new treatment for interactable cluster headache

Continuous electrical stimulation of bilateral occipital nerve was found to be effective in the treatment of interactable cluster headahe.Eight patients with medically intractable chronic cluster headache were implanted in the suboccipital region with electrodes for occipital nerve stimulation.At a median follow-up of 20 months ( for bilateral stimulation), six of eight patients reported responses that were sufficiently meaningful for them to recommend the treatment to similarly affected patients with chronic cluster headache. Two patients noticed a substantial improvement (90% and 95%) in their attacks; three patients noticed a moderate improvement (40%, 60%, and 20–80%) and one reported mild improvement (25%). Improvements occurred in both frequency and severity of attacks. These changes took place over weeks or months, although attacks returned in days when the device malfunctioned (eg, with battery depletion). Adverse events of concern were lead migrations in one patient and battery depletion requiring replacement in four.In these patients a range of different stimulation frequencies, pulse widths, and voltages were used.Peripheral nerve stimulation has been used in neuropathic pain with mixed success in the past.
Source.Lancet

What is the chance of Inheritance of diabetes?

Adult onset Diabetes(Type 2)

When one twin of an identical twin pair develops type 2 diabetes, the risk that the other twin will develop the condition is between 50% and 100%. Despite this clue to the involvement of genetics in the development of the condition, just as with type 1 diabetes, the inheritance pattern of maturity-onset type 2 diabetes is not clear-cut.
Recent research suggests that type 1 and type 2 diabetes "cluster" in the same families. These findings support a possible genetic interaction between type 1 and type 2 diabetes mediated by the HLA genes .
From work on animals, it is suggested that predisposition to develop type 2 maturity-onset diabetes may be due to inherited variations in one or more of several genes. Genes located on the long arms of chromosomes 2 (2q), 12 (12q), 1 (1q), 3 (3q) and 20 (20q) have been implicated.

Thus while research is continuing to define the genetic involvement in type 2 diabetes, the risk that relatives of a family member with diabetes will also develop the condition has been estimated from observation of families with a history of the condition.

For example, the risk for developing type 2 diabetes to the siblings of people with the condition is about 30%. When one parent has type 2 diabetes, the risk that their child will also develop diabetes in middle age is about 10 % or 1 chance in 10.

If however both parents have type 2 diabetes, that risk increases to about 20% or 1 chance in 5 and the diabetes may also onset earlier than middle age. Nevertheless, since these risks relate to the tendency or predisposition to develop the condition, diet and exercise may postpone the onset of the condition, or the diabetes may not develop at all.
Inheritance pattern in type-1(JUVENILE ONSET) diabetes is less strong.Even in persons with genetic suceptibility an environmental trigger is required.

What is the chance of getting Cervical Cancer after an HPV infection?

Human Papilloma Virus


Human Papilloma Virus is the name given to a group of more than 100 different viruses. Some of these are the most common type of sexually transmitted diseases (STD) and some are related to cervical cancer.Anyone who is sexually active, , can get HPV. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of men and women . Any woman who has ever been sexually active is at risk for getting
cervical cancer from HPV.
Less than 5% of women who get HPV will actually get cervical cancer. Many will never know they have HPV since it can go away on its own.Getting the HPV vaccine between the ages of 9 and 26 can prevent up to 70% of cervical cancers caused by HPV types 6,11,16 and 18. The best time to get the vaccine is before your first sexual contact. It will not prevent disease if you already have the virus. The vaccine does not prevent infections or disease from any other strains of the HPV virus.

What are obesity genes

Researchers have announced the discovery of the first common gene link to obesity.
They reviewed genetic data on more than 38,000 children and adults in the U.K. and Europe. A certain variation in the FTO gene was associated extra body fat, obesity, and type 2 diabetes.But this does not mean that diet and Exercise are important in controlling obesity.The association is mediated through changes in fat mass and is detected across a range of adiposity.This results were announced by researchers of
Institute of Biomedical and Clinical Science, Peninsula Medical School, Magdalen Road, Exeter,UK.But one important potential source of false positive associations in genetic studies is population stratification.This could arise from either ethnic admixture or alternatively population stratification within an ethnically homogenous
group. In this study cohorts any individuals who were not European whites were excluded. In addition the cohorts were all recruited from single countries with the
majority coming from specific small geographically defined regions and analysis for association was only done within individual cohorts. Analysis of the FTO signal does not support this association resulting from population
stratification

Source:Science express

what is obesity?

Obesity can be defined as a body mass index of more than 30.Body mass index is weight divided by square of hight.Normally it is between 18.5 and 25.if it is between 25 and 30 it is overweight and above 30 it is called obesity
Risks of obesity
Hypertension
Diabetes melitus
Coronary heart disease
sleep apnoea

Side effects of Cholesrol lowering drugs

Statins are the drugs usually prescribed for reducing high Cholestrol.. They are generally well-tolerated, and side effects are rare. Minor side effects include constipation, diarrhea, fatigue, gas, heartburn, and headache. Atorvastatin should be used with caution in patients with alcohol or other liver diseases. Persistently abnormal liver tests during treatment are rare but may require discontinuation of the medication. Rare cases of muscle inflammation (myositis) and breakdown have been reported with other drugs in this class (HMGCoA reductase antagonists), and it is assumed that this side effect also may occur with atorvastatin. Muscle breakdown causes the release of muscle protein (myoglobin) into the blood and accumulation of the protein in the kidney tubules, resulting in kidney failure.

Where to look for support and informations on Neurological diseases

http://www.epilepsy.ca/eng/mainSet.html
http://www.americanheadachesociety.org/
http://www.parkinson.ca/pd/prof.html
http://www.strokeassociation.org/
http://www.nationalmssociety.org/

Brain death and neurologist

neurologist will be often called in to declare brain death.It is often a tricky situation especially when patient is in a ventilator.The heart and lung will be often functioning normally in these cases.
So how brain death is declared.
Unresponsiveness
The patient is completely unresponsive to external visual, auditory, and tactile stimuli and is incapable of communication in any manner.
Absence of cerebral and brain stem function
Pupillary responses are absent, and eye movements cannot be elicited by the vestibulo-ocular reflex or by irrigating the ears with cold water.
The corneal and gag reflex are absent, and there is no facial or tongue movement.
The limbs are flaccid, and there is no movement, although primitive withdrawal movements in response to local painful stimuli, mediated at a spinal cord level, can occur.
APNOEA TEST: An apnea test should be performed to ascertain that no respirations occur at a PCO2 level of at least 60 mmHg. The patient oxygenation should be maintained with giving 100% oxygen by a cannula inserted into endotracheal tube as the PCO2 rises. The inability to develop respiration is consistent with medullary failure.
Nature of coma must be know
Known structural disease or irreversible systemic metabolic cause that can explain the clinical picture.
Some causes must be ruled out
Body temperature must be above 32 C to rule out hypothermia
No chance of drug intoxication or neuromuscular blockade
Patient is not in shock
EEG and Brain blood flow studies are not mandatory but often helpful in doubtful cases.

What ia alopecia ?

Alopecia is the medical term used for HAIR LOSS.Alopecia areata is the patchy hair loss which is an autoimmune problem.
Causes of Generalised alopacia
In males testosterone action results in baldness

Hormonal changes eg thyroid disease, childbirth, or use of the birth control pill
A serious illness (like a tumor of the ovary or adrenal glands) or fever
Medication such as cancer chemotherapy
Collagen vascular disorder like SLE
Excessive shampooing and blow-drying
Emotional or physical stress
Nervous habits such as continual hair pulling or scalp rubbing
Burns or radiation therapy
Zinc deficiency
Tinea capitis (ringworm of the scalp)

Multiple sclerosis- what are the presenting features

MS can cause present with variety of symptoms, including changes in sensation(parasthesia) visual problems due to optic nerve involvement, muscle weakness, depression, difficulties with coordination and speech(cerebellar or its connection), severe fatigue, cognitive impairment, problems with balance, sensitivity to heat and pain. The initial attacks are often transient, mild (or asymptomatic), and self-limited. They often do not prompt a health care visit and sometimes are only identified in retrospect once the diagnosis has been made based on further attacks. The most common initial symptoms reported are: changes in sensation in the arms, legs or face (33%), complete or partial vision loss (optic neuritis) (16%), weakness (13%), double vision (7%), unsteadiness when walking (5%), and balance problems (3%); but many rare initial symptoms have been reported such as aphasia or psychosis. Fifteen percent of individuals have multiple symptoms when they first seek medical attention. For some people the initial MS attack is preceded by infection, trauma, or strenuous physical effort.Another form of MS otherwise called neuromyelitis optica present with paraplegia and visual loss.MS is more common in women than in men

What is the significance of high triglyceride in serum?

High triglyceride levels are common in Diabetes melitus,obesity and Alcoholism.If the blood sugar is normal and there is no other risk factors a fasting glucose tolerance test should be performed as impaired glucose tolerance is so often associated with high serum triglyceride.Impaired GTT indicate the high chance of developing diabetes in near fuure.High triglyceride levels are independent risk factor for stroke and coronary heart disease.Very high levels are associated with pancreatitis.So dietary restriction of carbohydrate and fat is important in such patients.
Drugs useful are nicotinic acid ,fibrates and statins particularly atorvastatin.
Fish oil which contain plenty of omega 3 fatty acid also are helpful.
Fish oil if given in excess to children can elevate intracranial(INSIDE SKULL) pressure and lead to interactable headache.

How to Search Medical Literature

The best way to do Medical literature survey is to Search in pubmed for authentic articles in standard medical journals.But most of the search results are abstracts.The full articles can be obtained in MD.Consult,or Science direct which are avilable with most of the libraries.The Search engines like Google ,Yahoo and ,MSN give mixed General medical literature along with scietific medical literature,so it is so often difficult to differentiate between these two.So the authenticity of this information is so often questionable and misleading.

Dietary Advice for GOUT patients

Uric acid ia a metabolic product of purines.So high purine containing items should be particularly avoided.
brains
kidney
Beef,liver
sardines
scallops and
sweetbreads
Vegetables HIGHEST in purine include:

asparagus
cauliflower and
mushrooms
Milk, eggs, and cheese, are good sources of protein, and do NOT contain high levels of purine.

Diets high in fat and alcohol, as well as very low calorie diets, can lead to more frequent and severe GOUT attacks.

Birth control pills a word of caution

High eostrogen containing birth control pillsare well known to produce side effects in about one third of people who are taking it.Most of them are insignificant but rarely can be dangerous also.In a neurological point of view they increases the incidence of migraine,stroke and Venous thrombosis inside the brain vessels.weight gain,abdominal discomfort,fluid retention and acne are very common.There is also increased chance of developing peptic ulcer hypertension and heart disease in people who use these drugs for a long period

Menstrual migraine

Women suffer migraines three times more frequently than men. Out of 60 percent of these women experience worsening during menstruation. They occur before, during or immediately after the period, or during ovulation.Menstrual migraines are primarily caused by estrogen.so, women on birth control pills may experience more menstrual Migraine,Headche begins as a one-sided, throbbing headache accompanied by nausea, vomiting, or sensitivity to bright lights and sounds. An aura may precede the menstrual migraine.Premenstrual headache occurs before the periods and is associated with a variety of symptoms .The symptoms include headache pain accompanied by fatigue, acne, joint pain, decreased urination, constipation and lack of coordination. You may also experience an increase in appetite and a craving for chocolate, salt, or alcohol.Analgesics,sumatriptan and ergotamine are effective in acute stages.

Vitamins are they protective against aging

Anti oxidants are molecules which prevent oxidative damage of tissues.Some of thevitamins
acts as antioxidants
Much research has recently focused on how antioxidant vitamins may reduce cardiovascular disease risk. Antioxidant vitamins — E, C and beta carotene (a form of vitamin A) — have potential health-promoting properties. Though the data are incomplete, So antioxidents may have a role in delaying aging,preventing heart disease,Treating parkinsonism.But the data are insufficient to prove defenite benefit
Vitamin B and C if taken in excess will be excreted in urine.They are generally safe except a small increase in incidence of renal stone formation if Vitamin c is taken in excess.But a normal diet with fish,meat and plenty of fresh vegetables are sufficient source for a normal adult.

you witness a newly developed stroke.what next?

Stroke can be in simple terms defined as brain attack.it is either due to blocking of the cerebral vessels or bleeding into the brain.treatment is different for both the condition.if it is due to blockage you can lyse the block with drug called rtpa which should be given within 3 hours.As time passes brain damage is irreversible and the drug become ineffective.So the patient should be rushed into Emergency where thrombolytic therapy is avilable.A CT is performed on arrival and if there is no bleed and no contraindication for the drug,it is given as iv infusion over one hour.The dreaded complication is development of bleed,though it is rare.

Are you suffering from Tremor

It may be just normal this is called physiological
TREMOR ,it get exaggerated in anxiety states.Another common form of tremor is Beinign essential tremor.Essential tremor (sometimes called benign essential tremor) is the most common of the more than 20 types of tremor.The hands are most often affected but the head, voice, tongue, legs, and trunk may also be involved. Head tremor may be seen as a "yes-yes" or "no-no" motion. Onset is most common after age 40, although symptoms can appear at any age. Parkinsonian tremor is caused by damage to structures within the brain that control movement. The tremor is classically seen as a "pill-rolling" action of the hands but may also affect the chin, lips, legs, and trunk. Dystonic tremor occurs in individuals of all ages who are affected by dystonia, a movement disorder in which sustained involuntary muscle contractions cause twisting motions or painful postures or positions. The most commonly used drug for benign essential tremor is propanalol.IT should not be used in patients with bronchial asthma.Parkinsons tremor do not respond to propanalol.Alcohol reduces benign essential tremor.But it is not a good idea to have alcohol to alleviate tremor

laughter the best medicine

Doctor to Nurse : please give an injection B-12 to this patient
Nurse: B-12 is out of stock,We have only Injection B-6 avilable
Doctor : Oh ,I see In that case Give two of them.

what to do if you see a patient have fits

Aviod injury by moving the patient to safe surrounding
Dont try to restrain
Prevent tongue bite by inserting a firm object into mouth But dont chock him !
Turn the head to one side this will prevent aspiration
Immediate hospitalisation required if fits last more than 15 minutes
No scientific proof for giving a key to the patient
Clear the airway once the episode is over
It may take a while for the patient to regain full consciouness
Dont leave him alone as the patient will be disoriented for several hours after
a fit
Post fit vomiting and headache are common and do not indicate a serious problem
Remember him to take next dose drug as he may be unaware of it.

diet for hypertensives

Dietary restrictions are important in control of hypertension.First and formost among this is reducing dietary salt intake.Increasing dietay potassium is hepful.Almost all fresh fruits are good source of potassium especially Oranges and goosberry.dietary calcium is also helpful.
Another imporatant aspect is reducing the high fatty diet.High fibre in diet in turn reduces high cholestrol by reducing the fatabsorption
The main complication of hypertension is target organ damage in the form of herat failure,kidney failure,stroke,coronary heart disease.High cholestrol is a risk factor for all these disease.
Exercise is also beneficial in reducing blood pressure
stress management is often helpful but impractical.More about
DIETcan be learned here.

Music therapy

music therapyis an established allied health profession in which music is used to address the physical,psychologicalcognitive spiritual and social needs of the individual.Board certified music therapists must complete 100 continuing music therapy education credits,within five year period.In parkinsonism
Rhythemic auditary stimulation to improve gait
Patterned sensory enhancement
theraputic instrumental music perfomanceMusic assister relaxation
theraputic singing to improve speech and song discussion can be used.

Avoid tight Under garments

Tight undergarments are known to compress lateral cutaneous nerve of thigh and produce an unpleasant sensation of parasthesia and pain on thigh on outer aspect.This is known by a fancy term meralgia parasthetica.This can be helped by avoiding tight belts,waist bands and undergarments.This condition is quite common in DIABETESand Obecity.

Treatment is symptomatic.If a tender point is identified at the nerve exit a local steriod injection may alleviate the symptoms.
Drugs used include Amitriptiline,Gabapentin,Carbamazepine and pregabalin
Control of diabetes is also important

Do you have sleep disturbances

Sleep problemscan occur in various psychological disorders especially depression.Early morning awakening and difficulty in getting into sleep again may be a feature of underlying depression

REM sleep behaviour Disorder is quite common inParkinsonism.This term means that dream acting out associated with yelling ,hitting and can be quite violent also.This may disrupt sleep as well as relation ship with the partner.REM sleep behaviour has been reported to precede several years before onset of parkinsons disease.

this condition is heled by clonazepam and gabapentin

Health Tourism -why it is significant

Medical tourism in India is in a big boom because of two reasons
1-Long waiting list for a procedure in north america
2-High cost of treatment in US
Just see the following cost comparison between Indian and US hospitals


Procedure
Approx.Cost
US India

Hip Replacement 14000$ 4500$

Bypass Surgery 15000 $ 4500$

DBS in Parkinsons 30000$ 1200$

What is duschene muscular dystrophy

DMD is an X-linked recessive disease and is the commonest childhood muscular dystrophy. The basic defect is the absence of dystrophin a protein in skeletal muscle, cardiac muscle and brain. In muscle, this binds the contractile filaments to the sarcoplasmic membrane. Absence of dystrophin renders the sarcolemma susceptible to breaks and tears during muscle contraction and allowing entry of calcium ions into cell leading to cell death. The gene is located at Mp 21 site. The disease presents when the child stands up from squatting. As time passes weakness increase and respiratory muscle weakness leads to death. The selective involvement of muscles spares certain muscles like deltoid and hypertrophy of calf muscle occur with contracture. Brain involvement may result in mild mental retardation. Treatment with steroids and supportive physiotherapy may delay the progression of the disease. Newer modalities of treatment include myoblast transfer therapy and gene therapy which are yet to become completely successful.

Role of exercise in Back pain

Back pain can be due to various causes.A very common cause is disc diseases.This condition can be helped by exercise.Exercise is contraindicated in acute painful state.But once the pain is controlled rigular exercise to strengthen paraspinal muscle can help in preventing further recurrence.

what to do when parkinsons patient freeze

Try visual cues- lines on floor
Canes which depicts laser beams are avilable
Walker which emit laser beams to floor may help
An obstracle in front may help
Auditary cue
Rhythemic music
Marching band
Try it next time

Are you suffering from headache

Headache is quite common disease and almost every body had it at least once in life time,
But watch for the warning symptoms,if it is there see your doctor immediately
Associated Early morning vomiting
Associated double vision
Eyelid droop or facial deviation
First onset fits with headache
Weakness of limbs with headache
Worst headache in life
Progressively increasing headache foe weaks

It is time to undergo a CT head or MRI if such symptoms are present

Do you have a relative with Alzheimers Disease

Here are the Treatment options avilable
Donepezil is the most commonly prescribed anti-dementia therapy in the world. In the initial clinical trials, both 5 mg and 10 mg daily doses were equally effective in improving cognitive and functional ability of individuals with mild and moderate Alzheimer disease over 3 months to 6 months. Recent evidence suggests that donepezil maintains cognitive test scores at or above baseline for a period of 9 months to 12 months and is superior to placebo for more than one year
Rivastigmine is a carbamate derived cholinesterase inhibitor. As a newer agent, somewhat less published information and treatment experience is available. It has shown efficacy for improving cognition, behavior, and function similar to that reported for donepezil. A dose-dependent response occurs with the greatest efficacy at highest doses, but tolerability at those dose ranges is sometimes problematic
Galantamine has acetylcholinesterase activity and may also have a direct facilitative effect on nicotinic ACh receptors. As with rivastigmine, clinical experience is limited, in comparison to donepezil and tacrine. The clinical trials experience suggests cognitive, behavioral, and functional effects similar in magnitude to other cholinesterase inhibitors
The preceding drugs are considered cognitive-enhancing agents, but are not known to affect the underlying mechanisms of cell death in Alzheimer disease. Other agents have been studied for their ability to slow the progression of Alzheimer disease by altering the rate of neuronal death. The antioxidant compounds vitamin E (alpha-tocopherol) and selegiline have been reported to slow the progress of moderately severe Alzheimer disease, without improving cognitive ability
Noncognitive symptoms are often a greater source of caregiver difficulty than the memory loss. These are usually treated with conventional psychotropic agents such as neuroleptics, antidepressants, and anxiolytics. Cholinesterase inhibitors can also alleviate noncognitive symptoms, with the greatest effect in moderately affected individuals

what is perry syndrome

It is a rare type of inherited parkinsonian disorder
it is characterised by apathy,hypoventilation,progressive weight loss and finally leading to death from respiratory arrest.No defenitive treatment so far.Tracheostomy and mechanical ventilation will prolong longivity

gene therapy - the future of medicine?

Gene transfer to human patients may be ex vivo or in vivo.
Ex vivo gene therapy. Ex vivo gene transfer techniques usually involve the genetic alterations of cells (cell lines or human cells), mostly by use of viral vectors, prior to implanting these into the tissues of the living body. These methods have been frequently used in clinical trials because they are usually more efficient than in vivo methods. One disadvantage is that reimplantation of genetically engineered cells grown in culture may not result in long-term survival of a large portion of the cells unless they are protected by encapsulation before injection.In vivo gene delivery may be local (in situ) or systemic. In situ gene therapy means the introduction of genetic material directly into a localized area in the human body. The site of gene delivery may be irrelevant in systemic delivery with some form of targeting, provided the therapeutic molecule is released effectively and can reach its final site of action. In vivo gene delivery is likely to combine specific targeting systems with novel transcription switches.

memory loss -what all are the common causes

Causes of Persistent Recent Memory Loss

Korsakoff syndrome
Sequelae of head Injury
Sequelae of cardiac arrest
Sequelae of anterior cerebral artery aneurysm rupture
Cerebral infarction in:
-hippocampal formations
-medial thalamic regions
Herpes simplex encephalitis
Structural lesions of hypothalamic-mammillary body region
-tumors
-granulomatous disease
Dementias:
Alzheimer disease
vascular dementia
dementia with Lewy Bodies
fronto-temporal dementias
Huntington disease

Can Radiation therapy be dangerous

The answer is yes.
Delayed necrosis of the spinal cord and brain is a well recognized sequelae of radiation therapy for tumours in these regions and in the thorax and neck. The peripheral nerves are more resistant to this adverse affect.Transient myelopathy: The “early” type of radiation myelopathy (appearing 3 to 6 months after radiotherapy) is characterized mainly by paresthesias in the extremities. The paresthesias may be evoked or exacerbated by neck flexion (Lhermitte symptom). Delayed Progressive Radiation Myelopathy: This, the most dreaded complication of radiation therapy, is a progressive myelopathy that follows, after the characteristic latent period, the irradiation of malignant tissues in the vicinity of the spinal cord. The incidence of this complication is difficult to determine because many patients die of their malignant disease before the cord lesion matures, but it is estimated to be between 2 and 3 percent .

Why young onset parkinsonism is common in Canada

This is just a hypothesis,yet to prove by clinical studies

The incidence of parkinsonism is much more common In canada when compared to countries like India.What may be the possible cause,
Canada is a cold country.Most people are shut down in rooms with poor ventilation
Many of them live in basements.Rebreathing of air in poorly ventilated rooms result in carbondioxide retension and possibly carbon monoxide formation.Carbonmonoxide poisoning is a wellknown cause for development of parkinsonism.There are several reports of overnight development of parkinsonism resulting fron acute carbonmonoxide poisoning.eg.attempted suicide .so living in poorly ventilated room may be probably resulting in development of basal bganglia toxicity resulting in toxicity.doctors and scientists are welcome to give your openion.

why sexual dysfunction is increasingly common in young

I have encountered several cases of erectile dysfunction in the last 7 years of clinical practice.The possible cause of early onset erectile dysfunction is diet.Almost 90% of erectile dysfunction is thought to have a vascular etiology.That means the vessels supplying penis which has a major role in maintaining erection get blocked resulting in inadequate blood supply.Erection is maintained through pooling of blood in the region of corpora cavarnosa of penis.When the blood supply is limited ,naturally the process of erection is impaired.So any condition that compromise the inner diameter of pudental vessels(that supply penis) will result in impotence.Hypercholestrolemia andDiabetes melitus are well known to produce vascular narrowing.So the dietary habits which predisposes to these conditions has a major role in erectile dysfunction.
What we can do about this,
Control high cholestrol
Treat Diabetes are primary preventive measures
In established cases drugs which increase bolood flow to pudental arteries are found very helpful.
Sildenafil citrate popularly known as VIAGRArevolutionised treatment of sexual dysfunction.this drug acts in 1/2-1 hr time after oral intake and the effect will last for 8 hours.
The story of invention of viagra is interesting.This drug was initially tested for treating heart disease in angina patient in a clinical trial.the investigators gave medicines to patients butthis drug was found not useful in its treatment.When patients participated in the study was asked to return the tablets they were reluctant to return it.On further questioning they revealed the fact that this drug was remarkably improving sexual function.
Viagra is of course a drug having side effects and ideally taken with the prescription by a medical practitioner.Patients with heart disease on nitrate should be especially cautious in taking this drug.

Newer derivatives of this drugs with prolonged duration of action are also in the market.,

Botox in Neurology

You must be aware that botox is a toxin used for treatment.it has wide spread use in beauty therapy otherwise called as cosmetology.this mainly acts by reducing ringles on face due to aging.It is also used to reduce swating in axilla.But more importantly it is useful in treating conditions like dystonia, blepharospasm and spasticity.These terms are pretyy complicated for common man but I should say they are not,if you watch people around you ypu must have seen people who blinks so often ,may be onside only repeatedly.This is a very common condition.patients with this condition are reluctant to face public for cosmetic reasons.Botox is the solution as most of the oral drugs do not work here.It is relatively free of side effects if used by a expert neurologist familiar in its use.An excess dose can cause drooping of eye lid.what botox actually does is paralysing the overactive muscle.The main poroblem with this form of treatment is that the effects wanes of easily in about 3-6months time.That means you will have to repeat the treatment in 3-6 months time.The drug is costly too.In canada it costs about 400 dollars.The vial once opened has to be used within a day as its potency is lost

Hi Friends

I am new to this venture.Iet me introduce myself I am a neurologist working in university of british columbia hospital.I will be happy to answer any questions in my field of expertise,if you need.