Health Watch

SSCCEM annual scientific sessions

Nipuni Wimalapala

The Sri Lankan Society of Critical Care and Emergency Medicine (SSCCEM) had its annual scientific sessions recently at the Hilton hotel Colombo, with the participation of a number of foreign and local medical professionals.

The guest lecturers for the sessions were the award winning Liver Transplant team from the Mayo's clinic in Jacksonville, Florida USA. The visiting team of experts on liver transplantation for these sessions would have undoubtedly generated great interest amongst the many medical professionals from specialties of transplant surgery, general surgery, hepatology, critical care and anesthesiology.

The SSCCEM was established in Sri Lanka in 2002 with the participation of 109 doctors and nurses working in diverse fields of medicine. Inspired by its motto of being “The pulse of the critically ill” the society strives to improve the standard of critical care and emergency medical services in Sri Lanka.

Dr. Harendra Cooray, the secretary of SSCCEM speaking to Daily News emphasized the importance of the annual scientific sessions.

According to him, the award winning medical team from USA was not here to teach our transplant teams what they already know, but to share their experiences with us.

“The medical team from USA has performed over 2000 liver transplantations and has been recognized as an award winning liver transplant team in the USA for their outstanding successes.

We are fortunate to have them in Sri Lanka. A considerable number of specialists, junior doctors and nurses attended the annual scientific sessions. I am sure they were able to expand their knowledge base, adopt the correct attitudes and team work skills to perform many more successful liver transplantation in the future”, said Dr. Cooray.

According to Dr Cooray, the SSCCEM has proposed the establishment of a National Transplant co-ordination centre in Sri Lanka under the advocacy of the Ministry of Health. Health Minister Maithreepala Sirisena has stated at the inauguration ceremony of the Annual scientific sessions that he will put into motion the establishment process of a National transplant co-ordination centre.

This will enable us to address all the complex issues that arise in relation to donors and recipients of organs.

The final goal of any successful transplant programme is to alleviate the suffering of thousands of critically ill patients of our nation and to see that all ethical and social issues that arise from such a program are addressed appropriately.

The initiation of specialty training in both Critical care medicine and Emergency medicine to produce physicians with multidisciplinary expertise is another vision of the SSCCEM.

This will undoubtedly improve the quality of care provided to critically ill and acutely sick patients who need continuous attention while being cared for and they need to be assessed and reassessed depending on the response to critical and emergency care being instituted.

Sri Lnaka needs to change the approach to managing critically ill and acutely sick patients as have been done in most other countries that include India, Singapore, China, South Africa, Australia, most European nations including UK, Canada and USA.

South Asian Academy of Aesthetic Dentistry

Installation of third President:

Prof Prafulla Thimati from India was installed as the third President of the South Asian Academy of Aesthetic Dentistry by President Dr V Vijayakumaran at the regional conference of the South Asian Academy of Aesthetic Dentistry which was held in Bangaluru, India recently. Outgoing President of the SAAAD Dr V Vijayakumaran during his concluding address he recognised the dental specialists from different parts of the world who gave him their untiring support in organizing two regional conferences in India and one in Bangladesh.

The main second Biennial Aesthetic Dental Conference was held in Sri Lanka for the first time and this was a historical event that brought fame to Sri Lanka. All in all SAAAD council was able to conduct 50 hands on programme in the entire region. Newly elected President Prof Prafulla Thimati in his address, while thanking the academy for electing him to this prestigious post and mentioned that he will also continue the SAAAD activities to promote the continuing education programmes as done before his predecessors. Dr V Vijayakumaran was recognized by the President of the SAAAD Prof Prafulla Thimati at this function for his outstanding leadership and the contribution which he has rendered to promote continuous dental education programmes in South Asian countries.

Nearly 500 dentists from India, Sri Lanka, Bangladesh and Nepal were attended at this function.

Impotence risk higher if men take several drugs

Men taking multiple medications for different health conditions may have a higher risk of erectile dysfunction, a link that doesn't seem to be explained by the underlying health problems themselves, a U.S. study of more than 37,000 men showed.

It is known that men with chronic health problems such as high blood pressure, diabetes and high cholesterol are more likely to develop erectile dysfunction, or ED, than healthier men their age.

But researchers looking at 37,700 men in a large California health plan found that those on three or more medications had higher rates of ED, according to findings published in the British Journal of Urology International.

"The data suggest that some characteristic of men on multiple medications may predispose them to ED," said senior researcher Steven Jacobsen at Kaiser Permanente Southern California's Department of Research and Evaluation.

Overall, 16 percent of men on no more than two drugs reported moderate ED, meaning they sometimes had trouble getting or maintaining an erection. That compared with 20 percent of men on three to five medications, 25 percent of men on six to nine drugs and 31 percent of those on at least 10 drugs.

Not surprisingly, ED was more common in men who were older, heavier, smoked or had health problems like diabetes or high blood pressure. But even when the researchers accounted for that, being on multiple medications was still tied to an increased ED risk.

The findings were based on questionnaires given to 37,712 men aged 45 to 69. Overall, 29 percent reported moderate or severe ED.

More than half of the men were on more than three medications in the past year. As expected, men with high cholesterol, high blood pressure, diabetes or depression tended to be on more medications.

Men on three to five medications were 15 percent more likely to report ED than those on fewer drugs, with the odds more than doubled among men on 10 or more medications.

But the findings do not prove that the drugs themselves are to blame, said Jacobsen.

"We did try to control for the underlying conditions, but we may not have completely accounted for aspects such as severity," he told Reuters Health in an email.

But he also said it was possible the drugs could contribute to or worsen ED via drug interactions, for example, although there was no way to tell for sure from the findings.

He added that while men with ED should not stop taking their medications without talking to their doctor, they could ask to see if it might be possible to lower a dose or try an alternative treatment.

Reuters

Fake malaria drugs, a growing problem: experts

Fake or poor quality malaria drugs are boosting resistance in parts of southeast Asia, a problem that is likely to worsen unless tighter regulations are adopted, US experts said Monday.

“The malaria parasite has a history of adapting to drugs and adapting to insecticides,” Regina Rabinovich, director of infectious diseases at the Bill and Melinda Gates Foundation, told a hearing of US lawmakers.

“Drug resistance to the most effective drug available, artemisinin-based combination therapy, is developing and has been recognized in southeast Asia.”

Last month, the World Health Organization said resistance to artemisinin appeared to be spreading in the region from the Cambodia-Thailand border, where it was first detected in 2009, and possibly moving into Myanmar.

Half of the world’s population is exposed to the mosquito-borne disease which kills 860,000 people every year, according to the WHO.

According to Roger Bate of the American Enterprise Institute, research has shown that about half the malaria drugs that failed quality control tests also contained some artemisinin.

“So they are directly contributing to resistance,” he told lawmakers at the House subcommitee on Africa, Global Health, and Human Rights.

“Resistance is being noticed on the Thai, Cambodian, Burmese borders and resistance is likely to increase,” he said. “Fake and substandard antimalarial medications are a significant and probably growing problem.”

While the actual number of poor quality drugs in circulation is unknown, “it is certainly not a negligible amount,” he added, and the problem is festering because these medications are not illegal in the countries affected.

“Simply getting the medical regulatory authorities to control what is on the market for anti malarials I think is important,” said Bate. The sale and use of monotherapies, which contain just one active agent, have long been known to contribute to resistance. Experts favor combination therapies which last longer.

Bate said that coordinated action to get monotherapies off the market in Africa has shown some success, “but some companies in China, India and Vietnam are still producing them and this is a major contribution to resistance.”

In addition to tougher regulations, researchers need to focus on developing new drugs against malaria, and consider making sure they cannot be sold or distributed as monotherapies, the panelists urged. “The goal now going forward is the new drugs we develop need to be made as fixed dose combinations immediately, and never be sold or available as single entities,” said Dennis Schmatz, president of Medicines for Malaria Venture North America, Inc. “And that will definitely extend the life of any of those new drugs we develop going forward.”

AFP