Morning MEDtalks with Dr KK Aggarwal 30^th November 2018

Negative social cues on tobacco packaging may be a novel alternative to help smokers quit. A new research has suggested that using negative social cues on packaging is effective at discouraging smoking. The results support the view that packaging, which conveys to smokers that “others” view smoking negatively is sufficient to trigger feelings of self‐consciousness, which in turn reduces smoking intentions. This approach is particularly effective in “isolated” smokers who do not see smoking as identity‐relevant or congruent with their social self... (Journal of Consumer Affairs, online Nov. 20, 2018)

Malaria control campaign launched in Democratic Republic of the Congo: A spike in malaria cases is threatening the health of people in parts of the eastern Democratic Republic of the Congo (DRC) where health workers are also battling an Ebola outbreak.  In response, a four-day mass drug administration (MDA) campaign was launched today in the Northern Kivu province town of Beni, with a target to reach up to 450 000 people with anti-malarial drugs combined with the distribution of insecticide-treated mosquito nets.

“Controlling malaria is critical in areas like North Kivu, as it causes widespread disease and death, especially among the region’s children,” says Dr Yokouide Allarangar, WHO’s Representative to the DRC. “This anti-malaria campaign will also help reduce the pressure on the overall health system, which is currently striving to protect people from the ongoing Ebola threat in the region.”

North Kivu’s malaria outbreak has overburdened Ebola responders; many suspected cases of Ebola have turned out to be malaria, as early symptoms of both diseases are similar. Up to 50% of people screened in Ebola treatment centers have been found to only have malaria. Therefore, the anti-malaria campaign has two main aims.

1. Firstly, the distribution of insecticide-treated mosquito nets will prevent malaria transmission and its accompanying health consequences, thus saving lives.
2. Secondly, the mass drug administration will treat people who have already contracted malaria and curtail transmission of malaria among Ebola-affected populations and health centres. Having fewer people present with malaria will lessen the workload on already stretched Ebola treatment centres.

(Source: WHO Africa, Nov. 28, 2018)

16 actions for girls’ and women’s safety in emergencies (UNICEF)

For International Day for the Elimination of Violence Against Women and the following 16 days of activism, here are 16 actions UNICEF and its partners are taking to increase girls’ and women’s safety in emergencies:

1. Let girls’ and women’s voices be heard:Most importantly, #HearMeToo. Women and girls should be the at the centre of all design and delivery.
2. Connect to those who know, who care:When developing programmes, ensure local women’s and youth organisations are consulted and build on their best practices and evidence. And for the many men and boys who are champions for an end to GBV, let’s work together.
3. Light the way:All shelters, latrines, water points and pathways within camps must have ample lighting to reduce the risk of sexual violence.
4. Be non-apologetic about female-only safe spaces:Most public spaces in emergencies are dominated by men and boys. Women and girls need a place where they can feel safe, report gender-based violence confidentially, receive information and support, and build their social network and confidence.
5. Make safe spaces mobile:The most vulnerable women, married adolescents, adolescent mothers, and disabled women and girls need services brought to them.
6. Build a trusted partnership for case management:Case managers provide crucial support to survivors of gender-based violence, empowering them to assess their needs and develop a plan to heal and recover.
7. Train frontline health workers:Frontline health workers should be trained in supporting survivors of gender-based violence, including skills on survivor-centred communication and clinical management of rape.
8. Equip toilets with locks:All latrines and toilets must have locks to offer women and girls security, and there should be separate facilities for males and females.
9. Expand the partnership circle:In addition to local civil society, engage governments, donors and private partners to find new ways to collaborate – including blended financing mechanisms—to bring results to scale.
10. Construct secure shelters:Women and girls often lack privacy within their shelter due to thin walls and proximity to neighboring tents. Shelters should be built to the design and needs that women and girls request for their safety.
11. Supply hygiene kits:Women and girls have the right to manage their periods with privacy and dignity. WASH and hygiene kits, designed by women, with menstrual health products, soap, whistles and torches keep them safe and allow them to participate in school and other activities.
12. Build referral systems:These give survivors a pathway to receive life-saving and confidential health care, psychosocial and other support on their journey to recovery.
13. Provide age-appropriate sexual and reproductive health services:Access to clinical care for sexual assault, HIV and sexually-transmitted disease testing, and other health services should be accessible and adolescent-friendly.
14. Deliver life skills: Through life skills training, women and adolescent girls can be leaders and creative thinkers, engage in citizenship, and gain skills that can reduce their risk of gender-based violence.
15. Cash in the hands of those who need it most: In severe cases where a woman or a girl’s life is in danger, emergency cash can help facilitate access to immediate shelter and subsistence.
16. Women in WASH: Meaningful participation of women and girls in water, sanitation and hygiene (WASH) committees allow them to raise their concerns about safety and privacy, and the solutions to improve services.

The US FDA has approved Xospata (gilteritinib) tablets for the treatment of adult patients who have relapsed or refractory acute myeloid leukemia (AML) with a FLT3 mutation as detected by an FDA-approved test. The FDA also approved an expanded indication for a companion diagnostic, to include use with Xospata. The LeukoStrat CDx FLT3 Mutation Assay, developed by Invivoscribe Technologies, Inc., is used to detect the FLT3 mutation in patients with AML… (US FDA)

UK leads Western countries in deaths from respiratory illnesses, says a new observational study reported Nov. 28, 2018 in the BMJ. Mortality from overall respiratory disease was higher in the UK than in EU15+ countries (UK, Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden, Australia, Canada, the United States, and Norway) between 1985 and 2015. Mortality was reduced in men, but remained the same in women. Mortality from obstructive, interstitial, and infectious respiratory disease was higher in the UK than in EU15+ countries.

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