Three Important Indications of Parenteral Alcohol for Therapeutic Purposes
OP Kapoor
There are three conditions, where alcohol injection
is being increasingly used for therapeutic indications:-
H.O.C.M. (Hypertrophic Obstructive Cardiomyopathy) - In this condition alcohol is injected in the septal arteries supplying the hypertrophied septum in the heart in order to produce necrosis and reduce the obstruction.
Hepatoma - One of the non-surgical treatments of hepatoma is to inject alcohol into the hepatoma in order to produce necrosis (specially if it is less than 3 cm.)
In a patient having a cyst of the liver or kidney (even Hydatid cyst) and specially, if the cyst appears again and again; in such cases injection of alcohol into the cyst causes shrinkage. It can be used even in patients having ovarian cysts.
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
A NEW COURSE FOR ASCOT?
`We hope these results will be used to inform clinical practice in ways that should greatly reduce the burden of cardiovascular mortality and morbidity are well established. However, no individual trial using standard diuretic or b-blocker therapy has shown a significant reduction in coronary heart disease. In the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), Björn Dahlöf and colleagues compared the effect of combinations of older drugs - atenolol and thiazide - with newer drugs - amlodipine and perindopril. After 5 years the investigators found that those allocated the amlodipine - based regimen had lower blood pressure values, and noted that the newer drugs prevented more major cardiovascular events and caused fewer cases of diabetes than the older drugs. In a second ASCOT study, Neil Poulter and colleagues found that a reduction in blood pressure was the single biggest contributor to the effect on stroke events, but other factors, such as differences in cholesterol, were more important for coronary events. In a Comment, Jan Staessen and Willem Birkenhäger discuss the implications of these studies on the use of newer drugs, especially in patients with complicated hypertension, associated risk factors, or metabolic disturbance.
