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BMJ 1997; 314 doi: (Published 15 March 1997) Cite this as: BMJ 1997;314:838

The British National Formulary continues to recommend quinine sulphate as a treatment for nocturnal leg cramps despite the scant evidence that it is effective. What is certain is that people who take an overdose of quinine (usually prescribed for an older relative) may suffer permanent visual impairment (Scottish Medical Journal 1997;42:8-9). Between 1988 and 1992 a total of 246 patients were discharged from hospitals in Scotland having taken overdoses of quinine, and a detailed review of 30 found eight with visual impairment, two of whom were blind.

Minerva was an early supporter of hormone replacement therapy for women after the menopause, but she sometimes worries that women who take HRT may expect that it will keep them youthful with no further effort. In fact, says a review in the British Journal of Sports Medicine (1997;31:5-10), it is inactivity that is, to a great degree, responsible for the physiological decline attributed to the aging process. Even the decline in cognitive function may be attenuated or reversed by regular physical activity.

Cognitive impairment with aging seems also to be associated with risk factors for cardiovascular disease. Data from the Medical Research Council's trial of antithrombotic medication in the prevention of coronary heart disease (Journal of Neurology, Neurosurgery, …

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