A critique of the WHO TobReg's "Advisory Note" report entitled: "Waterpipe tobacco smoking: health effects, research needs and recommended actions by regulators"

BACKGROUND AND AIM: The World Health Organisation Study Group on Tobacco Product Regulation (TobReg) has issued in 2005 an "Advisory Note" entitled: "Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators". "Waterpipe" smoking is now considered a global public health threat and the corresponding artefact is actually known in the world under three main terms: hookah, narghile and shisha. This important report, the first ever prepared by WHO on the subject, poses two major problems. On one hand, its bibliographical references dismiss world chief relevant studies. On the other, it contains a certain number of errors of many orders: biomedical, sociological, anthropological and historical. The purpose of the present study is to highlight, one by one, where these weaknesses and errors lie and show how this official report can be considerably improved. RESULTS: We realise that widely advertised early anthropological studies were not taken into consideration whereas they shed a substantial light on this peculiar form of smoking and help understanding its high complexity. As for concrete errors to be found in this report, they deal with the chemistry of smoke, health-related effects, smoking patterns, description and history of the artefact and its use, gender and underage use aspects, prevention and research needs in this field. CONCLUSION: The scientific credibility of an international expert report may be at stake if its recommendations do not rely on sound objective research findings and a comprehensive review of the existing literature. The critical comments in this study will certainly help improve the present WHO report

In vivo antiplatelet effect of intravenous alum in rabbits

ABSTRACT Traditionally known as a haemostatic agent, alum shows a paradoxical effect of increased prothrombin and partial thromboplastin times. This study investigated the in vivo effect of alum on platelet aggregation and bleeding time in rabbits. The collagen-induced platelet aggregation of platelet-rich plasma samples from 14 healthy rabbits was measured turbidometrically using a platelet aggregometer, before and 1 hour after intravenous injection of alum. Collagen-induced platelet aggregation was significantly reduced after alum injection. Bleeding time from an ear puncture in 8 rabbits was also significantly prolonged after intravenous alum injection. These results suggest that the use of alum as an oral antiplatelet drug could be explored further, taking into account possible side-effects especially in renal compromised patients. Effet antiplaquettaire in vivo de l'alun injecté par voie intraveineuse chez des lapins RÉSUMÉ Traditionnellement connu comme agent hémostatique, l'alun montre un effet paradoxal d'allongement des temps de prothrombine et de thromboplastine partielle. La présente étude a examiné l'effet in vivo de l'alun sur l'agrégation plaquettaire et le temps de saignement chez des lapins. L'agrégation plaquettaire induite par le collagène dans des échantillons de plasma riche en plaquettes de 14 lapins sains a été mesurée par turbidimétrie en utilisant un agrégomètre, avant et une heure après une injection intraveineuse d'alun. L'agrégation plaquettaire induite par le collagène était significativement réduite après l'injection d'alun. Le temps de saignement après incision à l'oreille chez 8 lapins était significativement prolongé après l'injection intraveineuse d'alun. Ces résultats semblent indiquer que l'utilisation de l'alun en tant qu'antiplaquettaire oral pourrait faire l'objet d'études complémentaires, en tenant compte des effets secondaires éventuels notamment chez les patients dont la fonction rénale est altérée