Tuesday 14 May 2013

Oral evening primrose oil and borage oil for eczema

Eczema is an allergic condition to the skin. Although these condition may be controlled but there is no cure. Some patient fear of the conventional medical products may switch to complementary alternative like evening primrose oil.
Bamford et al. written on Cochrane review looking at 27 studies (19 study evening primrose oil and 8 study on Borage oil). All study failed to improve global eczema symptom compared to placebo.

Saturday 11 May 2013

Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension

Coenzyme Q10 has been studied as a potential treatment for hypertension, a common medical condition.

A systematic review was conducted to try and use all available data to answer this question. Databases of clinical trials were searched for any studies that tested the effects of coenzyme Q10 on patients' blood pressure compared to a placebo.
 Three trials with a total of 96 participants were found in which coenzyme Q10 was used in patients with high blood pressure. The patients took coenzyme Q10 or a placebo daily for up to 8-12 weeks. Weighted data analysis showed that the systolic blood pressure was reduced by 11 mmHg and the diastolic blood pressure was lowered by 7 mmHg compared to placebo.

Cochrane author concludes that- uncertain if coenzyme Q10 could be a useful hypertension treatment, and more studies are needed

(Reference Cochrane Library)

Statin for Primary Prevention . Is it worth ?

The tasty of food and the rising of western food in The Malaysian comunity has make rising cholesterol an epidermic. The cholesterol has go up higher and higher in normal population on medical check up. Is statin is beneficial become an major thing to discuss.

Cochrane review showed that in the eight trials that reported on total mortality, none of the individual trials showed strong evidence of a reduction in total mortality, but when the data were pooled, a relative risk reduction of 17% was observed with statin treatment.No excess in combined adverse events, cancers, or specific biochemical markers were found. current systematic review highlights the shortcomings in the published trials of statins for primary prevention. They say that in people at high risk of cardiovascular events (>20% 10-year risk), "it is likely that the benefits of statins are greater than potential short-term harms, although long-term effects (over decades) remain unknown."
 recent meta-analysis from the Oxford group, published late last year, which showed a clear reduction in events with statin therapy in primary-prevention patients.

With the published of the cochrane and contraditing effects of Statin, therapy should be individulised. Patient with high risk of cardiovascular events (>20% in 10 years) worth for primary prevention. Whereas patient not fulfill the high risk Cv events, these need to be discussed with patient and decide .

Thursday 9 May 2013

Does eating standing up give you indigestion? Medical Myth


When you look at the causes of indigestion or functional dyspepsia, as it’s called in the medical literature, eating standing up doesn’t feature on the list. When likely causes such as stomach ulcers and gastritis have been ruled out, the management of dyspepsia can include changes to lifestyle, but this means eating a healthy diet, giving up smoking and reducing alcohol and coffee consumption. It doesn’t mean sitting down when you eat.
In fact doctors even recommend the opposite, if the pain is caused by acid reflux, when acid from the stomach comes back up into the oesophagus. This is where gravity can help; remaining upright during and after eating can keep the acid down in the stomach where it belongs. For the same reason, patients with reflux are advised to tip the head of their bed up, so that they sleep on a slant.
There are very few studies comparing fast and slow eaters, partly because it wouldn’t be easy to randomise people into eating at a particular speed and then to enforce that at every meal. A study from 1994 did include questions about eating speed in a survey of dietary habits. They found the speed at which you believed you ate had no relationship with the frequency of indigestion.  Research conducted in 2010 found the same, but these two studies rely on our ability both to judge our eating speed accurately, and to report it honestly.  
Professor Marc Levine, a radiologist at Hospital of the University of Pennsylvania x-rayed the stomach of a speed-eating champion after eating 36 hot dogs in ten minutes. The participant was happy to continue after eating 36, but the decision was made to terminate the study for his own safety. He didn’t have indigestion, while the unlucky man who’d volunteered to act as a controlfelt sick after seven hot dogs and had to stop.  The x-ray showed that the speed-eater had trained his stomach to expand to such an extent that he no longer felt full when he’d eaten.
 This brings us to what could be the problem with eating fast – it’s not indigestion, butthe disruption of the usual mechanism that makes you feel full. But even here the evidence is inconsistent. Some studies foundthat eating fast leaves you feeling hungrier, causing you to eat more. Other studies have shown the opposite.
 Conclusion :Whether sitting or standing doesn't matters as long as it doesn’t make you feel ill at the time, there doesn’t seem to be any harm in it.