HEALTH TRIBUNE

Use morphine, it is harmless
by Monica Sharma
CHANDIGARH:
Morphine and other strong opioids, when correctly used, are safer than non-steroidal anti-inflammatory drugs. But every year millions of people unnecessarily die in agony due to "pockets of resistance" regarding their use to prevent pain.

Link between asthma, hormone replacement
CHICAGO:
Post-menopausal women on hormone replacement therapy are twice as likely to develop asthma as women who donít take the controversial hormone supplements, according to a study that has been released outlining yet another side-effect of the popular therapy.

Anticipating relief is the best pain reliever
WASHINGTON:
The brainís prefrontal cortex tends to anticipate relief and triggers reduced activity in areas that sense pain, claims a new study by scientists from the Ann Arbor Veterans Affairs Health Care System, University of Michigan and Princeton University.

Eyes deserve greater care
E
yes are one of the most precious gifts of God to man. They serve as windows on the world. Eyes also help in the diagnosis of various ailments. We should, therefore, be greatly careful about their health.

Cognitive decline in diabetic women
LONDON:
Researchers have warned that women with diabetes have worse mental (cognitive) function and suffer greater cognitive decline than those without diabetes, according to a British Medical Journal report.

 

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Use morphine, it is harmless
by Monica Sharma

CHANDIGARH: Morphine and other strong opioids, when correctly used, are safer than non-steroidal anti-inflammatory drugs. But every year millions of people unnecessarily die in agony due to "pockets of resistance" regarding their use to prevent pain.

Doctors from various parts of the world, who were in Chandigarh to participate in an international conference on palliative care, say that 90 per cent of the times pain can be managed straightaway, but in India only 3 per cent of the population has access to pain control measures.

"Even though government regulations and policies are changing, still patients do not get morphine," reveals palliative care physician from Aberteen University in Scotland Dr Mhoira Leng.

The assertion assumes significance as addiction to narcotic analgesic or opioids is common among patients recovering from orthopaedic and post-operative pain. Closely associated with the misuse of opioids are social problems. Instead of seeking treatment, many addicts raise funds by engaging in petty thefts, forgery and even prostitution. When potent narcotics are not available, the addicts seek closely-related drugs and sometimes even use large quantities of cough preparations containing codeine or hydrocodone.

"The use of both classes of analgesic ó morphine and non-steroidal anti-inflammatory drugs ó is justified on the basis that the benefit of pain relief far outweighs the risk of serious adverse effects," says Dr Robert G. Twycross of Oxford. "Indeed, clinical experience suggests that a patient, whose pain is relieved, lives longer than he would have if he had continued to be exhausted and demoralised by severe unremitting pain".

He adds, "A proper understanding of the principle of double effect is necessary. An action having two possible foreseen effects, one good and one harmful, is not always morally prohibited if the harmful effect is not intended. This is a universal principle without which the practice of medicine would be impossible. It follows inevitably from the fact that all treatment has inherent risk."

Patients, even doctors, sometimes get the "false impression" that the use of Morphine is a high-risk strategy. "But when correctly used, morphine and other strong opioids are very safe drugs, safer than drugs widely prescribed with impunity," says Dr Twycross.

However, there are still pockets of resistance regarding the use of morphine to relieve cancer pain. "Internationally, such resistance is generally the norm," the doctor adds.

He concludes: "Governmental and bureaucratic resistance or indifference continues to be a major stumbling block in this area. This resistance stems from Opiophobia ó the fear that patients will become addicted, the doctors will divert supplies, and the number of street addicts will escalate. Unfortunately, many doctors are also opiophobic. But without a strong professional and public lobby in favour of change, the status quo will continue."
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Link between asthma, hormone replacement

CHICAGO: Post-menopausal women on hormone replacement therapy are twice as likely to develop asthma as women who donít take the controversial hormone supplements, according to a study that has been released outlining yet another side-effect of the popular therapy.

US researchers who reviewed data on more than 121,000 women found that women taking estrogen or estrogen plus progestin were twice as likely to have been recently diagnosed with the condition as women who did not use the supplements.

Even women who had come off the therapy had a higher incidence of asthma than a control group: past use was associated with a 50 per cent increase in risk, although it tailed off to zero after a few years.

The authors of the study cautioned that the numbers of older women who develop the respiratory disorder, which is characterised by wheezing and shortness of breath, is small.

Statistics show that only 1 per cent of women fall into the at-risk category, according to the study carried in the Journal of the American Medical Association.

"The findings do, however, support an important role of female productive hormones in asthma," said Graham Barr, an epidemiologist at Brigham and Womenís Hospital (BWH) in Boston, Massachusetts, and lead researcher on the study.

"The data suggest that for women who have severe asthma that develops late in life, they may want to consider a trial of stopping HRT to see if this alleviates their condition." ó AFPTop

Anticipating relief is the best pain reliever

WASHINGTON: The brainís prefrontal cortex tends to anticipate relief and triggers reduced activity in areas that sense pain, claims a new study by scientists from the Ann Arbor Veterans Affairs Health Care System, University of Michigan and Princeton University.

According to a report in Ivanhoe, the prefrontal cortex is responsible, among many things, for judgment, attention span, problem solving and impulse control.

The scientists performed functional magnetic resonance imaging (fMRI) on 24 individuals with the intention of mapping changes in brain blood flow. They were given painful electric shots or heat, followed by a placebo anti-pain cream. The brainís pain pathway was less active when the patients thought they were given the anti-pain cream.

Dr Kenneth L. Casey, the co-author of the study, is confident that it will further the development of integrating placebos into future patient treatments.

"If youíre providing a treatment to patients, itís important that you realistically provide them with the expectation that it would work, so you enhance the effect," Casey said.

"If you gave them a drug or any kind of treatment with the attitude, either explicit or implicit, that might not be effective, it would be much less likely to be effective," he concluded. ó ANITop

Eyes deserve greater care

Guide to Healthy EyesEyes are one of the most precious gifts of God to man. They serve as windows on the world. Eyes also help in the diagnosis of various ailments. 

We should, therefore, be greatly careful about their health.

One way to ensure the health of our eyes is to acquire as much information on the subject as possible. This can go a long way in preventing vision-threatening problems. 

The book, "Guide to Healthy Eyes", by Dr R. Kumar and Dr Meenal Kumar, published recently, can be greatly useful for the general public, students and their parents, teachers and all other professionals. It covers most common eye problems affecting different age groups.

The book, published by Deep and Deep Publications, New Delhi, also provides basic details about the functioning of our eyes. The writers have employed simple language for the benefit of lay readers.Top

Cognitive decline in diabetic women

LONDON: Researchers have warned that women with diabetes have worse mental (cognitive) function and suffer greater cognitive decline than those without diabetes, according to a British Medical Journal report.

Cognitive decline is an intermediate stage between normal ageing and dementia. The study is available on bmj.com.

Interviewing 18,999 women aged between 70-81 years, who were taking part in the nursesí health study in the United States, the researchers tested the women for cognitive function and cognitive decline over two years.

At the start of the study, women with Type 2 diabetes performed worse on all cognitive tests than women without diabetes. Odds of poor cognition were 50 per cent higher for women who had diabetes for 15 years or more.ó ANI

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