Perambulations in Puttenahalli.

Scared witless by dire warnings from medical friends about the horrifying ailments that will befall those who turn fifty, one decides to embark on a fitness drive.

Thus, clad with one ‘Reeback’ tracksuit from a roadside boutique (made as USA, assures the label), one pair of cloned Nikes, one Chinese iPod and hot walking tips from the Net, one sets off on a morning walk.  In Puttenahalli.

The walker’s website advises ‘Start with a deep breath’.  So, one goes ‘Aaaahh, Inhaaaale !’ Bad mistake. There’s an overflowing garbage bin at the corner. Gasp, choke, gag.

puttenahalli-1-2-c‘Avoid main roads’, the website further advises.  That’s easy, no main roads here. In fact, no roads here at all. There’s a huge bottomless pit where 15th Cross used to be. This bottomless pit, the notice board says, is the JNURM Underpass – that should have come up in Feb 2009. So much for the IT City.

One trips and stumbles across the debris, and ducks into a side-lane. Another bad mistake. No tar on this road. The stones slice into desi Nikes. The feet howl in protest. One takes a detour into muddy 8th Cross. Soft mud may be dirty but it doesn’t chew up your soles.

Mud doesn’t chew up soles but the local canine brigade certainly does. For sheer raw excitement in the morning, there’s nothing like five growling feral dogs charging right at you.

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One takes very quick detour into the next lane. Right. We start again.

Feel the air in your lungs, the website says. The air has a misty feel. Just like a dream sequence from Bollywood.  Gasp, choke, wheeze. Dream sequence shattered. The mist turns out to be dust from a local maid’s vigorous broom.

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Website walking tips be damned. One finally seeks refuge in the newly tarred main road.  Nice smooth tar, no dogs, no vigorous brooms, no bins. One can put in some serious walking finally.

Impact of one round object on the cranium. “Ball please!”, yell ten future Sachins, in one collective scream, from the playground across the road. One doesn’t wish to ruin the future of Indian cricket.  So one tosses ball. Which bounces back from the fence. Future of Indian cricket giggles loudly. With a mighty heave one clears the fence. And adds injury to insult as one’s ancient shoulder screams in protest.

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Now it’s one lonely man against the Elements. Dusty lungs, torn feet, aching arm, but one walks on grimly.

“MOOOOOOOOOOOOOOOOO!!!”  “Daari bidee Saar !”

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Entire cardiac system skips one colossal beat.  It’s the local milkman and his bovine employees. One doesn’t wish to incur the wrath of 300 crore devis and devtas that our scriptures say reside in those cows, so one makes a strategic retreat. The Gods have won.

One retires hurt to one’s pavilion, and one bows to the inevitable. One joins the local gym, for an astronomical fee. It’s expensive, it’s crowded with brash, pushy IT types, the music is loud enough waken the dead but it does have a couple of good treadmills – and it does have several nubile nymphets in clingy garments, merrily jiggling away with no concern for the laws of gravity or for an elderly bachelor’s pounding heart.

Finally, one can put in a brisk walk…and flirt a bit in the process. And maybe get oneself a nice young girlfriend. Thus filled with hope in one’s heart, one grins broadly at the nubile nymphet merrily jiggling on the next treadmill and says, “HI. Isn’t it a fine morning?”

And afore-mentioned nubile nymphet sniffs and says, “Hello, Uncle”.

Next morning – armed with one TV remote, one tunes into the aerobics show on ESPN , and firmly settles down into nearest couch.

Potatoes are good for the heart, say my medical friends.

Naturally, that includes couch potatoes.

Cheers … Srini.

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Great Drugs of the 20th Century – The beta blockers – 1964.

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William Heberden, 1710-1801, British physician.

They who are afflicted with it are seized …with a painful and most disagreeable sensation in the breast, which seems as if it would extinguish life …  William Heberden, British physician, 1768. A classic description of an impending heart attack.

Cardiovascular disease is the number one killer in the world.  And as late as the 1950’s, doctors couldn’t do much about it.

Sir James Black at Imperial Chemical Industries, UK  tried to tackle the issue by developing drugs that could decrease the heart’s demand for oxygen, thereby reducing the strain on it.  Along with chemist John Stephenson, he developed a series of compounds, one of which was code-named ICI 45,520.

ICI 45,520 did decrease oxygen demand and slowed down racing hearts.  Patients treated with the drug had a death rate four times less than those who had not received the drug.

ICI 45,520 was officially launched by ICI in 1964 as Propranolol under the brand Inderal.

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Sir James Black and his Nobel! Image source: bbc.co.uk

Sir James Black flagged off the age of the beta-blockers.

Propranolol is a remarkably versatile drug. It has proved useful in managing many heart ailments like essential hypertension, arrhythmias and cardiomyopathy (weakening of the heart muscle).

Propanolol is prescribed for migraines and cluster headaches. It is also used in the management of anxiety and post-traumatic stress. Propranolol, in fact, prominently featured in Selling Sickness, a famous episode of Boston Legal, in which a vehement argument is made for the use of propranolol in treating a teenage rape victim.

Stage performers use propranolol for stage-fright and even surgeons are known to use it to control hand tremors during surgery.

Black’s beta-blocker is currently being tested as a potential anti-cancer drug and for the management of malaria. Clearly, propranolol is a multi-faceted drug that will be with us for a long time to come.

No wonder James Black picked up a Knighthood and a Nobel, among several other honors and awards.

Cardiologists today have several beta-blockers at their disposal, but their first choice would still be Black’s Boon – propranolol.

To be continued …

Great Drugs of the 20th Century – the Chill Pill – 1963.

THE CHILL PILL – VALIUM – 1963

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Marilyn Monroe – victim of barbiturate poisoning.

By the 1950’s, doctors were disillusioned with the barbiturate sedatives.  There were far too many cases of barbiturate abuse, accidental deaths and suicides.  The challenge was on for safer sedatives.

In 1955, Dr. Leo Sternbach, an organic chemist with Hoffman-LaRoche at Nutley, New Jersey, took up the challenge.  For two years, Sternbach made one molecule after another in his lab and tested each of them for sedative activity. Not one of them worked. Finally, in 1957, the company told him to ‘stop these foolish things and go back to more useful work.’

Sternback decided to have his lab cleared out and move on to other research. One of his assistants came across a white, crystalline powder that Sternbach had made many months before and code-named as Ro 5-0690. 

Sternbach decided to test this last molecule and sent it to his colleague Dr Lowell Randall, head of the pharmacology section, for testing on mice. This one made all the mice come tumbling down. Leo Sternbach had made the first Benzodiazepine. Roche patented it in 1958 as chlordiazepoxide, and after approval from the US FDA, introduced it under the brand name Librium in 1960.

Along with fellow chemist, Earl Reeder, Sternbach eventually developed a more powerful benzodiazepine called Diazepam, that was launched by Roche in 1963 as Valium.

The name Valium is derived from the Latin phrase Valeo Valui Valiturus, and that means be strong, have power and be well.

Valium quickly became the world’s favorite bedtime story, and one of the world’s most popular pharmaceutical products.

After Valium, Roche and other companies quickly introduced several other benzodiazepines, like alprazolam, nitrazepam, flurazepam, midazolam and temazepam.

There are about 40 different benzodiazepines available today. Alprazolam, better known in the US by its brand name Xanax (Upjohn Pharmaceuticals), is currently the leading benzodiazepine.

Diazepam is still widely prescribed for insomnia and anxiety disorders.  Unlike the older barbiturates, benzo’s are reasonably safe drugs with a high therapeutic index – when used correctly and when used strictly under medical supervision.

Benzodiazepines are habit-forming drugs, with the potential to cause physical dependence, even at normal therapeutic doses. And they should never, ever be taken with alcohol. sternbach5

Leo Sternbach didn’t get a Nobel for putting the world to sleep and he didn’t make money from his discovery. But he was a happy man all the same, and lived up to the age of 97.

He lived that long, one would suppose, because he slept well every night – although he never took Valium himself!

To be continued …