NEWS CAPSULES

CMI 13:3 71 July 2015

News Capsules – Medical news from around the world

Smartphone overuse may impair hand function

A recent publication in Muscle and Nerve has shown that

university students who use their smartphones most frequently,

especially for texting and browsing the internet, are more likely to

have a larger median nerve and impaired hand function. Repetitive

flexion-extension of the thumb and wrist while texting and pinching

movements of the fingers can stress the tendons of the thumb

(especially of the flexor pollicis longus) and the median nerve. Hand

function was measured using a standardised index and tendon and

median nerve sizes were measured using ultrasound. The study

found that FPL tendon and median nerve sizes were consistently

larger in those who used a smartphone most frequently. Hand function in terms of pinch strength and

thumb pain was also worse in this group when compared to those who used these devices less often.

This study however does not link heavy smartphone use to carpal tunnel syndrome. Using a phone

with two hands instead of one and using it less often were suggestions that could reduce the

stress on the tendons and nerves of the hand.

Heat stroke deaths

hit all-time high If one was to go by statistics,

2015 has been the most lethal

year in terms of heatstroke

deaths in the history of India.

Around 1300 deaths have been attributed to heat

stroke in the states of Andhra Pradesh and Telangana alone,

which is higher than the total for the entire country in 2014.

Ramagundam in Telangana for example sizzled at 46° C and

temperatures reached as high as 50°C in the quarries where

miners worked. The most vulnerable are manual labourers,

autorickshaw and bus drivers, the elderly, miners, street-side

vendors and cart-pullers. The poor who cannot afford

temperature controlling measures (air-conditioners and even

fans) or who are forced to work in hot conditions are

particularly vulnerable. Hospitals in these two states have

been seeing large numbers of patients who come in with heat

related symptoms.

You may be hard-wired to quit smoking A recent study published in

Neuropsychopharmacology suggests

that smokers who were able to quit the

habit were probably helped by a better

neural connectivity in their brains,

when compared to their compatriots

who found it difficult. In a randomised

study, the researchers compared the

functional connectivity of the part of

the brain called the insula in two

groups of individuals (smokers who

were able to quit after an attempt vs

those who relapsed) using a functional

MRI scan. Those who had successfully

quit smoking were found to have

better functional connectivity between

the certain regions of the insula and

the sensorimotor cortex when

compared to those who relapsed. They

concluded that the better connectivity

perhaps improved the ability to inhibit

the motor response to cigarette

cravings.

NEWS CAPSULES

CMI 13:3 72 July 2015

Exercise alone without modifying dietary intake will not help in reducing weight

It is a common recommendation to

spend time in exercise in order to reduce

weight. The number of people who have

started exercising has increased thanks to

increased awareness but so has the number

of those who are obese. It turns out that

exercise alone without reducing caloric intake is not of much use

if one is interested in reducing weight. A 30 minute bout of

moderate exercise may burn around 300 calories but this is soon

regained with two bottles of soft drinks – and not everyone

exercises regularly every single day.

A systematic study published in 2012 showed

that we routinely overestimate the amount of calories lost and

the weight lost with exercise. A more recent meta-analysis in

2014 has shown that diet restriction with exercise shows no

greater benefit over just diet restriction alone over a 6 month

period. There was significant benefit after one year however, if

diet restriction was combined with exercise consistently. This

study suggests that combining diet with exercise is more

beneficial in the long run than just diet or exercise alone.

‘Smart’ cane for the visually impaired

A ‘smart’ cane developed by Dr.

Roshan Paul and his IIT friends has

been helping the visually impaired to

navigate their surrounding safely for

over a year now. Ordinary canes

cannot detect objects above the

ground like branches of trees,

signboards etc. which pose obstacles

to movement for the blind in a country

like India. Designed in IIT Delhi, the

product called SmartCane uses

ultrasonic ranging to detect such

obstacles (ground to head-level)

and a vibrator indicates the

distance to the user through

different vibratory patterns. People

using the cane have said that walking

has become safer and is associated

with lesser injuries as they are able to

avoid objects that an ordinary cane

would not detect.

The cane is affordable, priced at around Rs. 3000, which is 1/20

th the

price of a similar imported device. It works well in both indoor and outdoor environments and uses a rechargea-ble battery. The SmartCane, has been commercially available since May 2014.

A study by the Maharashtra Food and Drug Administration

(FDA) has revealed that the maximum retail price of a cardiac stent

is 300% to 700% more than the actual cost of import in Maharashtra. The finding is based on the department’s

eight- month long (Sep 2014 to May 2015) inquiry against major importing companies dealing

in cardiac stents as well as distributors and hospitals in Mumbai, Pune and Nashik

division. The inquiries were specifically conducted to find the cost to the importing

company and also cost to the distributors, hospitals and, finally, the cost to the patients.

The department has now sent a set of recommendations to the National Pharmaceutical

Pricing Authority (NPPA) to bring it under control. The report stated that for one of the

stents, which had a landing cost of Rs. 25,000, the MRP was fixed at Rs. 1.55 lakh. The

FDA has also recommended that cardiac stents be brought under the national list of

essential medicines (NLEM) under Drugs Price Control Order (DPCO) since they are life-

saving. Even though cardiac stents fall under medical devices category, they are “drugs” as defined under Drugs

and Cosmetics Act 1940.Alarmed by unusual spikes in prices of cardiac stents (the MRP of stents is fixed by the

importing company), NPPA had also sought pricing data from manufacturers, importers and distributors of these

devices. (Source: CMC Pharmacy Bulletin June 2015)

Cardiac stents are unreasonably expensive, recommendations may lower prices