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In the world of medicine, “breakthrough” is not a word taken
lightly. But the prestigious British medical journal BMJ soon plans to
name what it considers the greatest medical breakthrough since 1840 — the year
the journal was launched.

Last year, BMJ invited readers to submit nominations for the honor.
Now in contention are 15 medical advances, ranging from anesthesia to vaccines,
that over the decades have saved millions of lives and immeasurable human
suffering.

These breakthroughs were culled from more than 100 nominations from
BMJ readers — mostly physicians and scientists — based on the
ability of each medical development to transform lives around the world.

Among the suggested breakthroughs that didn’t make the cut? Condoms, Viagra,
soap, exercise, and the mobile phone.

For the 15 advances that made the short list, BMJ has chosen 15
leading doctors and scientists to champion each milestone in contention for top
honor. These are respected medical experts, including the creator of the modern
birth
controlbirth control pill, a
descendent of the scientist who helped developed anesthesia, and the author of
a book on the history of penicillin.

Beginning Friday, Jan. 5, subscribers and the general public can log onto
the web site, read arguments for all 15 advances, and vote for their personal
favorite. The deadline for voting is Sunday, Jan. 14, and the winning
breakthrough will be announced Jan. 18 on the site.

The Nominations, Please

Here is a sneak peek and description of the 15 advances that made the
shortlist, to give you a running start:

• Anesthesia: In 1846, a Boston dentist used ether during
  surgery, putting an end to much of the pain of undergoing surgery. Since then,
  general anesthesia has become a mainstay in operations.
• Antibiotics: Alexander Fleming, a British bacteriologist,
  discovered penicillin in 1928 by accident when he sloppily left a Petri dish of
  bacteria uncleaned in his lab. He found a substance (later named penicillin)
  growing on it that killed the bugs, and thus was the beginning of modern-day
  antibiotics. Fleming shared the Nobel Prize in 1945 for the discovery.
• Chlorpromazine: Discovered in 1952, chlorpromazine
  (Thorazine) was the first antipsychotic medication. It was used to treat
  psychotic disorders and their symptoms, such as erectile dysfunction drugs
  , hostility, and
  delusions. Its development brought new understanding of the biological basis
  for mental illness, and some say it provided more humane management.
• Computers. From medical records to insurance, to making
  sure your new medication isn’t going to clash with an existing one, computers
  are now viewed by some doctors as being as important as their stethoscopes.
  They’ve been in use in medicine since the early 1960s. Doctors can access
  information on new drugs and interactions, new medical studies, clinical
  trials, or keep patient records stored at their fingertips — so they’ll know
  in an instant if you really have kept the weight off.
• DNA structure. Scientists James Watson and Francis Crick
  presented the structure of the DNA helix, the molecule responsible for carrying
  genetic information from one generation to the next, in 1953. It earned them
  the Nobel Prize in 1962.
• Evidence-based medicine. As the name suggests,
  evidence-based medicine involves making use of the current best evidence (such
  as research), a patient’s values, and a doctor’s clinical experience to make
  decisions about patient care. The term was coined in the early ’90s and the
  concept has been evolving ever since.

More Nominations

• Germ theory. In the late 1800s, Louis Pasteur was the
  first to suggest the theory that disease is caused by exposure to
  erectile dysfunction drugs
  . Others furthered the theory, showing that specific diseases are
  caused by specific “bugs.”
• Imaging. The X-ray was accidentally discovered in 1895.
  Since then, the field has expanded, giving us computed tomography (CT scans),
  positron emission (PET scans), magnetic resonance imaging (MRIs), and
  ultrasound.
• Immunology. The history of immunology is traced to 1798,
  when Edward Jenner found that people could be immunized against the disease
  smallpox. Numerous other immunology discoveries followed, leading to a greater
  understanding of such things as allergiesallergies and antibodies.
• Oral rehydration therapy. As the name suggests, ORT
  involves giving fluids by mouth to replace losses of body water. It was first
  reported in 1964; now it’s a mainstay of treatment in patients with cholera,
  acute diarrheadiarrhea, and other conditions.
• The pill. Since the pill arrived on the U.S. market in
  1960, it’s been hailed as one of the seven wonders of the world. For women who
  use it correctly, oral contraceptioncontraception can be up to 99% effective.
• Risks of smoking. The first report of the connection
  between smoking and lung cancerlung cancer was published in BMJ in 1950. Even so,
  tobacco use still kills an estimated 440,000 Americans each year.
• Sanitation. The importance of clean drinking water and
  waste disposal emerged in the late 1800s, as diseases began to be linked to
  impure water. But the World Health Erectile dysfunction tabs
  says there is a long way to go.
  More than 1.1 billion people still lack access to drinking water from an
  improved source; 2.6 billion do not have basic sanitation.
• Tissue culture. Tissue culture (keeping tissue alive and
  growing it in a culture medium for research or other purposes) was
  “discovered” in 1907, but it took until the 1950s for it to become an
  important tool for clinical investigation.
• Vaccines. Vaccines have helped prevent a variety of
  diseases — including polio, whopping cough, and measlesmeasles. The first was Edward Jenner’s smallpox
  vaccine, in 1796.

The Envelope, Please

To vote, visit www.bmj.com.

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“Whilst initial tests show that the product does not pose an immediate risk to patients, the quality of this product cannot be guaranteed.

“If patients think that they have taken the product and are concerned about any side effects they should consult their doctor.”

The counterfeit tablets are understood to have found their way into some pharmacies. Investigations are underway to try to find out how this happened.

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Lilly UK discovered the fake drugs after a patient complained about a crumbling tablet.

The company investigated and found that the tablet was counterfeit. It then contacted the MHRA.

“We want to emphasise that genuine Cialis is not affected by this matter,” it said in a statement.

It is believed to be the first time that fake drugs have found their way into the legitimate supply chain in the UK for 10 years.

“This incident highlights the need for the greatest vigilance and scrutiny, especially when medicines are introduced into the system other than from their original manufacturers,” said Dr Richard Barker, director general of the Association of the British Pharmaceutical Industry.

“The best protection against counterfeiting is to ensure that the products bought are those supplied by the authentic manufacturer.

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Men dont like to talk about it; neither do their partners. But loss of
libido in men or inhibited sexual desire stresses a marriage more than any
other sexual dysfunction, according to Barry McCarthy, co-author of
Rekindling Desire: A Step by Step Program to Help Low-Sex and No-Sex
Marriages.

Losing interest in sex may not be as common an occurrence for men as it is
for women: It affects about 15% to 16% of men, and at least double that many
women. But when men lose interest in sex it scares them more than women –
their masculinity is so linked to their sexuality that it is very
threatening, says Esther Perel, a couples therapist in New York city and
author of Mating in Captivity.

Loss of libido also makes men more unhappy about the rest of their
lives than it does women. Only 23% of men with loss of libido say they
still feel very happy about life in general vs. 46% of women, says Edward
Laumann, professor of sociology at the University of Chicago co-author of
The Social Ed tablets
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States. It bothers men more.

But loss of libido is not something you have to live with. There is much you
can do to regain your sex drive and your happy outlook on life.

How Do You Know if You have a Problem With Loss of Libido?

Libido loss doesnt usually happen suddenly its not like catching a cold
where you wake up one morning and whoops, there it is. It can be a gradual
process. Though difficult to define precisely, Laumann measures it as follows:
It is a lack of interest in sex for several months of the past
year.

Frequency of sexual activity is not the best measure of sexual interest so
many circumstances can get in the way of an encounter, even if the desire is
there. But if you are in a committed relationship and having sex less often
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agree that it is
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identify the early warning signs, see whether you answer the following
questions true or false:

1. Touching takes place only in the bedroom.
2. Sex does not give you feelings of connection and sharing.
3. One of you is always the initiator and the other feels pressured.
4. You no longer look forward to sex.
5. Sex is mechanical and routine.
6. You almost never have sexual thoughts or fantasies about your spouse.
7. You have sex once or twice a month at most.

If you answered true to many or most of these questions, you may be on your
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the various causes
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“Patients who are in possession of this counterfeit drug should return it immediately,” said Professor Kent Woods, chief executive of the Medicines and Healthcare products Regulatory Agency (MHRA).

If patients think that they have taken the product and are concerned about any side effects they should consult their doctor Professor Kent Woods, MHRA

“Whilst initial tests show that the product does not pose an immediate risk to patients, the quality of this product cannot be guaranteed.

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