Dr K K Aggarwal

eMedinewS Editorial

Alternative drug option for cholera treatment

In a randomized double-blind trial, single dose azithromycin treatment of cholera resulted in better clinical and bacteriological results than six doses of ciprofloxacin. The study results were presented by Wasif Khan, MBBS, of the International Centre for Diarrhoeal Diseases Research in Dhaka, Bangladesh at the annual meeting of the Infectious Diseases Society of America (IDSA). He said that single-dose azithromycin is now the standard of care at the center, which treats around 30,000 cholera cases annually. The objective of the study was to find an alternative for ciprofloxacin, which in recent years had shown declining efficacy, though frank resistance was rare. A single dose of ciprofloxacin had clinical and bacteriological success rates of 93% and 97%, respectively in 1993-1994. The respective rates were 27% and 10% in 2003-2004. The center compensated by administering multiple doses of the drug, which brought the rates back up to 67% and 60%. The study included 246 men with cholera, who were randomly assigned to receive either a single dose of azithromycin 1 gm or six doses of ciprofloxacin twice-daily for three days. The first two doses were one gram each and the last four were 500 mg each. The salient observations of the study were as follows:

• Clinical success (no watery stool within 48 hours of starting the drug): Azithromycin 63% vs ciprofloxacin 44%; the difference was significant at p=0.005.
• Bacteriological success (no cholera bacteria in the stool after 48 hours of starting the drug): Azithromycin 68% vs ciprofloxacin 45%; the difference was significant at p<0.001.
• Patients on azithromycin had significantly fewer stools and lower stool volume, at P=0.004 and P<0.001, respectively.

The minimum inhibitory concentration (MIC) needed to block 90% of the bacteria was 0.404 micrograms per milliliter for ciprofloxacin, some 135 times greater than the amount needed when the drug was first tested against cholera.

Dr KK Aggarwal
Editor in Chief

eMedinewS Editorial

Perfect Health Mela to open for the public today

The 17th MTNL Perfect Health Mela will open to general public today at 8 am. The 10-day Mela, an annual event of the Heart Care Foundation of India, will end on 31st October. The Mela is organized in association with various departments of Government of Delhi. It will be a blend of health exhibitions, competitions, checkups, entertainment incorporating all pathies under one roof.

The Mela will be a perfect picnic spot for the public. Competitions like Inter School, Inter Nursing School/College, Inter Dancing School, Inter School for Children with Special Needs etc. are being organized during the Mela.

Seminars on ‘Women Empowerment’ and another on ‘Global Warming and Ethnic Crisis’ are also being organized as part of the Mela activities.

There will be special sessions for general practitioners on ‘Chest Pain’ and ‘Obesity’ on the 24th and 31st October, respectively, 2010. On 30th there will be a lively cultural evening for the doctors.

I take this opportunity to invite you all to the Mela and especially request my doctor colleagues to offer community service OPDs at the Mela venue.

Dr KK Aggarwal
Editor in Chief

eMedinewS Editorial

FDA warns makers of chelation treatments

The U.S. FDA is cracking down on the over–the–counter sale of so–called chelation products that claim to treat conditions such as autism, heart disease and Alzheimer’s by removing heavy metals from the body.

The FDA said it sent warning letters to eight companies telling them their products were unapproved drugs and devices, and any claims about treating medical conditions with these products violated federal law. These products are dangerously misleading because they are targeted to patients with serious conditions and limited treatment options, said Deborah Autor, director of the Office of Compliance in the FDA’s Center for Drug Evaluation and Research. Although there are FDA-approved chelation drugs that are used in cases of heavy metal poisoning with a prescription, no chelation therapy products are approved for sale over the counter or on the Internet. Serious safety issues have been linked with chelation products, which can alter the levels of certain substances in the blood. Even when used under medical supervision, these products can cause serious harm, including dehydration, kidney failure and death. One child died while being treated for autism with an intravenous chelation product, FDA said.

Some claim to treat autism spectrum disorder, cardiovascular diseases, Parkinson’s disease, Alzheimer’s disease, macular degeneration – a major cause of blindness –– and other serious conditions, the FDA said.

The letters were issued to the following companies: World Health Products LLC; Hormonal Health LLC; Evenbetternow LLC; Maxam Nutraceutics/Maxam Laboratories; Cardio Renew Inc; Artery Health Institute LLC; Longevity Plus, and Dr. Rhonda Henry, a nutritionist.

Dr KK Aggarwal
Editor in Chief