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Tuesday, February 21, 2012

Prostatectomy and Erectile dysfuncton

Its a well known fact that radical prostatectomy, the surgery done in cases of prostatic cancer results in erectile /sexual dysfunction in nearly 40% of men. A recent study concentrated on the methods to reduce the same.
Prostate gland which forms a part of the male reproductive system is a walnut sized gland weighing about 11 grams. It is situated below the urinary bladder and surrounding the urethra. It secretes an alkaline, milky white fluid which forms about 30% of the bulk of semen. These secretions are necessary for the life of sperms in the acidic female reproductive tract.
Prostatectomy or the surgery for the removal of prostate gland is indicated in prostatic cancer in early stages as a curative treatment and in advanced cases as a palliative measure to relieve the patient of the urinary obstruction. This surgery can be done by transurethral approach or retropubic approach or perineal approch or by a laparoscopic method. The most common complications of this surgery are urinary incontenance and impotence.

What is this study?
Researchers in the Cornell university tried to find out measures to decrease the incidence of sexual dysfunction in patients undergoing prostatectomy.
The study involved 408 men with a mean age of 60, who underwent a robot-assisted laparoscopic radical prostatectomy and were for an average of three years. All of them were able to have an orgasm before the surgery.
This study was published in the British Journal of Urology International.

The results
Patients whose cavernous nerves of the penis were spared on both sides had a better chance to retain their ability to achieve orgasm than those who had not had the chance for the same.

74% of the men were able to have their nerves spared bilaterally. Of this group, 91 percent experienced no change in their ability to achieve orgasm following the surgery.

About 13 % of the men had their nerves spared on only one side. Of them, 82 percent had the same ability to reach orgasm.
Another 12 percent had little or no nerve sparing, with 62 percent of them were still able to achieve orgasm the same way they did before the operation.

Another factor found to influence the outcome was age of the patient.
This study showed that orgasm rates were significantly higher in men younger than 60 who had their nerves spared on both sides. Orgasm rates dropped by 10 percent to 83 percent among men older than 60, even if their nerves were spared on both sides.

What is the treatment?
Psychotherapy forms the mainstay of treatment. Sildenafil (Viagra), Vardenafil (Levitra), and Tadalafil (Cialis) may help in some cases.

Monday, February 20, 2012

Breast feeding and diabetes, obesity in children

Can breast feeding prevent obesity in children?
According to a recent study the answer is YES!
A recent study published in the International journal of obesity, breast feeding reduces the risk of developing obesity in children whose mothers are diabetic.
Maternal diabetes during pregnancy is a known risk factor for childhood obesity. This study was done comparing the risk of childhood obesity in babies born to diabetic and non- diabetic mothers. Surprisingly in both the groups there was a decrease in incidence of obesity in children of both the groups when they were breast fed for a minimum of 6 months. These breast fed infants had recorded a much lesser growth of BMI compared to their counterparts.
This study involved 94 children of diabetic and 399 children of non diabetic mothers and were studied for a period of 13 years. Body Mass Index or BMI an indicator for childhood obesity was used.

This study has once again proved the vitality of mother's milk and also reiterated the importance of breast feeding upto atleast 6 months. This study also has proved that diabetic mothers can not only safely breast feed their infants but also decrease the incidence of obesity in their children and maybe future diabetes in them.!

Friday, February 10, 2012

Smoking and Health- New Factors


Smoking and oral health problems
The findings of a series of studies involving researches from the centres for disease control and prevention CDC, USA on feb 7, 2012 have given the following findings.
1) Smokers have 4 times the risk of developing oral health problems including mouth cancers, teeth and gum diseases compared to people who have never smoked.
2) People who have been smokerds but have stped smoking now are at half the risk of those who continue to smoke but twice the risk of non smokers in developing oral health problems.

Smoking and brain function
Whitehall II study in smokers by British researchers has revealed that
1) Male smokers loose their brain functions 10 years earlier than their non smoking counterparts. That is a smoker of age 50 years has the same cognitive decline as that of a 60 year old non smoker. But similar studies in women showed that no such rapid decline happened in women smokers.
2)The detrimental effects off cigarette smoking on memory and other brain funchions have been found as early as 45 years of age.
3) Study also showed that long term smokers who had recently stopped smoking were at nearly the same risk especially in executive function while those who have stopped smoking early didnot show the faster decline in cognitive function showed by their counterparts.
This study was aimed to study possible links between smoking history and cognitive decline in the transition from midlife to old age using data from 5,099 men and 2,137 women who are involved in a large research project called the Whitehall II study, which is based on employees of the British Civil Service.

Smoking and Psoriasis
Smoking is also found to aggreviate the risk of  psoriasis.
Psoriasis is an auto immune disease affecting the skin where the immune system of the body mistakes the body's own skin cells to be a pathogen and starts the faulty response against these cells causing thick, red, scaly patches on the skin.
1) Smokers were at twice the risk of developing psoriasis than non smokers
2) people who were smoking earlier but quit smoking were 39% more at risk of developing psoriasis
studies in past have also shown that obesity and drinking also increase the risk for psoriasis.
The study invovled 186,000 men and women who were followed for 12 to 20 years, out of which 2,410 developed psoriasis during that time
the study was published in American Journal of Epidemiology, January 12, 2012

Sunday, January 22, 2012

FDA recalls Minoxidil a commonly used drug for hair loss

Minoxidil a commonly used topical hair regrowth drug has been recalled by FDA due to safety concerns.
What is Minoxidil?
Minoxidil is a vasodilator commonly used for alopecia or hair loss. First developed as an oral anti hypertensive agent, an interesting side effect of increased hair growth was noted, anda 2% topical solution for women and 5% topical solution for men have been introduced.
It is to be appliedtwice daily and may have to be used continuously to support hair follicles.

How does Minoxidil work?
It essentially has a nitric oxide moiety which has a vasodilator action thus incresing the blood supply and in turn oxygen and nutrients for hair follicles. Also it is a potassium channel opener. These two functions add up to bring about the decrease in hairfall and promote the regrowth of hair. however it is largely implicated only in central(vertex) hair loss.

What are the side effects?
Irritation of eyes,
Itchingredness and irritation of treated area
Unwanted hair growth in other parts of body
Allergic reactions
Dandruff due to alcohol content of solution
Paradoxical hair loss

Trade names available:
Rogaine/Regaine, Vanarex, Mintop

What are the preparations that are recalled?

  • Men's Minoxidil 15% Azelaic 5% Hair regrowth topical, 60ml

  • Men's Minoxidil 10% Azelaic 5% Hair regrowth topical, 60mL

  • Men's Minoxidil 5% Azelaic 5% Hair regrowth topical, 60mL

  • Women's Minoxidil 3% Azelaic 5% Hair regrowth topical, 60mL

  • Hair regrowth shampoo enhanced with Ketoconazole and salicylic acid, 180mL

  • Why are these not safe?
    Use of these topical products containing 15% and 10% Minoxidil have not been shown to be safe, and could pose a risk due to the possibility of systemic absorption. Skin abrasions or irritations could increase the systemic absorption of topically administered Minoxidil causing low blood pressure, palpitations and associated cardiac symptoms. Azelaic acid contained in the topical products could make the skin where it is applied more sensitive to sunburn. Ketoconazole contained in the shampoo product could cause hair discoloration and abnormal hair texture, removal of the curl from permanently waved hair, itching, rash, skin irritation and dry skin. Salicylic acid contained in the shampoo could cause mild, temporary burning, itching, irritation, or stinging.