To be fair, some people do need extra help since diet and exercise alone cannot do much to help them reduce because they are abnormally obese. And so weight loss pills help them control and/or suppress their appetite or prevent their bodies from digesting the fat in the food they eat. But a recent study conducted by Brazilian and Canadian researchers and published in the British Medical Journal states that even the long term use of weight loss pills contributes only to a minor reduction in weight, an average of less than 11 pounds.

And when we take into consideration the number of side effects that these pills cause – the anti-obesity drug orlistat which is supposed to boost weight loss by preventing your body from digesting fats causes digestive side effects even as it promotes only an average weight loss of 7 pounds; sibutramine and rimonabant which suppress or interrupt neural signals to disguise hunger pangs and food cravings reduce weight by an average of 9 pounds, but at the cost of insomnia, high blood pressure, an elevated pulse rate, and nausea. Rimonabant has also been known to cause anxiety and depression and other mood disorders and is as of now not approved for sale by the FDA.

On the bright side however, the drugs did serve to improve cardiovascular health and prevent and/or control diabetes, hypertension, and cholesterol, the killer diseases that attack overweight people. But then again, with most weight loss drugs being available OTC, we must ask ourselves the question – is it ok to tempt and even court the disease just because we perceive that the cure is just a pill away? And are we fooling ourselves into believing that it is ok to be overweight because anti-obesity medicines are now available even without a prescription?

The truth cannot be written more clearly on the wall – we are a nation plagued by obesity; we invite disease with open arms because of our irresponsible lifestyles, a callous attitude towards exercise, and an overindulgence of food. And because of this, our healthcare costs are spiraling out of control. It’s time we stopped depending on pills and medicines as the panacea to cure all our ills and start looking at their source instead; it’s time we bring up our children to respect and safeguard their health instead of encouraging their sedentary lifestyles and feeding them with junk food; and it’s time we started giving good health the deference it deserves – we don’t have to place it on a pedestal, it’s enough that we acknowledge its importance in our lives.

(This article is contributed by Susan White, who regularly writes on the subject of online radiology technician schools. She invites your questions, comments at her email address: susan.white33@gmail.com)

But if we stop to think for a moment, we would realize the fact that medicines sometimes cause more harm than good, mostly because of our ignorance or because we abuse them knowingly. Take for instance a person who has been prescribed painkillers for a debilitating condition like a headache; seven times out of ten, you can bet that the patient takes them for more than the prescribed amount of time or uses these pills randomly even for perceived symptoms of pain. Some people become so addicted to painkillers that they suffer a relapse if they’re forced to stop. Painkillers have powerful chemicals that affect not just your digestive tract but also your overall physical and mental health.

While this is an instance of substance abuse, ignorance comes to the fore when we’re prescribed antibiotics or any other medication that must be taken for a certain period of time even if you feel better or the symptoms of disease are no longer present. Most people stop taking them when they feel ok, and because of this, variant and new strains of bacteria are formed and cause many more new diseases. Also, some people tend to dose themselves with antibiotics even for colds and other viral infections, thus setting themselves up for various health problems.

Be it the habitual pill popper or the compulsive addict, neither behavior bodes well for progress in the pharmaceutical world. The demand for drugs has also given rise to hundreds of spurious manufacturing units, most of which churn out OTC medicines that end up harming or even taking lives.

In order to maximize the efficiency of drugs and ensure that they do more good than harm, we must:

• Take them only with a prescription.
• Never use them beyond the recommended period or dosage.
• Never self-medicate.
• Never get into the habit of popping a pill for any perceived ailment.
• Always check for expiry dates and authenticity of the drug.

A little common sense goes a long way in making medicine effective and safe.

This article is contributed by Ashley M. Jones, who regularly writes on the subject of Online Pharmacy Technician Certification. She invites your questions, comments at her email address: ashleym.jones643@gmail.com

The word pandemic has been thrown around in recent years because of the prevalence of many major illnesses that have occurred throughout the third world nations as well as even many Western nations. However, the recent Swine Flu outbreak has caused much deliberation as to the proper terminology of the word itself.

There have been generations of widespread epidemics in the past that have included influenza, cholera, and a multitude of other diseases. However, the World Health Organization has come up with a six-tiered level in which to determine when to implement specific disease control efforts around the world, which has successfully led to many countries quarantining illnesses which could be easily spread abroad. However, the true definition of a pandemic is not delivered by the WHO nor can medical journals accurately define it as well. Rather, the general public is on its own to determine what a pandemic ensues, as it implies the “rapid spread of an infectious disease to many countries”. However, the severity of pandemics vary with each disease, and not every country is affected when an outbreak occurs.

Additionally, the variety of different illnesses affects the overall terminology of the word; scientists and doctors alike are still unsure as to how pandemics arise, how they spread, and why they vary in their lethality. The background of the originating country has a lot to do with the severity and contamination of the impending illness and helps contribute to the overall definition of a pandemic. The recent Swine Flu outbreak has increased concerns over the spread of a disease within these “Western nations” which otherwise were remarkably protected from threat of outside illnesses that could infiltrate these nations. The fact that the United States was one of the first countries to report signs of such a disease caused the WHO to scramble to upgrade their alert system in order to properly take care of this problem. It is unfortunate that it takes a Western nation to cause this much concern over an illness, while many African nations have been experiencing similar epidemics. The new limelight on these Western nations is solely due to the international trade that occurs within many of these nations, which therefore caused the disease to be spread throughout Europe, Asia, and Australia.

This new illness caused the WHO much stress as to a proper cure for the illness as well as a way in which to quarantine travelers from disease-ridden countries. While the illness can be treated with regular flu remedies, the fact that so many outside the tradition flu age group were coming down with the illness and succumbing to its side effects caused the WHO to take drastic measures and qualify it (perhaps prematurely) as a pandemic. This recent flu outbreak is vastly different from any earlier outbreaks which may be labeled as “true” pandemics, but this type of definition is forever changing and it may take another widespread illness before we can determine what is the proper scenario in which to classify as a pandemic.

This post was contributed by Meredith Walker, (Online nursing schools). She welcomes your feedback at MeredithWalker1983 at gmail.com

References: WHO Pandemic Phase Descriptions (pdf)

What would this graph look like?

The electric car has not come of age, because more than half of the electricity in this country (USA) is currently generated with coal – the dirtiest of fossil fuels.

- Comment in Time Magazine (Oct 13, 2008 issue)

Ten years later – we may be asking the same question. Again.

A prominent scientist X publishes a clinical trial that Drug A is effective in a particular disease.

Another scientist Y publishes another article reinforcing that Drug A is indeed an effective treatment.

Then several small studies are done which show that Drug A has harmful side effects. Some of these get accepted in prominent journals, while others are rejected. Five years later, FDA discovers to its surprise (!!!!) that Drug A is indeed associated with harmful side effects.

This has happened, is happening and will happen!!!

The big question is – Is there any way to prevent this?

Welcome to open source scientific data sharing.

Open source data sharing is similar to open source software, where not only the end result (i.e. software) but also the source code is given away for free. Open source data sharing therefore should aim to not only have all the scientific articles available for free but should also include the raw data that was generated during the course of the experiment or clinical trial.

There are thousands of scientists in the world who can benefit from this data and come up with amazing results. Probably, if the data for Vioxx and Vytorin studies was available online, their side effect profile would be exposed much earlier by “entrepreneur” scientists.

This talk given by Clay Shirky at TED in 2005 explains why we need to move from institutionalization towards open collaboration (which can only be enabled by data sharing).

Of course, there are certain differences between his and my proposal. He is giving public the authority to generate data. I am proposing that scientists generate data by careful experiments/clinical trials and publish their results but in addition make the data available for “entrepreneur” scientists to analyze. It is better to have many eyes looking at data rather than a few.

Besides searching for potential side effects in a mountain of data, open source data sharing has bigger benefits. Consider this:

Many NGO’s are currently funding scientific research in the hope of speeding up the process of scientific research to produce results quickly. Stand up to Cancer is bringing the best scientific minds across the world to develop new medications to fight cancer. This is excellent – but it goes back to Clay Shirky’s talk – Institutionalization vs open collaboration. The best brains can generate excellent data and also probably are the best people to analyze it. But, this data generated should be made available for all other scientists on this planet to analyze and build upon.

Historically most inventions happened by accident. Entrepreneur scientists can make these accidents happen more often - only if given access to scientific data.

The television medical drama Grey’s Anatomy apparently has more to offer than Patrick Dempsey’s rakish smile and a good cry. A new survey reports watching the show also may increase a viewer’s health smarts.

There is a lot of inaccurate information on television. According to this survey people remember health information imparted on TV, probably more so than given to them in their doctor’s office. Using the television media responsibly and effectively may increase public awareness of diseases and encourage healthy behavior.

The same goes for print media. Influential magazines should research medical articles before jumping to an opinion. The most recent example is an article in Time Magazine – Gastric bypass surgery less helpful for diabetics. A very catchy but misleading title. To the writer’s credit she did include this conversation with Dr. Hamdy:

I believe that the benefits of gastric bypass surgery outweigh any risk that a patient will have,” says Hamdy. “If you look at the mortality in relation to obesity itself, especially if it occurs with diabetics, that is much, much higher than the risk of mortality from the surgery.

… but it is included at the end of the article.

In my opinion the title should have been more appropriately worded as it gives an impression that gastric bypass surgery may not help in diabetes.

A lot of furore is ongoing on controlling health blogs and their content. However, the print media has a greater reach and authority than most blogs in influencing health related decisions for patients. Therefore they should carry equal if not greater social responsibility than health blogs.

Reference: USA Today, Time, ACP Internist Blog

Speaking at LIFT 2007, Sugata Mitra talks about his Hole in the Wall project. Young kids in this project figured out how to use a PC on their own — and then taught other kids. He asks, what else can children teach themselves?

“Up until now the treatment of this condition involved free water restriction and removal of inciting factors. Now a new drug – Tolvaptan promises to change it all.”

However, the article missed out the remaining post which in the end had my take on Tolvaptan -

“The main problem with the drug is that once approved, most clinicians will prescribe it for for a very long time especially in patients prone to developing and remaining hyponatremic. Since the study duration was only for 30 days, many new side effects may appear when the drug is finally marketed.”

Also my blog post was written in context of describing an article published in New England Journal of medicine and not for drug promotion which the article failed to mention. I should also add that I have no relationship with any pharmaceutical company as the article later implies (although not directly to this website) by writing:

“A recent survey reveals that 29% of blog authors have been approached by public relations professionals to endorse specific products, and 52% of them have written one post endorsing such products in their blog content. These endorsements are not advertisements that appear on the website; they are written into the blog narrative, often without any acknowledgement that they are paid promotions. Although we did find blogs that promoted health care products within their entries, we were unable to determine whether these were paid endorsements, because we found no disclosures indicating authors’ conflicts of interest.”

To all this I should also add that I pursue blogging because I have a passion for computers and technology and believe that we can help ourselves (physicians) as well as our patients by empowering them with the latest information in medicine that they can discuss with their physicians.

A very elderly lady, Mrs. Y presented to the ER for worsening congestive heart failure (CHF). She was diagnosed with CHF about 2 years ago. She had decompensated in the past 4-5 months and had been in and out of the hospital and rehab facility for CHF exacerbations. In the ER, she said that she does not want any treatment and wants to die since she cannot live with her family and is tired of being sick. Therefore in consultation with the family (who were present in the ER) she was changed to comfort measures and admitted to the medical floor.

When I saw the patient, I thought she was depressed and most likely did not have the capacity to take her own decisions. The family supported the patients decision for comfort measures although they admitted that they would like the patient to be treated for CHF.

It was a difficult situation for me, as I clearly knew that the patient’s CHF was easily reversible and the patient was depressed and most likely unable to take decisions. Also I was unable to reverse the patients code status.

I decided to take the midline approach i.e. treat the patient for CHF with high dose diuretics and give her morphine for difficulty in breathing (which is also a treatment for pulmonary edema and CHF) along with an antidepressant. I hoped that if she responds to the diuretics (and morphine) her breathing would get better and by 2-4 weeks her depression would be under control by the anti-depressants. On the other hand if she does not improve or deteriorates, she would be on morphine which would keep her comfortable and thus honor her desire to be on comfort measures.

What would you do?