Features

Cooling & Sick Newborn

Folate Reduce BP!

Pick's Disease !

'Carnitine' for Pain

Ca⁺& Vit-D in Crohn's !

'Mirtazapine' for Depression

New Products of SQUARE Pharmaceuticals Ltd.

EDITORIAL TEAM

OMAR AKRAMUR RAB

MBBS, FCGP, FIAGP,FRSH (UK)

P G Dip. Business Management

LATIFA NISHAT, MBBS

ASHRAFUL ALAM, MBBS

MAHBUBUR  RAHMAN, MBBS

Cooling Help Sick Newborn

Oxygen-deprived newborns can have a reduced risk of brain damage and cerebral palsy by having their brains cooled for 72 hours after birth, according to an international study. Researchers from hospitals in North America, New Zealand, and the United Kingdom were able to lower the babies' temperatures by between three and four degrees using a water-filled cap. Babies in the study had received an inadequate supply of oxygen to the brain during delivery and showed signs of being at a high risk for brain injury. The trial stems from 10 years of studies that began after researchers discovered brain damage does not happen immediately when babies are oxygen-deprived. Instead, researchers say, "A chemical cascade is triggered leading to brain damage hours or days afterwards." They say, "This demonstrates for the first time that treatment may be possible for babies who suffer oxygen deprivation at birth." But another researcher points out to the need to get further information on the timing and methods of cooling, as well as which babies are most suitable for treatment before cooling becomes the standard of care for oxygen-deprived babies.

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Folate Reduce Women's Blood Pressure

Higher intake of folic acid is associated with a decreased risk of developing high blood pressure, particularly among younger women, according to Harvard researchers. Small studies have suggested that high-dose folic acid supplementation may lower blood pressure, researchers note in the Journal of the American Medical Association, but there have been no large, forward-looking studies examining this issue. The team analyzed information on nearly 94,000 women ages 27 to 44 years participating in the Nurses' Health Study II, none of whom had high blood pressure when the study began. Their folate intake was estimated based on food questionnaires and information regarding folate- containing supplements. During 8 years of follow-up, 7373 of the women developed hypertension. After adjusting for factors such as physical activity, weight and family history, women who consumed at least 1000 micrograms per day of total folate had a 46 percent lower risk of becoming hypertensive compared with those with an intake less than 200 micrograms per day. Researcher team also examined data on more than 62,000 older women (43 to 70 years of age) in the Nurses' Health Study I, among whom 12,347 developed high blood pressure. In this group, the risk of hypertension was reduced 18 percent for the highest versus lowest folate intake. The benefit came primarily from folate supplementation rather than dietary folate, the researchers found. This may be because relatively few subjects consumed very high quantities of dietary folate, or perhaps folate from supplements is more readily used by the body.

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Pick’s Disease

Pick's disease is one form of frontotemporal dementia (FTD). FTDs are a group of rare brain disorders that affects primarily the frontal and temporal lobes of the brain, which control speech and personality. In Pick's disease, affected areas of the brain contain abnormal brain cells called Pick's bodies. The disease usually occurs in adults between the ages of 40 and 60. The cause isn't known. Unlike Alzheimer's disease in which memory loss usually is the first sign of a problem, people with FTD often show personality changes first. They may become more impulsive and uninhibited, causing them to be socially inappropriate and to make poor decisions. As the disease progresses, they can lose language skills. The disease varies greatly in the way it affects individuals. There is no cure for Pick's disease. Treatment, which may include medications, is directed at improving daily function and quality of life. The course of Pick's disease is an inevitable progressive deterioration. The length of progression varies, ranging from less than two years in some to more than 10 years in others. Death is usually caused by infection.

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'Carnitine' Eases Diabetic Nerve Pain

People with diabetes-related nerve damage may find pain is relieved by taking a compound related to the popular supplement 'L-carnitine' -- provided the treatment is started early -- according to a re-analysis of data from two large clinical trials. The original two trials -- one conducted in Europe and the other in the US and Canada -- involved over 1000 patients with diabetic neuropathy who were given Acetyl-L-Carnitin (500 or 1000 milligrams taken three times a day) or an inactive placebo for 52 weeks. Those tests showed ALC had no significant effect on nerve conduction velocity, an indicator of improvement in nerve damage, but when researcher group looked into the data they found certain patients did benefit. Apparently, ALC at the higher dose significantly alleviated pain in the 27 percent of patients who reported pain as "the most bothersome symptom" at the beginning of the studies.

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Calcium and Vitamin D Improve Crohn's

A new study shows patients with Crohn's disease do not have improved bone mineral density by adding bone-building drugs to calcium and vitamin D therapy. However, the study also shows treating patients with calcium and Vitamin D alone can improve BMD by 3 percent to 4 percent per year. Patients with Crohn's disease suffer bone mass loss and bone fractures due to treatment with corticosteroids, poor nutrition, active inflammation, and calcium and vitamin D deficiencies. Researchers from the University of Alberta studied the effectiveness of the bone-building drug etidronate in patients with Crohn's. They found it adds no additional benefit to calcium and vitamin D therapy. They found, "Calcium and vitamin D therapy alone provide benefit to Crohn's patients who suffer from osteoporosis and osteopenia." They add, "We encourage physicians to look for loss of bone density in high-risk patients with Crohn's disease and to start calcium and vitamin D therapy immediately if there is either osteoporosis or osteopenia." They conclude, "These results imply that physicians should only consider BMD testing and drug therapy for patients who are at higher risk for osteoporosis and fractures, not those who merely have Crohn's disease as a diagnosis." Clinical trials are underway to determine if newer, bone-building drugs will, in fact, benefit patients. Until then, researchers suggest patients should be primarily treated with vitamin D and calcium supplementation.

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'Mirtazapine' Prevents Post-stroke Depression

Treatment with the antidepressant 'mirtazapine', started on the first day after an acute stroke, is "remarkably effective" in preventing the onset of depression, results of a German trial suggest. Depression often complicates recovery after a stroke, researchers of Charite-University Medicine Berlin note in their report in the Journal of Clinical Psychiatry. Although there have been studies of preventative antidepressant treatment after stroke, results have been mixed, and none looked at beginning antidepressants immediately after the stroke. Researchers randomly assigned 70 stroke patients to treatment with 'mirtazapine', started on day 1, or an inactive placebo. Fourteen patients (40 percent) in the placebo group and two (5.7 percent) in the 'mirtazapine' group developed depression, the team reports. All 14 untreated patients who developed depression were then given 'mirtazapine', and all responded. For the two patients in the treatment group who developed depression, the dose of the antidepressant was increased and one responded "Post-stroke depression should be considered and taken seriously in acute stroke care units, since prophylactic antidepressant treatment may be highly beneficial," the investigators conclude.

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