Morning MEDtalks with Dr KK Aggarwal 15^th November 2018

Antibiotics are used far more in some countries than in others, a survey “WHO Report on Surveillance of Antibiotic Consumption” by the World Health Organisation showed on Monday, suggesting that urgent action was needed to slash unnecessary consumption of the medicines. The survey evaluated looked at antibiotic use in 65 countries and found the Netherlands used 9.78 defined daily doses (DDD) per 1,000 people, while Britain used twice as much and Turkey almost twice as much again, at 38.18 DDD per 1,000 inhabitants. Iran’s consumption was similar to Turkey’s, while Mongolia’s was the highest of all among the countries surveyed, at 64.41 DDD per 1,000 people. Collecting the data is vital for tackling antimicrobial resistance, the extremely worrying trend of bacterial infections becoming immune to antibiotics. The lowest score was for Burundi, with just 4.44 DDD/1,000 people, which the WHO said reflected limited data. A low score could also suggest that consumption is too low, leaving the population at risk of infectious diseases… (Deccan Chronicle)

All adults should be screened for unhealthy alcohol use, says USPSTF as it recommends screening for unhealthy alcohol use in primary care settings in adults 18 years or older, including pregnant women, and providing persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use (B recommendation) in a new updated statement published Nov. 13, 2018 in JAMA.

Some definitions on unhealthy alcohol use

1. USPSTF: “Unhealthy alcohol use” is a spectrum of behaviors, from risky drinking to alcohol use disorder (AUD) (eg, harmful alcohol use, abuse, or dependence). “Risky” or” hazardous” alcohol use means drinking more than the recommended daily, weekly, or per-occasion amounts, resulting in increased risk for health consequences but not meeting criteria for AUD ().
2. National Institute on Alcohol Abuse and Alcoholism (NIAAA): “Risky use” as exceeding the recommended limits of 4 drinks per day (56 g/d based on the US standard of 14 g/drink) or 14 drinks per week (196 g/d) for healthy adult men aged 21 to 64 years or 3 drinks per day or 7 drinks per week (42 g/d or 98 g/week) for all adult women of any age and men 65 years or older.
3. American Society of Addiction Medicine (ASAM): “Hazardous use” is alcohol use that increases the risk of future negative health consequences.

A five-minute neck scan, which analyzes the pulse of blood vessels in the neck, could predict a persons risk of developing dementia a full decade before symptoms emerge, say researchers from University College London. Their findings were presented at the American Heart Associations annual scientific conference.

Malaria control programs in Brazil, Paraguay and Suriname (as below) have received the “Malaria Champions of the Americas” award, given out each year by the Pan American Health Organization (PAHO) and its partners to initiatives that contribute to eliminating the disease in the region (PAHO / WHO). 

1. Suriname’s Malaria program, for introducing a solid, people-centered approach model to health, particularly focused on migrant miners and indigenous communities. The initiative has created local capacities and has led to improvements in diagnosis, treatment and vector control. It has also integrated health services and has sought innovative operational and technological solutions. 
2. The Machadinho D’Oeste Municipal Malaria Control program, also in Brazil, that implemented a series of strategies that led to greater access to diagnosis and treatment, the use of mosquito nets and a 44% reduction in cases of malaria between 2016 and 2017. 
3. The Alto Río Solimões malaria program in Brazil, for its efforts to control malaria in indigenous areas. This local program managed to reduce cases of the disease by 70% since 2015 in a hard-to-access area, where 70,000 people live in 13 villages along the banks of the river. 
4. The National Malaria Control Program in Paraguay, which has provided universal access to malaria diagnosis and treatment. The work of the program has ensured that the country has not registered any autochthonous cases of malaria since 2011. In June 2018, Paraguay became the first country in the Region in 45 years to obtain official WHO certification for having eliminated malaria.

An estimated 12 million people may be victims of statelessness the impact of which is “immediate and can be dire”, the UN refugee agency (UNHCR) said on Tuesday. Echoing that message, UNHCR Chief Filippo Grandi appealed for “decisive action” from governments to eliminate the problem, noting that it is the right thing to do, “humanly, ethically and politically”. Stateless people “still face huge barriers to exercising fundamental human rights”, such as education, medical care or legal employment, the High Commissioner said, before calling for States to tackle discrimination in nationality laws, which is regarded as the biggest driver of the problem... (UN)

Video to watch: TEDx Video: Doctor-patient relationship www.youtube(dot)com/ watch?v=i9ml1vKK2DQ

Dr KK Aggarwal

Padma Shri Awardee

President Elect CMAAO

President Heart Care Foundation of India