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Smoke-free laws tied to lowered BP

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Dr KK Aggarwal    25 November 2018

Morning MEDtalks with Dr KK Aggarwal 25th November 2018

 

WHO felicitates Nepal for trachoma elimination, rubella control: The WHO on 22 November 2018, felicitated Nepal for eliminating trachoma, a neglected tropical disease that leads to blindness, as a public health problem, and for controlling rubella that causes serious and irreversible birth defects. “Nepal’s remarkable achievements will positively impact the lives of hundreds of thousands of people country-wide and provide an inspiring example to countries striving to eliminate trachoma and other neglected tropical diseases”, said Dr Poonam Khetrapal Singh, Regional Director World Health Organization South-East Asia, at the event. Nepal is the first country in WHO South-East Asia to eliminate trachoma as a public health problem, and among the first countries in the Region to be verified for having controlled rubella. The validation for trachoma elimination and verification of rubella control were completed in May and August respectively… (SEAR/PR/1703, Nov. 23, 2018)

Smoke-free laws tied to lowered BP: Reductions in secondhand smoke exposure due to smoke-free policies appear to have modestly reduced BP on a population level, as stated a multicenter cohort study in the Journal of the American Heart Association. Nonsmokers in communities with smoke-free policies had significantly lower systolic BP compared with those in areas without smoke-free policies, with an adjusted predicted mean reduction of 1.14 mm Hg for policies against smoking in restaurants, 1.52 mm Hg for policies on smoking in bars, and 1.41 mm Hg for policies against smoking in the workplace, reported Stephanie Mayne, PhD, of The Childrens Hospital of Philadelphia, and colleagues.

Domestic violence a public health priority, says WHO. An estimated one-third of women have experienced physical or sexual violence at the hands of their partner. The WHO describes domestic and family violence as a global public health problem of epidemic proportions. Doctors, nurses and other health workers are often the first point of contact for women whove suffered abuse so the WHO is putting a lot of effort into raising awareness of domestic abuse among those on the frontline… (ABC Australia)

Ireland set to become the first European country to adopt WHO recommendations to reduce alcohol harm. Ireland set to be the first European country to adopt WHO recommendations to reduce alcohol harm. The new SAFER plan is being unveiled at the Reducing Alcohol Harm: The Power and Potential of Communities conference in Dundalk, Co Louth. THE SAFER initiative is a global response from the WHO to help governments reduce the harmful use of alcohol and related health, social and economic consequences through a package of proven interventions. It urges them to put in place effective control policies to reduce the harmful use of alcohol through actions such as restricting availability and advertising and increasing price. Senator Frances Black writes that “It is gratifying to see Ireland is already a step ahead. The Public Health (Alcohol) Bill 2018, which was enacted last month, echoes some of its key recommendations. This Irish bill will see the eventual introduction of minimum unit pricing, cancer warnings on alcohol product packaging and the segregation of alcohol sale in shops. Alcohol advertising will also be banned near schools and playgrounds… (Nov. 12, The Sun)

Top News From ESMO 2018: New data on RT in prostate cancer are “practice changing”. Radiotherapy to the prostate on top of standard hormonal therapy significantly improved overall survival for men with newly diagnosed metastatic prostatic cancer with low metastatic burden, according to new data from the STEMPEDE trial. However, only this subgroup of patients had the benefit; the OS benefit did not extend to the total unselected population of men with newly diagnosed mPCa. “Prostate radiation therapy should be the standard of care for men with low metastatic burden,” commented lead investigator Christopher C Parker, MD of the Royal Marsden NHS Foundation Trust, London, UK. “Until now, it was thought that there was no point in treating the prostate itself if the cancer had already spread because it would be like shutting the stable door after the horse has bolted,” Parker said at the press conference. “However, this study proves the benefit of prostate radiotherapy for these men. Unlike many new drugs for cancer, radiotherapy is a simple, relatively cheap treatment that is readily available in most parts of the world,” he added (Medscape)

Domestic financing is key to controlling malaria: As reductions in malaria cases and deaths slow, funding for the global response has also shown a levelling off, with US$ 3.1 billion made available for control and elimination programmes in 2017 including US$ 900 million (28%) from governments of malaria endemic countries.  The United States of America remains the largest single international donor, contributing US$ 1.2 billion (39%) in 2017. To meet the 2030 targets of the global malaria strategy, malaria investments should reach at least US$6.6 billion annually by 2020 – more than double the amount available today.

9 causes of altered mental status in the elderly: Subdural hematoma: Older adults who have a history of a recent fall or who use anticoagulants and present to the ED with confusion should be evaluated for the possibility of a subdural hematoma (Curr Treat Options Neurol. 2018 Jun 23;20(8):28). Families may report a minor fall and a slow cognitive decline over several days. Although these events can present in acute stage (<3 days), many geriatric patients present to the ED with subacute subdural hematomas (4-20 days). Most such bleeds are due to tearing or stretching of the bridging veins, and because they are venous bleeds, they can slowly accumulate over several days. Patients on anticoagulant or antiplatelet agents can have spontaneous bleeding events and may not report a history of trauma. Initial treatment of subdural hematomas revolves around lowering the intracranial pressure (Curr Treat Options Neurol. 2018 Jun 23;20(8):28). A neurosurgeon should be consulted if a subdural bleed is identified in the ED. However, age is a prognostic factor and surgical intervention may not benefit the patient (Curr Treat Options Neurol. 2018 Jun 23;20(8):28) (Medscape)

B12 deficiency is common in patients on metformin: Vitamin B12 should be monitored in patients with diabetes on metformin to avoid peripheral neuropathy, suggests a study presented Nov. 21, 2018 at the Society for Endocrinology BES 2018 conference in Glasgow. The study found that 64% of patients had not been tested for vitamin B12 deficiency. Almost 10% of patients were found to have vitamin B12 deficiency, although only just over 6% were being treated.

Eating a diet rich in leafy greens, dark orange and red vegetables, berries and orange juice lowers the risk of memory loss over time in men, suggests a study published online Nov. 21, 2018 in Neurology. The men who consumed the most vegetables were 34% less likely to develop poor thinking skills than the men who consumed the least amount of vegetables. The men who drank orange juice every day were 47% less likely to develop poor thinking skills than the men who drank less than one serving per month

    

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

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