When 22-year-old Karan (name changed) fell from a moving truck near Matunga five years ago, and injured his urethra—the membranous canal that carries urine—repeated infection and surgeries resulted in erectile dysfunction (ED). An implant would have set him back by at least Rs 70,000, a route that was too expensive for him. But now, the cure to erectile dysfunction need not be restricted to the rich. In the city’s public hospitals, a team of teachers are making it possible for the city’s poor to beat andropause blues, at affordable rates.
On Monday morning, Karan will get a silicone implant, all for a medical bill of Rs 10,000. “A child is the only one whom we can call our own. I want to marry in order to have a child. This will let me fulfill my dream of getting married and having a child,’’ says the unlettered vendor who hails form Mau district in UP.
Says Dr Sujata Patwardhan, who heads the urology department of KEM Hospital: “Penile implants are are expensive. A few American implants costs around Rs 2 lakh. We offer Indian prosthesis that have been in use since 1994 and have shown good results.’’ The public hospital programme only charges for the prosthesis; operation and hospitalisation charges are zero. The same prosthesis in a private hospital could cost over half a lakh.
Dr Patwardhan started the penile implant programme during her earlier stint at BMC’s other medical school, Sion Hospital, a few years ago. Between the two hospitals, her team has conducted 14 operations that have benefitted truck drivers, labourers, among others. “Soon, both hospitals will have independent implant programmes,’’ said Patwardhan.
In December, Kurla-based cobbler Abdul, a father of two, became KEM’s first penile implant patient. “He has been so happy with the results that he brought chappals as gifts for us,’’ says Dr Patwardhan.
Erectile dysfunction is usually a symptom of an underlying disease such as heart problem, diabetes or hypertension. “Considering that India has the largest number of diabetes cases, one can gauge the burden of erectile dysfunction. Roughly 10-20% of ED patients need an implant but barely 1% can afford it,’’ says andrologist Dr Rupin Shah, who devised the Indian penile prosthesis in 1994. He has since used it in roughly 150 patients each year.
His first patient for the desi implant was a young teacher at Bhatia Hospital who has since fathered two daughters and his oldest is an 82-year-old from Assam. “According to a study done in Gujarat, 20% of the men over 40 years had ED while 90% over 70 had ED. It is a sign of an underlying disease that is best treated at the earliest,’’ adds Dr Shah, who is attached to Lilavati Hospital.
Dr Shailesh Raini, urologist from Jaslok Hospital, says that the need for implants have come down since Viagra hit the shelves. “But there are those who have an irreversible ED and they need implants,’’ he says, adding that “they work, whether imported or Indian’’.
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Monday, May 10, 2010
Erectile Dysfunction Drugs Could Improve Delivery Of Anti-cancer Drug Herceptin
Erectile dysfunction drugs could improve delivery of anti-cancer drug Herceptin by lowering the “blood-brain barrier.” The research, published in the journal PLoS ONE, could help doctors improve treatments for lung and breast cancers that have metastasized to the brain
The new research by scientists at Cedars-Sinai's Maxine Dunitz Neurosurgical Institute suggests that a drug currently approved to treat erectile dysfunction may significantly enhance the delivery of the anti-cancer drug Herceptin to certain hard-to-treat brain tumors.
While cancers that originate in the brain are relatively rare -- approximately 22,000 patients are diagnosed with a primary brain tumor every year -- nearly 10 times that many people develop brain tumors from cancers that began elsewhere in the body. Lung cancer remains the leading cause of cancer death in the U.S., and about 20 percent of lung cancers metastasize to the brain. Breast cancer and melanoma may also spread to the brain, and once this happens, the cancer becomes extremely difficult to treat and the prognosis turns poor.
Even if a cancer is susceptible to drugs, these drugs must penetrate the "blood-brain barrier" if they're to treat cancer that's metastasized to the brain. "Mother Nature created this barrier to protect our brains from dangerous substances, but here we need to get through the barrier to deliver the drugs, and that's a problem," says study author Julia Y. Ljubimova, M.D., Ph.D., a research scientist at the Cedars-Sinai Maxine Dunitz Neurosurgical Institute in Los Angeles.
The new research by scientists at Cedars-Sinai's Maxine Dunitz Neurosurgical Institute suggests that a drug currently approved to treat erectile dysfunction may significantly enhance the delivery of the anti-cancer drug Herceptin to certain hard-to-treat brain tumors.
While cancers that originate in the brain are relatively rare -- approximately 22,000 patients are diagnosed with a primary brain tumor every year -- nearly 10 times that many people develop brain tumors from cancers that began elsewhere in the body. Lung cancer remains the leading cause of cancer death in the U.S., and about 20 percent of lung cancers metastasize to the brain. Breast cancer and melanoma may also spread to the brain, and once this happens, the cancer becomes extremely difficult to treat and the prognosis turns poor.
Even if a cancer is susceptible to drugs, these drugs must penetrate the "blood-brain barrier" if they're to treat cancer that's metastasized to the brain. "Mother Nature created this barrier to protect our brains from dangerous substances, but here we need to get through the barrier to deliver the drugs, and that's a problem," says study author Julia Y. Ljubimova, M.D., Ph.D., a research scientist at the Cedars-Sinai Maxine Dunitz Neurosurgical Institute in Los Angeles.
Why No Birth Control Pill For Men?
Two weeks ago, Care2 blogger Ann Pietrangelo wrote an excellent post looking back over the history of the birth control pill, which was approved by the FDA in 1960. The fiftieth anniversary of the pill has sparked many new retrospective looks at the way that the pill changed women's lives - although, as Ann points out, it's difficult to know what was caused by the pill and what was simply happening at the same time.
One question still remains, though: where is the male birth control pill? Elizabeth Landau explores this issue in an article published today on CNN, although it's definitely not a new issue - as Dr. John Amory, a researcher, points out, "The joke in the field is: The male pill's been five to 10 years away for the last 30 years." In researching this post, I stumbled upon several articles promising new and exciting leads - all of which seem to be duds. Landau points out that developing a male pill is more challenging because men produce far more sperm than women do eggs, and men have no periods where they shut off sperm production. Hormonal injections, though, seem to work, and certainly, we could be researching this more heavily.
Which leads us into a different realm, one that has less to do with science and more to do with demand. Landau quotes Andrea Tone, a professor at McGill, who points out that contraceptive gels and injections for men "could be very effective in preventing pregnancy, but if there isn't a clear market for it, companies understandably are a little reluctant to invest heavily in it." She also points out that women may mistrust men's ability to take a pill consistently, although this may be a myth (studies have shown that most women don't have this fear).
I think there may be another issue that Landau isn't mentioning, though. A few days ago, I stumbled upon a post on Jezebel declaring that hormonal birth control for women does reduce sexual desire. According to the post, "Researchers at the University of Heidelberg in Germany studied 1,086 women, and found that those taking hormonal contraceptives were at higher risk of sexual dysfunction than those using non-hormonal or no birth control."
This included other forms of birth control than the pill, but reveals a risk that may be much more threatening to men than to women - impotence. It's still socially acceptable (even though perhaps not desirable) for women to have low sexual drives, but for men, virility is still closely tied to masculinity. There would be zero demand for a contraceptive that would threaten male sexual performance or desire.
It doesn't really seem fair, though. Innumerable women can attest that the pill does not do good things for their sex drive, but we have few non-hormonal options. So instead of giving up on the male pill, maybe we should be thinking about hormonal birth control as a contraceptive, instead of period control (which is how the pill is often marketed), which would lead us to the obvious conclusion that maybe women don't like its side effects either. Would that require a dramatic revision in the way that pharmaceutical companies advertise the pill? Yes. Would it require companies to admit that people - gasp - use the pill because they're having sex? Absolutely. But would it help us get rid of some of the hang-ups that are preventing a male pill from being adequately researched? Maybe so.
Read more: sex, contraception, womens rights, the pill, male pill, hormonal birth control
One question still remains, though: where is the male birth control pill? Elizabeth Landau explores this issue in an article published today on CNN, although it's definitely not a new issue - as Dr. John Amory, a researcher, points out, "The joke in the field is: The male pill's been five to 10 years away for the last 30 years." In researching this post, I stumbled upon several articles promising new and exciting leads - all of which seem to be duds. Landau points out that developing a male pill is more challenging because men produce far more sperm than women do eggs, and men have no periods where they shut off sperm production. Hormonal injections, though, seem to work, and certainly, we could be researching this more heavily.
Which leads us into a different realm, one that has less to do with science and more to do with demand. Landau quotes Andrea Tone, a professor at McGill, who points out that contraceptive gels and injections for men "could be very effective in preventing pregnancy, but if there isn't a clear market for it, companies understandably are a little reluctant to invest heavily in it." She also points out that women may mistrust men's ability to take a pill consistently, although this may be a myth (studies have shown that most women don't have this fear).
I think there may be another issue that Landau isn't mentioning, though. A few days ago, I stumbled upon a post on Jezebel declaring that hormonal birth control for women does reduce sexual desire. According to the post, "Researchers at the University of Heidelberg in Germany studied 1,086 women, and found that those taking hormonal contraceptives were at higher risk of sexual dysfunction than those using non-hormonal or no birth control."
This included other forms of birth control than the pill, but reveals a risk that may be much more threatening to men than to women - impotence. It's still socially acceptable (even though perhaps not desirable) for women to have low sexual drives, but for men, virility is still closely tied to masculinity. There would be zero demand for a contraceptive that would threaten male sexual performance or desire.
It doesn't really seem fair, though. Innumerable women can attest that the pill does not do good things for their sex drive, but we have few non-hormonal options. So instead of giving up on the male pill, maybe we should be thinking about hormonal birth control as a contraceptive, instead of period control (which is how the pill is often marketed), which would lead us to the obvious conclusion that maybe women don't like its side effects either. Would that require a dramatic revision in the way that pharmaceutical companies advertise the pill? Yes. Would it require companies to admit that people - gasp - use the pill because they're having sex? Absolutely. But would it help us get rid of some of the hang-ups that are preventing a male pill from being adequately researched? Maybe so.
Read more: sex, contraception, womens rights, the pill, male pill, hormonal birth control
Herbal sex capsules hid drug in their casings
Erectile dysfunction pills marketed as "herbal" and "all-natural" have been recalled by Medsafe after tests found they contained a prescription ingredient that can be fatal.
Four products – SZM Formula for Men, Volcanic, Tomcat Ali and Stallion – have been recalled and the Health Ministry said consumers should stop taking any of the pills.
Tests showed that, although the capsule contents were all herbal ingredients, the capsule shells contained high levels of tadalafil – the active ingredient in prescription erectile dysfunction drug Cialis.
Tadalafil can interfere with some heart medications and using it in such cases can be harmful or even fatal.
The Health Ministry was not aware of any adverse reactions to the products.
The Medicines Act requires medicines to be approved by Medsafe before they are sold in New Zealand. Breaching the requirement carries a fine of up to $20,000 or six months' prison for individuals, and a maximum penalty of $100,000 for companies.
Medsafe estimates that hundreds of thousands of the capsules have been sold in pharmacies, health stores, adult shops and over the internet during the past two years.
Medsafe principal clinical adviser Enver Yousuf said the drug watchdog had become suspicious of the products after hearing reports of how effective they were.
Last year, Medsafe's Singapore counterpart discovered that some "rogue" manufacturers were adding active ingredients to capsule shells – which until now had not been tested.
"It was clear that the active ingredients were being added to the capsule shells in order to evade detection," Dr Yousuf said.
Medsafe would now test the capsule shells of other suspicious products.
SZM Formula NZ, which imports and markets SZM Formula for Men and Stallion, denied any knowledge that the capsule shells contained tadalafil. "The capsules are made in China," sales manager Ken Ringin said.
"It's been quite a shock – we're pretty angry with the suppliers of the product."
Four products – SZM Formula for Men, Volcanic, Tomcat Ali and Stallion – have been recalled and the Health Ministry said consumers should stop taking any of the pills.
Tests showed that, although the capsule contents were all herbal ingredients, the capsule shells contained high levels of tadalafil – the active ingredient in prescription erectile dysfunction drug Cialis.
Tadalafil can interfere with some heart medications and using it in such cases can be harmful or even fatal.
The Health Ministry was not aware of any adverse reactions to the products.
The Medicines Act requires medicines to be approved by Medsafe before they are sold in New Zealand. Breaching the requirement carries a fine of up to $20,000 or six months' prison for individuals, and a maximum penalty of $100,000 for companies.
Medsafe estimates that hundreds of thousands of the capsules have been sold in pharmacies, health stores, adult shops and over the internet during the past two years.
Medsafe principal clinical adviser Enver Yousuf said the drug watchdog had become suspicious of the products after hearing reports of how effective they were.
Last year, Medsafe's Singapore counterpart discovered that some "rogue" manufacturers were adding active ingredients to capsule shells – which until now had not been tested.
"It was clear that the active ingredients were being added to the capsule shells in order to evade detection," Dr Yousuf said.
Medsafe would now test the capsule shells of other suspicious products.
SZM Formula NZ, which imports and markets SZM Formula for Men and Stallion, denied any knowledge that the capsule shells contained tadalafil. "The capsules are made in China," sales manager Ken Ringin said.
"It's been quite a shock – we're pretty angry with the suppliers of the product."
How To Know Your Sex Pills Are Safe
The company marketing popular sex pill Herbal Ignite is delighted adulterated erectile dysfunction pills have been withdrawn from sale.
Company director Jenny Wheeler says the health authorities and people in the dietary supplements industry have known for some time that unscrupulous companies were selling adulterated pills because they have been detected by the FDA in the US and by health authorities in Australia.
However until now authorities have been slow to act to remove them from sale, something which has been of concern to local companies operating fully within New Zealand consumer law marketing product manufactured and tested according to Good Manufacturing Practice principles.
"Herbal Ignite is manufactured by a reputable Nelson company following all the testing procedures necessary to protect consumer safety," Jenny Wheeler said. "The capsules used are supplied by pharmaceutical giant Pfizer Inc, and all the herbs in Ignite are tested before and after manufacture to ensure they are not contaminated."
She says she understands if the Medsafe warning makes consumers question all erectile dysfunction products, but there are a few simple rules consumers can follow to ensure the product they are purchasing is safe.
Step One
Avoid any herbal pill that promises instant results. Tests done by Pfizer Inc, the New York-based pharmaceutical giant that developed Viagra, as well as other independent testing authorities, showed up to 90% of the herbal pills that promised "instant action" were spiked with illegal pharmaceutical ingredients, sometimes at dangerous levels.
Step Two
Choose herbs that have a long tradition in herbal medicine for treating men's sexual performance. In Europe, these include tribulus terrestris, Siberian ginseng, gingko biloba, horny goat weed, saw palmetto and wild oats. South American rain forest herbs like damiana, muira puama, and maca, and the Malaysian herb tongkat ali also all enjoy a long history of successful use for enhancing sexual performance.
Step Three
Ensure the formulation states clearly on the label what it contains and at what strength. For tribulus terrestris for example, studies show the best results require a formulation with at least 40 per cent concentration of the active saponens. Avoid products where the concentration of active ingredients is low or is not stated.
Step Four
Always use the product according to the manufacturer's instructions. If the product suggests taking the product according to body weight daily, you need to do this to get good results. The clinical trials with tribulus showed optimum benefits when used daily for 60 to 90 days. Many herbal remedies require gradual and consistent use for up to three months for the best results, so understand they do not generally offer an "instant solution". If they promise "instant results" they probably contain something which is undeclared on the label.
Company director Jenny Wheeler says the health authorities and people in the dietary supplements industry have known for some time that unscrupulous companies were selling adulterated pills because they have been detected by the FDA in the US and by health authorities in Australia.
However until now authorities have been slow to act to remove them from sale, something which has been of concern to local companies operating fully within New Zealand consumer law marketing product manufactured and tested according to Good Manufacturing Practice principles.
"Herbal Ignite is manufactured by a reputable Nelson company following all the testing procedures necessary to protect consumer safety," Jenny Wheeler said. "The capsules used are supplied by pharmaceutical giant Pfizer Inc, and all the herbs in Ignite are tested before and after manufacture to ensure they are not contaminated."
She says she understands if the Medsafe warning makes consumers question all erectile dysfunction products, but there are a few simple rules consumers can follow to ensure the product they are purchasing is safe.
Step One
Avoid any herbal pill that promises instant results. Tests done by Pfizer Inc, the New York-based pharmaceutical giant that developed Viagra, as well as other independent testing authorities, showed up to 90% of the herbal pills that promised "instant action" were spiked with illegal pharmaceutical ingredients, sometimes at dangerous levels.
Step Two
Choose herbs that have a long tradition in herbal medicine for treating men's sexual performance. In Europe, these include tribulus terrestris, Siberian ginseng, gingko biloba, horny goat weed, saw palmetto and wild oats. South American rain forest herbs like damiana, muira puama, and maca, and the Malaysian herb tongkat ali also all enjoy a long history of successful use for enhancing sexual performance.
Step Three
Ensure the formulation states clearly on the label what it contains and at what strength. For tribulus terrestris for example, studies show the best results require a formulation with at least 40 per cent concentration of the active saponens. Avoid products where the concentration of active ingredients is low or is not stated.
Step Four
Always use the product according to the manufacturer's instructions. If the product suggests taking the product according to body weight daily, you need to do this to get good results. The clinical trials with tribulus showed optimum benefits when used daily for 60 to 90 days. Many herbal remedies require gradual and consistent use for up to three months for the best results, so understand they do not generally offer an "instant solution". If they promise "instant results" they probably contain something which is undeclared on the label.
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