Fibromyalgia is a serious disorder of suspected neurological origin manifested by intense, recidivating muscular pain, joint stiffness, pronounced sate of generalized fatigue, sleep disturbances, anxiety, irritability, increased sensitivity to external stimuli and depression. At present, the exact causes and risk factors of the disease are unknown, fibromyalgia still being regarded as an enigma among the medical community.

There is no specific cure for fibromyalgia and the treatments available today are only partially efficient in slowing down the progression of the disease and alleviating its generated symptoms. In addition, due to the lack of conclusive medical data on fibromyalgia and the deceiving character of the symptoms it produces (the symptoms of fibromyalgia have an unspecific, general character, being also produced by a variety of other diseases that aren’t related to fibromyalgia), the disease can be very difficult to diagnose properly. In persons with special conditions (existing or past neuropsychological diseases, pregnant women, etc.), fibromyalgia is even more difficult to diagnose accurately and more important, timely.

Recent medical investigations have revealed the fact that fibromyalgia is often overlooked during pregnancy. According to the results of elaborate medical research conducted by a team of medical scientists from Temple University, the symptoms of fibromyalgia experienced by pregnant women are very often misdiagnosed as regular clinical manifestations of pregnancy. While symptoms such as intense pain, generalized fatigue and pronounced psychological stress generally point to fibromyalgia, their occurrence in pregnant women determine most doctors to think that they are a normal part of pregnancy, not indicators of disease.

In order to accurately distinguish between the early signs of fibromyalgia and the normal clinical manifestations of pregnancy in future mothers, doctors are currently focusing on establishing more reliable criteria of diagnosis, which would completely eliminate the existing confusion between normal indicators of pregnancy and the symptoms of fibromyalgia. Once they will discover efficient methods of identifying the symptoms of fibromyalgia in pregnant women, doctors will focus on reducing the impact of the disease in future mothers.

A very recent medical study has clearly revealed that the symptoms of fibromyalgia are very difficult to detect during pregnancy. However, the same study has concluded that there are ways to detect the presence of fibromyalgia in pregnant women by comparing their symptoms to those of pregnant women in good health. In addition, the researchers claimed that the presence of fibromyalgia in such categories of patients can also be spotted by verifying the patients’ medical history.

The study involved the participation of pregnant women with and without fibromyalgia. The volunteers were between the ages of 29 and 31, pregnant in the third trimester and had no history of premature, complicated birth or abortion. All the subjects who participated in the study had no chronic illnesses other than fibromyalgia and most of them were actually in perfect health. By the end of the study, the conclusions were that the signs of fibromyalgia can be distinguished from the clinical manifestations of pregnancy with already existing methods of diagnosis.

For instance, compared with the group of pregnant women without fibromyalgia, the group with the disease experienced exacerbated pain (perceived through the entire body), states of exhaustion and even states of mental confusion. Although it is extremely difficult to timely and accurately detect the presence of fibromyalgia in pregnant women, the researchers have demonstrated that this task is not impossible. Medical scientists have recently initiated a new series of studies, aiming to discover more effective, reliable methods of diagnosing fibromyalgia during pregnancy.

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Fibromyalgia is a complex neurological disorder with a pronounced chronic character. Although the most common symptoms generated by fibromyalgia are generalized pain and fatigue, the disorder can cause many other manifestations. Most people with the disorder have a wide diversity of physical symptoms that evolve latently, rarely becoming visible. Due to the fact that most fibromyalgia symptoms can’t be detected by medical examinations, some people consider the disorder to be self-induced. However, the truth is that fibromyalgia is a serious condition and its symptoms are real.

Most people with fibromyalgia complain about ongoing pain felt throughout the entire body. This primary symptom generated by the disorder can vary in intensity from a person to another and it is usually associated with a generalized state of fatigue and body weakness. Fibromyalgia pain is felt deep within the muscles, bones and joints and it can sometimes become very intense, taking over the entire body. Most people affected by fibromyalgia also experience muscular stiffness and poor mobility of the joints. Although medical examinations can’t reveal the presence of physical abnormalities in people with fibromyalgia, most physical symptoms are very similar to those generated by rheumatoid arthritis or osteoporosis.

Apart from these common symptoms of fibromyalgia, people with the disorder may also experience sleep disturbances, gastrointestinal problems or urinary problems. People with fibromyalgia often suffer from insomnia or sleep apnea. Even when they get enough sleep, people affected by fibromyalgia may still have a pronounced feeling of fatigue. Many people with fibromyalgia also suffer from paresthesia, experiencing sensations of numbness and tingling in the muscles.

Although the specific causes of fibramyalgia remain unknown, it is believed that the disorder occurs on the premises of increased nervous excitability. Medical scientists believe that most of the symptoms generated by fibromyalgia are the result of neurological dysfunctions that determine the nervous system to perceive external stimuli at a higher intensity than normal. This pertinent theory can easily explain some fibromyalgia symptoms such as ongoing pain, sensations of tingling, numbness, increased sensitivity to light and increased sensitivity to temperature. This theory can also explain why the symptoms of fibromyalgia can’t be effectively revealed by medical examinations. Apart from a wide range of physical symptoms, fibromyalgia also generates psychological manifestations such as depression, anxiety and sudden changes in mood, suggesting the multifaceted nature of the disorder.

There is no specific cure for fibromyalgia and the disorder can’t be effectively overcome with the means of medical treatments available today. Due to poor understanding of the actual causes of fibromyalgia and due to the multitude of generated symptoms, most medical treatments can only provide temporary relief for people affected by this type of neurological disorder.



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Expectations woo and loud cheers fill the boxing arena – manifestations of excitement, pride, hope and victory. Yet, behind the festive atmosphere, viewers are unmindful that in one corner, there lies death creeping, waiting for the next soul to claim.



The sudden death of a Filipino boxer in Thailand after a knockout has risen concerns not only officials of both countries but of other countries as well. The tragic incident has prompted officials to review rules that govern the sport.



Several boxing ring deaths have already been reported with Angelito Sisnorio as the latest fatality in a long line of boxers to be killed or badly injured in the sport. He collapsed a few hours after suffering a fourth –round knockout to former World Boxing Council Flyweight king Chatchai Sasakul in the city of Samat Prakan, Thailand.

An addition to statistics

Statistics show there have been 1,200 ring related deaths recorded; 32 of those in the United States of America and 8 in Africa, so far.

Among the more publicized boxing ring deaths was Zambian boxer Felix Bwalya who died nine days after being knocked down three times in the final rounds of a Commonwealth title clash with Britain’s Paul Burke in 1998.

In 1995, Colombian Jimmy Garcia died of a blood clot on the brain, 13 days after his challenge for the WBC super-featherweight title held by Gabriel Ruelas in Las Vegas. On the same year, James Murray died after the British bantamweight title fight against Drew Docherty in Glasgow.

Also in 1995, James Murray, a Scottish professional bantamweight boxer died as a result of injuries sustained in his last fight.

There is also Londoner Bradley Stone died after an unsuccessful British super-bantamweight title fight with Richie Wenton and former Olympic welterweight gold medalist Wangila Napunyi of Kenya died after being stopped by American David Gonzalez in 1994.

Causes of deaths

According to medical experts, majority of the boxing fatalities suffered brain injuries brought by repeated punches. They cited subdural haematoma, brain oedema and brain hernation as the main causes of their deaths.

Subdural hematomas are most often caused by head injury, when rapidly changing velocities within the skull may stretch and tear small bridging veins. This may also be due to head injuries which are described as traumatic.

Brain oedema, more commonly known as cerebral swelling, is the accumulation of water and sodium in the brain.

Brain herniation on the other hand is the displacement of brain tissue, cerebrospinal fluid, and blood vessels outside the compartments in the head that they normally occupy. A herniation can occur through a natural opening at the base of the skull which is called the foramen occipitalis or through surgical openings created by a craniotomy procedure. Herniation can also occur between compartments inside the skull, such as those separated by a rigid membrane called the “tentorium”.

Usually, these people die instantly or shortly after. An example of this condition is Cleveland Denny’s story, a lightweight/welterweight boxer from Canada. After being battered by six straight punches to the head by Gaetan Hart in 1980, Denny went down and died seventeen days later, without ever regaining consciousness after the fight.

The last prominent cause of death related to boxing is kidney or other organ failure, which caused the death of Colombian boxer Jimmy Garcia in 1995. Twenty-five seconds into the 11th round of his match against Gabriel Ruelas, for the World Boxing Council super featherweight title; Garcia slumped to the mat unconscious. He later lapsed into a coma at the hospital due to extreme kidney failure. He ended up staying alive for thirteen days until the doctors finally took him off life support, still deeply comatose.

With the latest fatality of the sport, proponents to ban boxing are starting to gather anew to further their outcry – stop this violent and deadly sport. Boxers also started to contemplate on their plight. There is indeed a great price a boxer must pay in order to gain respect and short-lived glorified career.

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Migraine is a type of headache and a recognised medical condition. Migraine is widespread in the population. In the U.S., 18% of women and 6% of men report having had at least one migraine episode in the previous year. Migraines afflict about 30 million people in the United States. They may occur at any age, but usually begin between the ages of 10 and 40 and diminish after age 50. Some people experience several migraines a month, while others have only a few migraines throughout their lifetime. Approximately 75% of migraine sufferers are women. Migraines’ secondary characteristics are inconsistent. Triggers precipitating a particular episode of migraine vary widely. The efficacy of the simplest treatment, applying warmth or coolness to the affected area of the head, varies between persons, sometimes worsening the migraine. Migraines are classified as either “with aura” or “without aura.” Migraine is a neurological disorder that generally involves recurring headaches. Other symptoms may occur with the headaches. Migraines are often classified based on whether they include an early symptom called an aura. Visual aura is the most common of the neurological events.

Migraine is a true organic neurological disease. Migraine with aura is characterized by a neurological phenomenon (aura) that is experienced 10 to 30 minutes before the headache. Most auras are visual and are described as bright shimmering lights around objects or at the edges of the field of vision (called scintillating scotomas) or zigzag lines, wavy images, or hallucinations. Migraine without aura is the most prevalent type and may occur on one or both sides (bilateral) of the head. Tiredness or mood changes may be experienced the day before the headache. Nausea, vomiting, and sensitivity to light (photophobia) often accompany migraine without aura. Migraine headaches affect about 11 out of 100 people. They are a common type of chronic, recurring headache. They most commonly occur in women and usually begin between the ages of 10 and 46. In some cases, they appear to run in families. A migraine is caused by abnormal brain activity, which is triggered by stress, food, or some other factor.

Migraine-specific therapies are designed specifically to treat migraine attacks. Ergotamine preparations are no longer readily available. Several medications may need to be tried before you find one that works. A class of drugs known as triptans can relieve a migraine once it starts. Rest in a quiet, darkened room. Drink fluids to prevent dehydration, especially if vomiting occurs. Several medications may help relieve symptoms. However, the effectiveness of migraine medications is highly variable in different people. Some medicines can prevent migraines. These include propranolol, amitriptyline, ergonovine, cyproheptadine, clonidine, methysergide, calcium channel antagonists, valproic acid, carbamazepine, topiramate (Topamax), and many others. Ergotamine tartrate preparations constrict the arteries of the head and may be used alone or in combination with other drugs such as caffeine (Cafergot), phenobarbital, or Fioricet. Propoxyphene or other medications that relieve pain or inflammation may provide relief for some people. Nausea should be treated early with Reglan, Compazine, or other anti-emetics.

Migraines Treatment Tips

1. Conventional treatment focuses on three areas: trigger avoidance, symptomatic control, and preventive drugs.

2. Moderation in alcohol and caffeine intake, consistency in sleep habits, and regular meals may be helpful.

3. Triptans are a mid-line treatment suitable for many migraineurs with typical migraines.

4. Ergot drugs can be used either as a preventive or abortive therapy, though their relative expense.

5. Sumatriptan and related selective serotonin receptor agonists are now the therapy of choice for chronic migraine attacks.

6. Anti-emetics by suppository or injection may be needed in cases where vomiting dominates the symptoms.

7. Amidrine is sometimes prescribed for migraine headaches.

8. Intravenous chlorpromazine has proven very effective in treating status migrainosus—intractable and unremitting migraine.

9. Diet, visualization, and self-hypnosis are also alternative treatments and prevention approaches.

10. Massage therapy and physical therapy are often very effective forms of treatment to reduce the frequency and intensity of migraines.

11. Massage therapy of the jaw area can also reduce such pain.

12. Botox is being used by many headache specialists for patients with frequent or chronic migraines with encouraging results.

13. Try to avoid any factors that have triggered a migraine in the past.



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American women are more prone to migraine than their Asian counterparts.

Medical researches showed that in the United States, white women have the highest frequency of migraine, while Asian women have the lowest.

The female-to-male ratio increases from 2.5:1 at puberty to 3.5:1 at age 40 years, after which it declines. The rate of migraine headaches in females of reproductive age has increased over the last 20 years, studies showed.

Migraine headaches affect 17% of females and 6% of males in the United States. Before puberty, boys and girls get migraines at about the same rate, although boys may get them slightly more often.

In individuals older than 12 years, the frequency of migraines increases in both males and females. The frequency declines in individuals older than 40 years.

The causes of migraine headaches are not clearly understood. In the 1940s, medical researches believed that a migraine begins with a spasm, or partial closing, of the arteries leading to the main part of the brain called the cerebrum.

The first spasm decreases blood supply to part of the brain, which causes the aura (lights, haze, zig-zag lines, or other symptoms) that some people experience. These same arteries then become too relaxed, which increases blood flow and causes pain.

About 30 years later, the chemicals dopamine and serotonin, both known as neurotransmitters, were found to play a role in migraine headaches.

Dopamine and serotonin are normally found in the brain, but they can cause blood vessels to act in uncharacteristic ways if they are present in abnormal amounts or if the blood vessels are unusually sensitive to them.

Together, these 2 theories have come to be known as the neurovascular theory of migraine, and it is presently believed that both theories provide insight into the causes of headache.

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About Migraines

A migraine is a severe headache that tends to recur with symptoms like nausea and vomiting. The pain is usually on one side of the head and there is an added sensitivity to bright lights and noises. Moving around can make the headaches feel worse. Although, there are many forms of migraine headaches, classic and common are the two major varieties. People with migraines are called migraineurs.

About 15% of the population is affected by migraines. Three times more women than men are affected. Over 80% of migraineurs have family members who are regularly afflicted with migraines. Prominently migraines are of three types. They are:

Migraine without aura (common migraine): Accounting for 80% of all migraine headaches, no aura is seen before this common migraine affects an individual.

Migraine with aura (classic migraine): Usually preceded by an aura, this type of migraine is generally much worse than a common migraine. Usually, an aura is said to be a visual disturbance, that is, outlines of lights or jagged light images.

Status migrainosus: Generally, a long-lasting migraine, it does not go away by itself.

Causes of Migraine headaches

The medical fraternity thinks that the migraines are caused by a chemical or electrical problem in certain parts of the brain. A key element of a migraine headache is blood flow change in the brain. According to hypothesis, the nervous system responds to a trigger such as stress by creating spasms in the nerve-rich arteries at the base of the brain. The spasms constrict several arteries supplying blood to the brain, including arteries from the scalp and the neck. As these arteries tighten, the flow of blood to the brain is reduced. At the same time, platelets clump together and release a chemical called serotonin which also acts as a powerful constrictor of arteries. This further reduces blood and oxygen supply to the brain. In reaction to this, some arteries in the brain expand to meet the brain’s energy needs. This dilation is believed to cause migraine headaches. Because, migraine headaches tend to run in families, it can be assumed that genetic factors may also contribute to a person’s susceptibility to migraines.

Headache triggers can be things that are eaten, smelt, heard or seen. They are:

· Stress and time pressure, major hassles and losses, anger and conflict

· Smells and fumes, tobacco smoke, light glare or dazzle and weather changes

· Monthly periods, birth control pills, estrogen therapy and too much, too little or interrupted sleep

· Hunger, fasting and specific foods or beverages

· Excessive activity

· Certain medications

Certain foods that might trigger a migraine:

· Aged Cheese

· Bananas, figs and raisins

· Beer, wine and hard liquor

· Caffeine as well as caffeine withdrawal and chocolates

· Dairy products such as ice cream, milk, yogurt, cheese, whipped cream and sour cream

· Fermented and pickled foods

· Monosodium glutamate (MSG), seasoned salt, canned soups, TV dinners, processed meats, and some processed nuts and snack chips

· Most citrus fruits like oranges, grapefruit and lemons

· Nuts and peanuts

· Onions

· Pea pods or lima beans

· Processed meats, deli sandwich meats, hotdogs and other nitrite-containing meats

· Saccharin or aspartame in diet foods or diet sodas and drinks

· Sulfites in shrimp and processed potatoes, like boxed mashed potato mix

· Yeast-containing products, such as fresh breads and donuts

Medicines that might trigger a migraine headache are:

· Cimetidine (brand name: Tagamet)

· Estrogens (including birth control pills)

· Fenfluramine (brand name: Pondimin)

· Indomethacin (brand name: Indocin)

· Nifedipine (brand name: Adalat, Procardia)

· Nitroglycerin (brand name: Nitrostat)

· Pain killers (either overuse or withdrawal from them)

· Reserpine containing medicines (brand names: Ser-ap-Es, Hydropres, Regroton)

· Theophylline (brand name: TheoDur, Theo-24)

Migraine Guide

Having ridden the migraine train on several occasions, you may have an aura the acts like a warning whistle of the approaching headache. The pain builds slowly and steadily until you are in no position to tolerate the bright light and loud noises. You may even feel nauseated or end up vomitting. Lying down in a dark, quiet room is the only means that will help you ride it out.

While scientists still debate the exact mechanisms in the brain that cause migraines, there progress has helped them find treatment medications that may either be taken as soon as a migraine comes on or taken on a daily basis to help prevent migraines.

This guide will help you weigh the pros and cons of a variety of treatments, to help determine the best course of action for your migraine.

Although, much can be done to prevent the onset of migraines like avoid triggers, exercise regularly and keep stress under control — most people with migraines will need medication. Providentially, medication options for migraines have expanded greatly in the last decade which helps keep migraine disruption to a minimum.

Migraine medications can be divided into two broad categories of migraine treatment. They are:

· Acute – Taken after the onset of a migraine

· Preventive – Taken every day to ward off migraines

· Various nontraditional and emerging therapies may be helpful in some cases, too



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At some point in our lives, we will experience some sort of chronic pain that we positively hate and wish to go away. But as much as we seek pain relief immediately and despise the discomfort, the truth is that pain is useful to our survival as it alerts us to problems within our body. Pain also prevents a person from further injuring themselves and so it can be very useful. But, while useful, we all seek pain relief from time to time because-well, it hurts!

Oral Pain Relief

Now when most people think of pain relief, the first thing that comes to mind is aspirin or some other form of oral medication. In fact, we have been conditioned to believe that “you take something for the pain” and this usually involves a pill of some kind. For severe or chronic pain, opiates are most often prescribed. Morphine and heroine are two common opiates, and you will generally see cancer patients given these pain medicines as pain relief of last resort. Opiates are considered highly addictive and generally reserved for terminally ill patients.

Anti-depressants once were prescribed solely to treat depression and other mental illnesses. However, recent research has concluded that anti-depressants do relieve certain types of physical pain and are often used in pain relief applications to help a patient sleep.

Anti-seizure medications are prescribed to deal with sharp or acute pain caused by malfunctioning or damaged nerves. They most often deaden or numb the nerves themselves so pain signals do not reach the brain.

Less severe forms of oral pain relief generally come in the form of aspirin or ibuprofen. Ibuprofen are specifically designed to reduce inflammation and are therefore recommended for things like muscle aches while aspirin are more useful on headaches and fever reduction.

Pain Relief From Injections

One of the more severe but useful types of pain relief come in the form of injections. Cortisone treatments are common in athletes and involve an injection directly into the muscle or nerve causing the pain. This sort of pain relief is very effective, but it cannot be done on regular intervals due to tissue damage. Therefore, it is only recommended for temporary relief of acute pain.

Dentists also use this form of pain relief when they inject your mouth with Novocain-or, a local anesthetic. These injections will numb your nerves so that they are no longer sending signals to the brain. The inflammation or source of the pain will remain, but your body won’t feel anything until the local wears off.

Nerve Block Pain Relief

This type of pain relief is related to injections but deals with specific nerve blocks within the body. Called a ganglion or plexus, a nerve block will affect a group of nerves relating to a specific organ or part of the body. The doctor provides an injection of a specific nerve blocker in order to temporarily relieve pain to that organ or part of the body. It is different than a local anesthetic in that it has been specifically designed to affect one type of nerve so it is specialized pain relief and tends to be more expensive than standard cortisone shots or Novocain.

Physical Therapy as Pain Relief

Physical therapy is often viewed as a means to rebuild damaged muscles and nerves after a trauma. However, physical therapy is also used as a natural form of pain relief. Whirlpool therapy, deep muscle massage, and ultrasound are all forms of physical therapy used in natural pain relief treatments.

Electrical Stimulation Pain Relief

Known as TENS, Transcutaneous Electrical Nerve Stimulation is an alternative to more traditional pain relief treatments. Without using any needles or medicine, pain is relieved when tiny electrical impulses are applied to the skin. The electrical current then stimulates nerve fibers in other parts of the skin and has the affect of relieving pain. The effects are only short term but TENS has proven itself as a legitimate means of pain relief and is a standard component of many physical therapy programs.

Acupuncture Pain Relief

While not widely recognized by the medical community as a legitimate form of pain relief, this Oriental treatment has been around for centuries and is considered by its adherents as a very effective pain management tool. Acupuncture specialists use lots of thin, small needles on various pressure points of the body. The pressure points in which a practitioner applies the needles will depend on the source of the pain. Although not a proven form of pain relief, acupuncture does remain one natural alternative to more traditional and accepted forms of pain management.

Surgery

In very severe cases and when other forms of pain relief have failed, surgery may be the last best chance to end chronic pain. In most cases, a surgeon will go in and actually severe nerve connections so that pain receptors in the brain no longer receive signals. Again, this is a method of last resort because as we stated earlier-pain can be useful and necessary to our survival. Doctors don’t like completely severing nerve endings as they will no longer be able to alert your body to problems-but when other forms of pain management fail, surgery may be the only viable alternative.

Topical Pain Relief

Finally, there are also topical ointments, creams, and liquids that can be directly applied to an affected area for temporary pain relief. Topical pain relief has the advantage of being quicker to reduce pain than oral medicines without being as invasive as the injections. While topical pain relief is not recommended for relief of chronic pain, it is highly effective with short term alleviation of minor aches and pains.

Pain relief is something we all must concern ourselves with from time to time. There are a wide array of medical and natural pain relief options available to you, and the one you choose will depend on the nature of the pain and your own comfort level with the treatment. For relief of minor, short-term pain, oral medication is most preferred, but topical pain relief options are growing in popularity and should be considered as a viable option in most cases.

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What is the meaning of the word “of” when used in a patent? The Federal Circuit Court of Appeals that deal elusive question in a recent dispute between two pharmaceutical manufacturers and expert testimony of great help to find the answer.

But while the court has accepted the advice of experts on the meaning of “approximately” used in the patent, it appeared an about-face and rejected their testimony as to the ultimate question of infringement.

Ortho-McNeil Pharmaceutical brought the lawsuit against the manufacturer of generic drugs-Caraco Pharmaceutical Laboratories, alleging infringement of its U.S. Patent No. 5,336,691. Ortho patent covered a painkiller composed of two well-known analgesics, tramadol and acetaminophen.

The patent has shown that when combined in certain ratios the effects of both drugs were increased. Involved in this case was the claim of the patent No. 6, which involved a composition where the ratio of the material to acetaminophen is tramadol   a weight of about 1:5. “

Ortho continued after Caraco filed an application for abbreviated new drug to disclose its plan to manufacture and sell his own composition containing tramadol and acetaminophen. Caraco said the medicine had an average ratio of tramadol to acetaminophen of 1:8.67 and no less than 1:7.5. Ortho Caraco argued that the drug would infringe its patent.

The district court granted the summary trial and Ortho appealed to the Federal Circuit. Both the district court and on appeal, the case focused on the construction of the term “about 1:5.” Ortho argued that covered a radius of at least 1:3.6 to 1:7.1, and that, under the doctrine of equivalents, the wording of Caraco infringed. Caraco argued for a restrictive interpretation.

The district court adopted the construction asserted by Ortho, the “about 1:5″ means “approximately 1:5, encompassing a range of ratios of no more than 1:3.6 to 1:7.1.” He came to this conclusion relying in part on the intrinsic evidence of the application and the specification and in part to the extrinsic evidence of Ortho experts, Dr. Donald R. Stanski and Dr. Eric Smith. The two experts gave the Notice that one of ordinary skill in the art to conclude that “about 1:5″ limitation include a series of reports that would extend to include and 1:7.1.

The Federal Circuit upheld that construction. As the district court, he found support for this construction as in the claim itself and the testimony of the expert Ortho, Dr. Stanski. “Dr. Stanski has estimated that” about 1:5 “means” about 1:5, which includes up to and including 1:7.1 “, noted the court.

Caraco Accepting this construction means that the product did not literally infringe Ortho patent. Ortho patent covered a maximum ratio of 1:7.1, while Caraco started 1:7.5. The question, therefore, became Caraco if the drug under the violation of the doctrine of equivalents.

Building on its experts, Ortho said it did. One expert, Dr. Stanski, said that the weight of 1:8.76 is substantially similar to a weight ratio of 1:5. Another expert, Dr. Smith said in its report that the “degree of synergy of a composition with a weight of tramadol to acetaminophen of 1:5 is identical to the measure of the synergy of a composition with a weight of tramadol to acetaminophen of 1:8.67.

But the district court agreed. It concluded that a finding of infringement by a formulation with an average weight of 1:8.67 would render meaningless “about 1:5″ limitation.

The Federal Circuit affirmed, finding that the 1:5 critical parameter for the invention. Stretching the limits of this parameter Caraco to cover the drug would be in direct conflict with the patent for the express both the claim of 1:1 and 1:5 ratios, the court said.

“In this case, if the ratio of 1:5 of the analgesic response is statistically different from that of other ratios any time,” the court said. “The intrinsic evidence points to the desirability and thus the criticality of the ratio of 1:5 compared to other ratios.”

“Ortho can not now claim that the parameter is sufficiently broad to encompass, through the doctrine of equivalents, the rate outside the confidence interval expressly identified in the patent,” continued the court. “We agree with the district court that eviscerate the limitation.”

For these reasons, the court said, he concluded that the drug Caraco does not infringe Ortho’s patent and that the district court properly granted a summary of non-infringement.

Ortho-McNeil Pharmaceutical, Inc. v. Caraco Pharmaceutical Laboratories, Ltd., Case No. 06-1102 (Fed. Cir. January 19, 2007).

Written by Robert Ambrogi for Bullseye, IMS Expert Services Publication

Robert Ambrogi is the editor of Bullseye, a monthly newsletter distributed by IMS Expert Services. IMS Expert Services is the first expert witness consulting and litigation research firm in the legal industry, focused exclusively on providing custom expert witness in search of lawyers.



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Headaches can do more than ruin your day – they can interfere with your life. There are many different types of headaches and in this article, we are going to discuss a few of them.

Migraine Headache

If you have a stable pattern of recurring headaches accompanied by nausea at least some of the time, you probably have migraine. Migraines may sometimes cause extreme nausea, vomiting and altered vision. Symptoms may include tiredness or moodiness as early as 12- 18 hours before onset of the headache.

Migraine tends to recur periodically but what really causes migraines is not well understood. Migraine headaches can do more than ruin your day – they can interfere with your life. Headaches are of different variations.

Migraine headaches are usually described as a one-sided, throbbing pain of the temple, forehead, or eye. Once the pain of a migraine sets in, it is sheer agony. How bad are your headaches? The most important symptom you will probably have with your migraine headache is pain, and as you know, the pain can be very severe and last many hours.

Migraine headache resulted from the expansion (or dilation) of blood vessels in the brain and scalp. It is possible for people to have migraine even when nobody in the family has it. Though it has been seen that migraine does run in families, it is not necessary that children of migraine patients will also have it. Stress is one of the major factors that can contribute to the onset of a migraine.

Tension headache

Tension headaches are also common in many people. Stress and anxiety are causes for tension headaches. Tension headaches often start in the middle of the day. Tension headaches usually begin slowly and gradually. Tension headaches commonly come on in the middle of the day. If you have tension headaches almost every day or over-the-counter medicines don’t help your pain, you should see a medical practitioner.

For a person who is prompt to tension headache, the moment the person gets tense about something, the person will develop a tension headache. People with tension headaches may also suffer from pain, throbbing or a sensation of tightness in the head. Contrary to popular belief, tension headache is not necessarily the result of emotional stress, but rather, like migraine, probably as a result of a neurochemical process inherent in the brain of the headache sufferer. Most tension-type headaches respond to simple analgesics like acetaminophen or ibuprofen, but some can be somewhat disabling.

Tests are not usually required to diagnose a tension headache. If you only have tension headaches occasionally, an over-the-counter (available without a prescription) pain reliever can probably help. These headaches come on slowly, and gradually increase in intensity. Some people report that their tension headaches are worse than a migraine headache.

Common Headache Treatment Options

There are a lot of treatment options presently available for your migraine and tension headaches. Some of you will get spectacular results with one or more of these treatments and others will not. Sometimes a separate visit to your physician to discuss your headaches specifically may be necessary. Migraine can be triggered in susceptible individuals by tyramine-containing foods, some food additives and sugar substitutes, as well as by skipping meals.

Selective serotonin-agonist drugs like sumatriptan have revolutionized treatment of migraines and dramatically changed the lives of millions of people. Most commonly used drugs for migraine headaches are regular analgesics available over the counter like Tylenol, Aspirin or ibuprofen (Advil). There are several natural solutions that can help you fight headaches, but the first thing you need to do is work out what sort of headaches you’re actually suffering from.

There are many natural remedies for tension headaches. These include stress and tension reduction, ice therapy (used at the base of the skull), eliminating food triggers, getting the proper amount of rest, biofeedback, headache pillows or cushions, exercise and many others. Sunglasses can often even prevent the headaches.

All treatments for migraine and tension headaches have the same treatment goals in common. They are designed to take away your headache symptoms. There is no need to endure the pain when you really have an option. Follow the tips given here and you will be amazed to find that the prevention is actually in your hands.



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The present article has been read by many of our visitors and greatly appreciated. Hopefully you will delight it likewise. A great many people in the world have at one point or another, experienced headaches. They may say that they have a migraine or a stress headache. Some people will experience headache problems due to their sinuses. While Suffering from headaches is an annoying problem knowing the cause of headaches may help to prevent promote attacks.

Headaches can be caused by a multifariousness of reasons. They can be simple problems like eyestrain to the venous sinus cavities being inflamed. They can also rise from life threatening conditions like encephalitis, brain cancer or intellectual aneurysms. Sometimes a head wound will also be the cause of headaches.

These types of headaches are easy to find and treat. There are some headaches where the cause is some what elusive to diagnose immediately. Cluster headaches are one character of headache where the cause is a little difficult to state immediately. Quite a little headaches are headaches that cause a sharp and very painful headache to the individual.

Now even though these headaches occur at to the lowest degree several times a day and last for some months they are less usually occurring than that of sick headache or tenseness headaches. A tension headache on the other hand is more often experienced by people.

Some times the cause of headaches like this may be attributed to feelings of hungriness or dehydration. The other causes can be muscle contractions in the shoulders, the neck area, scalp and the jaw. Stress, low pressure and anxiousness can also be regarded as being the cause of headaches.

Other causes of tenseness headaches are not getting enough sleep, overwork, wanting(a) mealtimes and exploitation diverse drugs and alcohol. Some people will experience tautness headaches due to the types of foods and drinks that they have.

Migraine headaches are another case of occupy that many people will experience during their life. The cause of headaches of this nature are as yet not distinctly known. All the same for the somebody who suffers from this ill they will have symptoms like feeling nauseous, blurred vision and light sensitivity. The annoyance from these headaches is usually felt only on one side of the head. Sometimes the anguish will be felt on both sides of the temple.

As was stated earlier sometimes the cause of headaches can be found linked to sinus problems. These headaches are known as sinus headaches and they are caused by an inflammation in the sinus passage.

There are quite a few headaches types that we must deal with in our lives and knowing what the cause of headaches is, can help us to avoid situations that may trip up such painful attacks. Possibly someday we will be able to stop the headaches from occurring right at their beginning.

I desire this article provided you with the information you were looking for. I have many other articles online that may be of interest to you.



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