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.

puttenahalli-1-4-c

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.

puttenahalli-1-10

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.

puttenahalli-1-8

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

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

puttenahalli-1-c

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.

Great Drugs of the 20th century – Viagra – 1998.

STAND UP AND BE COUNTED – VIAGRA – 1998

keep-calm-and-have-a-viagraOn March 27, 1998, men across the world stood up to be counted. Literally.

On this day, the USFDA formally approved a drug called Sildenafil citrate, better known as – Viagra.

And the world was blessed with a new form of adult humor – Viagra jokes.viagtoon

But make no mistake. Erectile Dysfunction (ED), or primary impotence, isn’t funny at all.  It can be devastating. Right from the dawn of recorded history, quacks have been peddling all kinds of ‘remedies’ for this extremely embarrassing and traumatic ailment.

Viagra is mankind’s first serious drug against ED.  It’s reported to benefit about 80% of ED patients who have taken it.

Actually, we’re lucky. Sildenafil was almost discarded as a failure. In early 1990, Dr. Ian Osterloh and his research team at Pfizer’s lab at Sandwich, UK, began work on drugs that could expand blood vessels and reduce hypertension. One promising molecule was code-named UK-92480.  This compound had a moderate effect on blood vessels but it did not remain in the body long enough and it could cause muscle pains in some volunteers. By 1992, Osterloh was about to abandon the drug as a failure.  Until some test subjects said they were having erections.  Osterloh and his team investigated this finding further and the results were, well, ‘upstanding’.

Osterloh convinced Pfizer to invest in extensive clinical trials on this potential treatment for erectile dysfunction. Eight years after UK-92480 was first made by Osterloh’s team, several clinical trials and a few hundred million dollars later, Pfizer formally applied to the drug regulatory authorities for a license in 1997.

viagra_45305Viagra is now regularly prescribed to more than 30 million ED victims. It has ‘uplifted’ men and saved millions of relationships.

Technically, Sildenafil is a vasodilator, i.e. it can dilate blood vessels. Sildenafil blocks an enzyme in the body called phosphodiesterase (PDE5). By blocking PDE5, certain blood vessels in the body expand and allow more blood to flow through. And this in turn causes a rush of blood to, well, the “right” place. What is special about Viagra is that the rush of blood it causes is in a specific direction – the afore-mentioned “right” place. Until Viagra came along, no other vasodilator could increase blood flow specifically to that one organ.

Incidentally, Viagra can cause other things to stand up as well. Israeli and Australian researchers have discovered that small concentrations of Viagra dissolved in a vase of water can double the shelf life of cut flowers, making them stand up straight for as long as a week beyond their natural life span.

Viagra, however, is not a toy.  Osterloh cautions that, ‘It is a serious medication for a serious disease.  It is not intended for healthy, functioning men.  It is not a ‘stud’ drug.’

Dr. Ian Osterloh says he has never taken Viagra himself.  Presumably because he does not need it!

And in case you’re wondering, yes, sildenafil is available in India, from several Indian manufacturers – but only on prescription.

Great Drugs of the 20th Century … Concluded.

Cheers … Srini.

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

heberden
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.

_46073405_sir_james_black_466
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 …