Accident victims and soldiers with severe head injuries could soon be treated with a contraceptive pill if the results of a major trial prove successful.

Research has suggested that progesterone, a steroid used to fool a woman's body into thinking it is pregnant, could also be used to protect damaged brain tissue.

An earlier study of 100 patients showed that injections of the hormone soon after a head injury safely reduced the risk of death and long-term disability.

The new Phase III trial conducted at 17 medical centres around the US will enrol around 1,140 brain damaged patients over three to six years.

The ProTECT III study will be led by scientists from Emory University in Atlanta, Georgia, where the neuro-protective properties of progesterone were first discovered more than 25 years ago.

Trial leader Dr David Wright, who announced the research at the annual meeting of the American Association for the Advancement of Science in San Diego, California, said: "No new treatment for severe TBI (traumatic brain injury) has been approved in over 30 years.

"With such promising success in laboratory testing and in our previous clinical trial, we hope to conclude in this national trial that progesterone - along with standard medical trauma care - works better than standard medical care alone in reducing brain damage caused from a TBI."

Traumatic brain injuries are common among road accident victims, and are also the "signature wound" of soldiers injured in modern conflict zones such as Iraq and Afghanistan.

Around two million adults and children in the US suffer a significant TBI each year, the researchers said.

The injuries led to 50,000 deaths and 80,000 new cases of long-term disability.

The Medical Council of India (MCI) has finalised a code of conduct restraining doctors from getting influenced by drug makers through gifts and other disguised bribes to bring down costs for patients.

"Our efforts of the past three years have finally borne fruits and we have been able to bring out an enforceable code of ethics for doctors," said Dr Ketan Desai, president, MCI.

The MCI's code prohibits doctors from receiving gifts, travel facilities, hospitality, monetary grants, medical research, endorsements, etc.

The notification on December 10, 2009, amended the 'Indian Medical Council (Professional Conduct, Etiquette and Ethics), Regulations 2002', stipulating guidelines to be followed by medical practitioners in the country.

The doctors' self-regulatory body has been looking for ways to prevent corruption in the profession. This is probably the best step the body could have taken, although there is a belief that it may not be effective given that it won't be able to supervise lakhs of doctors spread throughout the country.

MCI is an appellate body regulating the country's medical practitioners through various state medical councils. The council started working on the draft regulations in 2006.

With this code, medical practitioners are prohibited from receiving gifts, cash or monetary grants, accepting tours, paid vacations or any hospitality from any representatives of pharma or health care companies under any pretext.

They will not be allowed to endorse any drug or product publicly and ensure that their professional autonomy is not compromised.

They may, however, work for pharmaceutical and allied healthcare industries in advisory capacities, as consultants, as researchers, as treating doctors or in any other professional capacity.

Through this amendment to the existing code of ethics, MCI aims to fulfill two chief objectives. "First, no medical professional should be influenced by any pharma company.

Secondly, since pharma companies will save on their marketing spend on doctors, we expect that they will pass on the benefit to the patients by reducing the prices of drugs," informs Dr. Desai.

The code lays down the summary of dos and don'ts to be followed by the doctors - leaving many questions unanswered.

New guidelines for predicting women's heart disease risk, updated in 2007 by the American Heart Association (AHA), work well, according to researchers who put the new strategy to the test.

The guidelines recommend a simplified approach to assessing a woman's heart disease risk, categorizing it as high risk, at-risk, or optimal risk.

The researchers evaluated how well the guidelines worked by testing them with participants in the Women's Health Initiative (WHI), which enrolled more than 160,000 women, ages 50 to 79. Next, they compared it to a commonly used approach for predicting cardiovascular disease risk from the long-running Framingham Heart Study.

''The advantage to the 2007 AHA guideline is that it's simple," says study researcher Judith Hsia, MD, director of clinical research at AstraZeneca, who conducted the study while a professor of medicine at George Washington University in Washington, D.C.

"One drawback is, it's only for women," she says, although ''there is no reason it shouldn't work for men."

Hsia and colleagues categorized the women from the WHI study as high risk, at-risk, or optimal or low risk, depending on risk factors. (The WHI study evaluated the effect of hormone therapy, diet, calcium, and vitamin D on heart disease and cancers.) Here are the characteristics of each category:

* High-risk women have known cardiovascular disease, diabetes, or end-stage or chronic kidney disease.
* At-risk women have more than one major risk factor for heart disease (such as cigarette smoking, poor diet, inactivity, obesity, family history of early heart disease, high blood pressure or cholesterol, evidence of ''subclinical'' vascular disease, metabolic syndrome, or poor treadmill test results).

Optimal or low-risk women have a healthy lifestyle and no risk factors. A healthy lifestyle included exercising the equivalent of 30 minutes of brisk walking six days a week and eating less than 7% of total calories from saturated fat.
The Framingham Heart Risk Method

Hsia's team compared the new AHA approach to one commonly used approach from the Framingham Heart Study, a long-running study of heart disease launched in 1948, that uses seven characteristics to compute the predicted risk of heart problems over the next 10 years:

* Age
* Gender
* Total cholesterol
* HDL "good" cholesterol
* Systolic blood pressure (upper number)
* Need for blood pressure medication
* Cigarette smoking

For instance, a woman who is 50 with healthy cholesterol levels (175 total and 60 HDL), doesn't smoke, is on blood pressure medication, and keeps systolic pressure at 120 would have a 10-year risk of 1% for heart attack or coronary death.

Those categorized as high-risk using this method have a 10-year risk of more than 20% and a history of heart disease or diabetes.
Testing the AHA Guidelines

Hsia and her colleagues found that 11% of the WHI participants were high risk, 72% were at risk, and 4% at optimal or low risk using the AHA guidelines.

Another 13% could not be categorized as they lacked risk factors but didn't have good lifestyle habits. That group may need to be addressed in future version of the guidelines, says Hsia.

At the follow-up about eight years later, women in the high-risk group were more likely to have a heart attack or die of coronary disease than were the lower-risk women. While 12.5% of the high-risk women had a heart attack or died from heart disease, 3.1% of the at-risk women did, and just 1.1% of the optimal-risk women did over 10 years.

When Hsia's team compared the new guidelines with the Framingham risk prediction, they found the new guidelines predicted heart problems with accuracy similar to the Framingham categories of less than 10%, 10% to 20%, and over 20%.

The AHA guidelines were less accurate, however, than another Framingham approach, which uses risks of less than 5%, 5% to 20%, and over 20%.

The new guideline, however, ''is more accessible," Hsia says. "It's easier for practitioners to use, easier for patients to understand. I am not saying this [AHA] guideline is preferable to Framingham, but it's worth considering," Hsia tells WebMD.

Based on the risk category, a doctor can then work with the woman to control or eliminate the risk factors.

The Cancer Research and Relief Trust (CRRT), in association with the Indian Institute of Technology Madras, will organise a three-day international conference on cancer biology 'Cancercon 2010' in the city from Thursday. It would explore means of using molecular biology for early detection and treatment of cancer with minimal or no side-effects.

Addressing reporters here on Monday, C.S. Mani, one of the founders of CRRT, said: "We have to move out from single-target cancer therapies where drugs or other treatment are used to block the growth and spread of cancer to multi-target therapy. Research plays a vital role in developing affordable and effective treatment."

About 200 doctors, students and representatives of laboratories in academic centres are expected to participate in the conference to be held at IIT-M.

People who suffer migraines may have a higher risk of heart attack or stroke than those without the painful headaches.

Previous studies have uncovered higher risks of heart problems and stroke among adults with migraine plus aura, but findings have been less consistent regarding people who have migraines without aura - the group that accounts for about 80 percent of migraine sufferers. As a group, migraine sufferers might have a relatively higher risk of cardiovascular problems, but their absolute risk is small.

Researchers studied 6,100 migraine patients where 4 percent reported a history of heart attack. The rate was 2 percent among the 5,243 people in the comparison group without migraine. Similarly, 2 percent of the migraine group reported a history of stroke, versus 1.2 percent of the comparison group. A further look showed that the increased stroke risk was only in the migraine with aura group; nearly 4 percent had a history of stroke, compared with just over 1 percent of migraine sufferers without aura symptoms.

It was found that the people with migraine did have higher rates of high blood pressure, high cholesterol and diabetes than those in the comparison group. Those rates did not, however, explain the link between migraine and heart problems and stroke. So exactly why migraine is connected to cardiovascular disease remains unclear. One possibility, according to the researchers, is that some people have an underlying susceptibility to both migraines and cardiovascular disease.

The findings add to evidence linking migraines to an increased risk of cardiovascular disease. They also suggest that the risks are not limited to people whose migraines are accompanied by neurological symptoms known as aura - visual disturbances, numbness, tingling or other bodily sensations that precede the headache.
The researchers agreed that the absolute risks are small but their findings should encourage migraine sufferers to be particularly careful about curbing the more common and significant risk factors for heart disease and stroke - such as high blood pressure, high cholesterol and obesity.
The precise cause of migraine headache is not fully understood, but the pain involves constriction, and then swelling, of brain blood vessels. The current findings support the notion that people with migraine may have dysfunction in the blood vessels throughout the body.

While the researchers noted that drugs that prevent migraine attacks could theoretically lower the risk of cardiovascular problems, certain medications might have negative effects; some anti-inflammatory painkillers have been linked to cardiovascular risks while migraine drugs known as "ergots" tend to constrict blood vessels throughout the body.

However, future studies are needed to look at whether certain migraine sufferers are at particular risk of heart problems and stroke - such as those with frequent headaches or frequent aura symptoms. Research should also investigate the effects of migraine treatment.