STDs probably have been around for thousands of years, but the most dangerous of these conditions, the acquired immunodeficiency syndrome(AIDS or HIV disease), has only been recognized since 1984.
Many STDs are treatable, but effective cures are lacking for others, such as HIV, HPV, andhepatitis B and hepatitis C. Even gonorrhea, once easily cured, has become resistant to many of the older traditional antibiotics. Many STDs can be present in, and spread by, people who do not have any symptoms of the condition and have not yet been diagnosed with an STD. Therefore, public awareness and education about these infections and the methods of preventing them is important.
There really is no such thing as "safe" sex. The only truly effective way to prevent STDs is abstinence. Sex in the context of a monogamous relationship wherein neither party is infected with an STD also is considered "safe." Most people think that kissing is a safe activity. But unfortunately, syphilis, herpes, and other infections can be contracted through this relatively simple and apparently harmless act. All other forms of sexual contact carry some risk. Condoms are commonly thought to protect against STDs. Condoms are useful in decreasing the spread of certain infections, such as chlamydia and gonorrhea; however, they do not fully protect against other infections such as genital herpes, genital warts, syphilis, and AIDS. Prevention of the spread of STDs is dependent upon the counseling of at-risk individuals and the early diagnosis and treatment of infections.

Prostate disorder proteins found

WESTERN AUSTRALIAN INSTITUTE FOR MEDICAL RESEARCH
MONDAY, 16 APRIL 2012
Innovative new technology has been used to identify and profile a novel combination of proteins that may improve treatment for prostate disorders. The study was published in the April 13th 2012 edition of the prestigious Journal of Biological Chemistry.
Researchers from the Western Australian Institute for Medical Research (WAIMR) and The University of Western Australia, in collaboration with the Monash Institute of Pharmaceutical Sciences in Melbourne, have used the novel G Protein-Coupled Receptor Heteromer Identification Technology.
Study senior author Associate Professor Kevin Pfleger co-invented this technology to identify and study 'G protein-coupled receptors', a family of 'receptors' that enable cells to respond to hormones and neurotransmitters. They are extremely important in treating disease and are the target of up to 50 per cent of all therapeutic drugs.
The technology was developed in the Laboratory for Molecular Endocrinology at WAIMR/UWA and assigned to the UWA spin-out company Dimerix Bioscience.
Associate Professor Pfleger, winner of the 2011 Australian Museum 3M Eureka Prize for Emerging Leader in Science, said G protein-coupled receptors were very important proteins on the outside of our cells that enabled signals from hormones and neurotransmitters to be transferred into the cell.
"Scientists now realise that these receptors do not work in isolation, but in particular combinations, which they call 'heteromers'," he said. "It is suggested that a number of side effects from drugs may result from not fully understanding which combinations form and what happens when they do."
Professor Pfleger said prostate disorders such as benign prostatic hyperplasia affected nearly every man at some point in his life. Better drugs with fewer side effects were needed to reduce or eliminate the need for surgical intervention in more serious cases, he said.
"This publication is itself the culmination of over four years of research and builds upon a decade of technological development in our laboratory," Professor Pfleger said.
"We hope that the identification of this novel combination of receptors, and the novel functioning that results from their interaction, will provide opportunities to develop better treatments for debilitating prostate disorders that affect so many ageing men."

UCLA-engineered stem cells seek out and kill HIV in living organisms By Enrique Rivero April 12, 2012

HIV virus
Expanding on previous research providing proof-of-principle that human stem cells can be genetically engineered into HIV-fighting cells, a team of UCLA researchers has now demonstrated that these cells can actually attack HIV-infected cells in a living organism.
The study, published April 12 in the journal PLoS Pathogens, demonstrates for the first time that engineering stem cells to form immune cells that target HIV is effective in suppressing the virus in living tissues in an animal model, said lead investigator Scott G. Kitchen, an assistant professor of medicine in the division of hematology and oncology at the David Geffen School of Medicine at UCLA and a member of the UCLA AIDS Institute. 
"We believe that this study lays the groundwork for the potential use of this type of an approach in combating HIV infection in infected individuals, in hopes of eradicating the virus from the body," he said. 
In the previous research, the scientists took CD8 cytotoxic T lymphocytes — the "killer" T cells that help fight infection — from an HIV-infected individual and identified the molecule known as the T cell receptor, which guides the T cell in recognizing and killing HIV-infected cells. However, these T cells, while able to destroy HIV-infected cells, do not exist in great enough quantities to clear the virus from the body. So the researchers cloned the receptor and used this to genetically engineer human blood stem cells. They then placed the engineered stem cells into human thymus tissue that had been implanted in mice, allowing them to study the reaction in a living organism.
The engineered stem cells developed into a large population of mature, multi-functional HIV-specific CD8 cells that could specifically target cells containing HIV proteins. The researchers also discovered that HIV-specific T cell receptors have to be matched to an individual in much the same way an organ is matched to a transplant patient.
In this current study, the researchers similarly engineered human blood stem cells and found that they can form mature T cells that can attack HIV in tissues where the virus resides and replicates. They did so by using a surrogate model, the humanized mouse, in which HIV infection closely resembles the disease and its progression in humans.
In a series of tests on the mice's peripheral blood, plasma and organs conducted two weeks and six weeks after introducing the engineered cells, the researchers found that the number of CD4 "helper" T cells — which become depleted as a result of HIV infection — increased, while levels of HIV in the blood decreased. CD4 cells are white blood cells that are an important component of the immune system, helping to fight off infections. These results indicated that the engineered cells were capable of developing and migrating to the organs to fight infection there.
The researchers did note a potential weakness with the study: Human immune cells reconstituted at a lower level in the humanized mice than they would in humans, and as a result, the mice's immune systems were mostly, though not completely, reconstructed. Because of this, HIV may be slower to mutate in the mice than in human hosts. So the use of multiple, engineered T cell receptors may be one way to adjust for the higher potential for HIV mutation in humans.
"We believe that this is the first step in developing a more aggressive approach in correcting the defects in the human T cell responses that allow HIV to persist in infected people," Kitchen said.
The researchers will now begin making T cell receptors that target different parts of HIV and that could be used in more genetically matched individuals, he said. 
Other study authors are Bernard R. Levin, Gregory Bristol, Valerie Rezek, Sohn Kim, Christian Aguilera-Sandoval, Arumugam Balamurugan, Otto O. Yang and Jerome A. Zack, all of UCLA.
The National Institutes of Health, the California HIV/AIDS Research Program, the California Institute for Regenerative Medicine, the UC Multicampus Research Program and Initiatives from the California Center for Antiviral Drug Discovery, and the UCLA Center for AIDS Research (CFAR) funded this study.
The UCLA AIDS Institute, established in 1992, is a multidisciplinary think tank drawing on the skills of top-flight researchers in the worldwide fight against HIV and AIDS, the first cases of which were reported in 1981 by UCLA physicians. Institute members include researchers in virology and immunology, genetics, cancer, neurology, ophthalmology, epidemiology, social sciences, public health, nursing and disease prevention. Their findings have led to advances in treating HIV, as well as other diseases, such as hepatitis B and C, influenza and cancer.

Gene therapy genes need 'off' switch: WA research investigates

 Gene therapy is a relatively new strategy that attempts to help injured brain cells survive and regrow and is being used to treat brain and spinal cord injury and neuro-degeneration. Image
THE alteration of nerve cell shape has been identified as a potential side effect of gene therapy.
The study, published in PLoS One, was led by Winthrop Professor Alan Harvey from UWA’s school of Anatomy, Physiology and Human Biology, and Associate Professor Jennifer Rodger, NHMRC Research Fellow in Experimental and Regenerative Neurosciences at UWA.
Gene therapy is a relatively new strategy that attempts to help injured brain cells survive and regrow and is being used to treat brain and spinal cord injury and neuro-degeneration.
Prof Harvey says his team has carried out work using modified viral vectors to introduce growth-promoting genes into injured nerve cells (neurons).
“We have looked at ways of protecting the neurons and getting them to regrow their nerve fibers after they are injured,” he says.
“But I had the concern that, using the current generation of commonly used vectors, the introduced gene is switched on all the time.”
“Once inside the cell, it’s likely that the new gene is constantly producing messages and constantly making its protein, which is not normally what happens with genes—they are switched on and off depending on when they’re needed.”
The team set out to determine what happened over a period of months to nerve cells in the retina that contained genes introduced by gene therapy, looking especially where the gene was “switched on” all the time and the protein, a growth factor, was being made consistently.
“There were changes in the shape of the processes of these cells over time,” Prof Harvey says.
“The changes varied depending on the type of growth factor gene that was introduced, but what was interesting was that the change didn’t only occur in the cells that contained the gene—the neighbouring cells changed as well, presumably due to secreted proteins present in the extracellular space,” he says.
Prof Harvey hopes this research raises a flag to what he says is an additional aspect that the gene therapy field really should be concerned about.
“If you are using these sorts of vectors and you can’t switch the gene off, then potentially that gene—if it’s making a protein that’s secreted into the extracellular space—may have all sorts of effects on those cells and on neighbouring cells,” Prof Harvey says
At this stage, the functional consequences of these findings are unknown.
“It is important to develop vectors where the expression of the introduced gene can be controlled, can be switched on or off when appropriate,” he says.

Ringworm (Tinea)

Ringworm facts

• Ringworm is a common fungal infection of the skin and is not due to a worm.
• The medical term for ringworm is tinea. The condition is further named for the site of the body where the infection occurs.
• Ringworm causes a scaly, crusted rash that may itch.
• Ringworm can be successfully treated with antifungal medications used either topically or orally.

What causes ringworm?

Although the world is full of yeasts, molds, and fungi, only a few cause skin problems. These agents are called the dermatophytes, which means "skin fungi." An infection with these fungi is sometimes known as dermatophytosis. Skin fungi can only live on the dead layer of keratin protein on top of the skin. They rarely invade deeper into the body and cannot live on mucous membranes, such as those in the mouth or vagina.
Scientific names for the most common of the dermatophyte fungi that cause ringworm include Trichophyton rubrum, Trichophyton tonsurans,Trichophyton interdigitale, and/or Trichophyton mentagrophytes,Microsporum canis, and Epidermophyton floccosum.

What is the treatment for ringworm? Are there home remedies?

Home remedies cannot cure ringworm. To cure ringworm, it is necessary to take antifungal medications. Ringworm can be treated topically (with external applications) or systemically (for example, with oral medications):
Topical treatment: When fungus affects the skin of the body or the groin, many antifungal creams can clear the condition in around two weeks. Examples of such preparations include those that contain clotrimazole (Cruex cream, Desenex cream, Lotrimin cream, lotion, and solution), miconazole (Monistat-Derm cream), ketoconazole (Nizoral cream), econazole (Spectazole), naftifine (Naftin), and terbinafine (Lamisil cream and solution). These treatments are effective for many cases of foot fungus as well. Many of these antifungal creams are available as over-the-counter preparations. It is usually necessary to use topical medications for at least two weeks.
Systemic treatment: Some fungal infections do not respond well to external applications. Examples include scalp fungus and fungus of the nails. To penetrate these areas and in cases of particularly severe or extensive disease, oral medications can be used.
For a long time, the only effective antifungal tablet was griseofulvin (Fulvicin, Grifulvin, and Gris-PEG). Now, other agents are available that are both safer and more effective. These include terbinafine, itraconazole (Sporanox), and fluconazole (Diflucan). Oral medications are usually given for a three-month course.

HEART DISEASE

FDA Warns Statin Users of Memory Loss and Diabetes Risks

By ALICE PARK | @aliceparkny | February 29, 2012 | 25

PHOTO RESEARCHERS / GETTY IMAGES

New safety warnings on statins like Zocor, above, cite increased risks of memory loss and diabetes.

The Food and Drug Administration (FDA) added new safety warnings to cholesterol-reducing statin drugs on Wednesday, noting increased risks of Type 2 diabetes and memory loss for patients who take the medications.

The changes to the prescribing information apply to the class of statins, including many popularly prescribed drugs such as Lipitor (atorvastatin), Crestor (rosuvastatin), Zocor (simvastatin) and Vytorin (simvastatin/ezetimibe). The new warnings are based on results from the latest clinical trials and reports of adverse events from patients, physicians and drugmakers.

The FDA said that statins may increase users’ risk of brain-related effects like memory loss and confusion. The reports have generally not been serious, however, and the symptoms go away once the drug is stopped, the agency said.

Statins’ labels will now also warn patients and doctors that the drugs may cause a small increase in blood sugar levels and Type 2 diabetes — an effect that has been shown previously in studies. Type 2 diabetes can further increase the risk of heart disease.

In addition, the FDA made a label change specific to Mevacor (lovastatin). Mevacor can interact with other drugs, increasing the risk for muscle pain and weakness, another side effect that has previously been associated with high-dose statin use. Other drugs may raise such risks by increasing the amount of statins in the blood, and the FDA warned that Mevacor should not be taken with protease inhibitors, which are used to treat HIV, certain antibiotics and some anti-fungal medications.

At the same time, the statins’ labeling will no longer require the routine monitoring of patients’ liver enzymes, which was originally intended to alert doctors if the medications were becoming toxic and starting to damage the liver. The FDA concluded that such serious damage is rare, and regular testing for all users isn’t necessary. The agency now recommends that liver enzyme tests be performed before starting statin therapy, and as clinically indicated thereafter.

MORE: Who Should Take Statins? The Debate Continues

Despite the new safety warnings, the agency said patients should not be scared off statins. “The value of statins in preventing heart disease has been clearly established,” said Dr. Amy G. Egan, deputy director for safety in the FDA’s division of metabolism and endocrinology products, in an agency statement. “Their benefit is indisputable, but they need to be taken with care and knowledge of their side effects.”

But some experts worried that the labeling changes would result in unnecessarily alarming patients and causing some who may benefit to shy away. “I do not believe there is enough hard evidence to justify information and warnings about memory loss and confusion or increase in blood sugar,” Dr. Scott Grundy of the University of Texas Southwestern Medical Center told MedPage Today. “I also think that these warnings will cause some people who need statins to stop taking them. That would be unfortunate.”

In general, however, experts tended to support the FDA’s action, noting that while the potential diabetes and cognitive side effects were rare, they should still be highlighted to doctors and patients. “These are reasonable and prudent recommendations,” Dr. Steven Nissen of the Cleveland Clinic also told MedPage Today. “I am pleased that FDA did not overstate the diabetes and cognitive function risks. Both problems are uncommon and don’t diminish the importance of statins in cardiovascular protection. For the vast majority of patients, the benefits far outweigh the risks.”

Dr. Gordon Tomaselli, president of the American Heart Association noted people concerned about their cholesterol levels should always focus on prevention through lifestyle changes first, trying drug treatment only if their physicians recommend it. “As with all therapies, the decision to use statins for primary or secondary prevention must include careful consideration of the risks and benefits, side effects and cost,” Tomaselli said in a statement. “The FDA’s announcement on the label changes does not question the benefit of statins to lowering cholesterol, but it does provide patients and healthcare providers the most current information about the safe use of statins.”

Read more: http://healthland.time.com/2012/02/29/fda-warns-statin-users-of-memory-loss-and-diabetes-risks/#ixzz1rkrJrsD9

RENAL COLIC (DARD E GURDAH VIDEO) IN URDU

SYED FAHAD NASIR ALI

NEW LOGO

Good News for the Medical Reps.

SCIENTIFIC FACTS

Bone Facts 
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- The smallest bone in the human body is the stapes bone which is located in the ear.

- There are 54 bones in your hands including the wrists.

- The only bone fully grown at birth is located in the ear.

- The human face is made up of 14 bones.

- Enamel is hardest substance in the human body.

- Adult human bones account for 14% of the body's total weight.

- Humans are born with 300 bones in their body, however when a person reaches adulthood they only have 206 bones. This occurs because many of them join together to make a single bone.

- Although the outsides of a bone are hard, they are generally light and soft inside. They are about 75% water.

- Fingernails grow nearly 4 times faster than toenails!

- Your thigh bone is stronger than concrete.

- The strongest bone in your body is the femur (thighbone), and it's hollow.
Brain Facts 
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- The human brain has about 100,000,000,000 (100 billion) neurons.

- From all the oxygen that a human breathes, twenty percent goes to the brain.

- Your brain is 80% water.

- Your brain is move active and thinks more at night than during the day.

- People who ride on roller coasters have a higher chance of having a blood clot in the brain.

- Once a human reaches the age of 35, he/she will start losing approximately 7,000 brain cells a day. The cells will never be replaced.

- In America, the most common mental illness is Anxiety Disorders.

Blood Facts 
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- Two million red blood cells die every second.

- The average life span of a single red blood cell is 120 days.

- The kidneys filter over 400 gallons of blood each day.

- A woman has approximately 4.5 liters of blood in her body, while men have 5.6 liters.

- Blood accounts for about 8% of a human's body weight.

- Each day 400 gallons of recycled blood are pumped through the kidneys.

- By donating just one pint of blood, four lives can be saved.

- Blood is such a good stain that Native Americans used it for paint.

- Your blood takes a very long trip through your body. If you could stretch out all of a human's blood vessels, they would be about 60,000 miles long. That's enough to go around the world twice.

- Half your body’s red blood cells are replaced every seven days.

- If all the blood vessels in your body were laid end to end, they would reach about 60,000 miles.