Pediatric Medicine

samit-islam-rudra

Nowadays parents strongly believe that if their baby is sick, there is no other way but only drug can cure their beloved baby. As drug is a foreign substance, it is not always safe . Most importantly the organs of the baby are not so matured and lack proper enzymes to do proper metabolism of the drug.

Most of us do not know “getting disease” for baby is important because the immune system of the baby is getting stronger by this process. The baby may be ill for some days, but its good effect is for lifetime. The more disease attacks the baby, the more the baby gets stronger.According to WHO the 2/3 drugs are unimportant for the child which are prescribed.

Fever, diarrhea& common cold are typical symptoms for which parents get frightened. The pathetic matter is sometimes parents insist doctor to give their child some drugs. By using those drugs, their baby is actually losing its natural immune system. The baby will be dependent on drugs which will effect badly in future.

According to a report of UNICEF Diarrhea causes death for 4 million child every year .If we spend only 50 cent per baby to buy required food and oral saline, we can save 2 million lives .It is strictly prohibited to prescribe any antidiarrheal medicine like loperamide and diphenoxylate for the patient under 12.

When the baby gets common cold or fever, antihistamine is prescribed. This causes nothing but deep sleep. Parents think that their baby may become well. But actually not .It produce nothing but sedative effect which will cause dangerous effects to him .The most common abuse for the child is antibiotic drug which is used for some virus attack . Normally virus causing diseases are cured naturally. So what is the reason behind prescribing antibiotic for virus attack? As there is no drug against virus in the local market, it does not mean we will use antibiotic instead of this .If the baby has fever,the baby should be kept in a cool room,he should be given plenty of fluids to avoid dehydration and a sponge bath in lukewarm water may make child feel more comfortable.

The health of a baby is mostly dependent on parents how they treat their child. They should be aware of the basic information about health. They should know how to make proper balanced diet for their baby. Prevention is better than cure .There is no pill for every ill .That is why Sir William Oslar said, “One of the first duties of the physician is to educate the masses not to take medicine”

We should never forget that drugs not only cure disease but also sometimes creates disease. In the developed countries there are plenty of organizations who teaches pregnant women how to treat their future baby .Every Parents should have some basic medical knowledge which will make their baby fit and eventually this fit baby will make a fit nation.

Samit Islam Rudra  is a student of depertment of Pharmacy, East West University. He can be reached at samitislam11@gmail.com

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Mental & Physical Fitness to be a Better Professional (Part:1)

arafat

To be a better professional, to progress continuously, what should we do? All we know this answer. We should do courses, do extra work, study a lot over internet, attending conferences and so on. But often, not often, always, we ignore one very much important factor. And that is fitness. By fitness, I refer to both mental and physical fitness. We never see slogans like do weightlifting to be a better project manager or do breathing exercise to be a better software developer etc but it should be. Yes, some of us are aware of the importance of physical fitness, but mental fitness is always hugely neglected, even more, many a time, we do not know what “mental fitness” denotes. If you care to notice, I put mental fitness before physical fitness.

Benchmarks of Fitness
We have some idea about physical fitness, something like men with 6 (six) Pecs and big biceps are fit and men with big belly are unfit. This may not necessarily be entirely true but up to many extents, this is not wrong.

But in real world, it may not be possible for you to achieve big shoulders with diamond shaped calves and achieving that may be one of the sweetest and proudest things on the earth but this is not a precondition for being successful in corporate world. To be successful in corporate world, “normal” level of physical fitness is enough. Now what does this “normal” level mean?

1. Immune Capability: You don’t feel sick easily. Of course, every human being has to fall ill sometimes, but if every season change makes you take bed rest for one week, then you are not fit.
2. Pain: You should not be enslaved by various pains like back pain, neck pain, shoulder pain, wrist pain, migraine etc. You should be able to move your limbs and bones as normal as a human being is supposed to. You should find it easy and smooth to do your daily activities like climbing stairs, sitting on chair, standing for hours, walking for hours etc. And if you have chronic pain like lower back pain, then you need to keep it under absolute control through proper medicine and exercise. In a word, whatever pain you have, keep it under control.
3. Digestion: You should have enough digestion ability. If you need to take pills for gastric and to digest your food very often, then you are not a fit person.
4. Sleep: You should be able to get good sleep. If you suffer from insomnia or if you need to take pills for good sleep, then you are not fit.
5. Long-term disease: If you have any chronic or long-term diseases like high blood pressure, high sugar, heart problems etc, then your these diseases should be under complete control and your these diseases should not be able to affect your daily business. Like if you have high cholesterol problem, then you must follow the proper diet and do regular exercises and take proper medicine to bring it under safe border and not let it to create blocks on your heart vessels.
6. Exercise: You must be able to do normal exercises like 60 minutes fast walk, playing cricket or swimming etc.
7. Controlled Weight: Your weight should be under complete control, your waist circumference should be ok. A slim and lean body do not only look attractive but also this a great indicator of your overall fitness.
8. Energy Level: By energy, I am not talking about energy required to run 20 miles. I am talking about energy required for day to day life. People usually feel weak and tired at work place. If you do not feel energetic and fresh, at least not weak and not gloomy, then you are not fit. When you come to office, and when you leave office, and the time span in between these two, if you feel weak and gloomy, you can’t produce great result even if you want to and even if you are capable of doing so.
9. Sex Life: You should be able to enjoy a normal and enjoyable sex life without medicines. If you are a guy, then this is far more important for you than girls. For various reasons, in today’s world, men are hugely suffering from various sexual weaknesses. Performance on bed hugely affects your overall confidence as well as overall performance of every sector of your life including your career.
10. Confidence: You must feel confident. If you find yourself having less confidence to express yourself to your boss or team, presenting your ideas, handling the pressure or etc, then you are not fit and you must get rid of it as best as you can. You should get psychotherapy or counseling or whatever you need. You need to feel confident at your workplace.

So, I have mentioned some points that are crucial for the fitness of a person. If you can remember more points to add, please let me know, I will add in the next column.

To be continued at part 2
(This Same Article will be found in My linkedin profile)

Arafat Ibn Sultan Riyadh is a seasoned product and project management professional and an agile coach. Moreover, he is a career counselor and motivational speaker. He is currently serving as the Software Project Manager at Augmedix. He is the cofounder and Strategic Consultant at NWIT Ltd and Strategic Consultant at Activation Ltd. He can be reached at arafatmist@gmail.com

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Environmental Pollution in Bangladesh

aboni_nasir

What does the term ‘Environment’ mean? In most literal sense ‘Environment’ simply means the natural world, or the surroundings, in which a person, animal, or plant lives or operates. A healthy environment ensures the continual existence and survival of all life on earth. What if the physical and biological components of the earth system are contaminated to such an extent that normal environmental processes are adversely affected! It leads environmental pollution, which is increasing with every passing year and causing grave and irreparable damage to the earth.

The present environmental condition of Bangladesh is not in equilibrium at all. Severe air, water and noise pollutions are threatening human health, ecosystems and economic growth of Bangladesh. Bangladesh has been ranked 4th among 91 countries with worst urban air quality in the latest air pollution monitoring report of World Health Organization (WHO).

Environmental pollution had been a discussed issue of life for many years but it became a burning one since the start of the industrial revolution. Environment pollution is illustrated by deforestation, destruction of wetlands and inland fisheries, soil nutrient depletion and inland sanity intrusion. Furthermore, natural calamities like flood, cyclones, tidal surges and tornadoes have resulted in severe socio-economic and environmental damage by a combination of factors. These factors include: a large and rapidly growing population; industrial development without sufficient protection from pollution; improper use of chemicals and pesticides in farming; poorly designed flood control systems, drainage and irrigation works; over cutting and indiscriminate felling of forests and royalties for forest products; lack of community control over open access resources; inadequate land use planning and institutional weakness among the public agencies in charge of environmental protection and natural resource management. However, the major root of man- made problems is lack of understanding of ecological principles, poverty and lack of adequate alternate resources.

Environment is the first casualty for increase in pollution whether in air or water. The increase in the amount of greenhouse gases particularly carbon dioxide in the atmosphere, which is due to new industries that are being set up, new vehicles on roads and trees that are cut to make way for new homes leads to melting of polar ice caps which increases the sea level and pose danger for the people living near coastal areas and also leads to smog which can restrict sunlight from reaching the earth, and contribute to the depletion of ozone layer. Gases like sulfur dioxide and nitrogen oxide can cause acid rain. Water pollution due to contamination of water, such as oil spill, may pose skin related problems including skin irritations and rashes, and may lead to death of several wildlife species. Similarly, noise pollution leads to hearing loss, stress and sleep disturbance. Due to constant release of industrial chemicals waste into the flowing water, and use of insecticides and pesticides, affects the quality of soil and the soil may become infertile preventing proper growth of plants. All types of pollution– air, water and soil pollution – have an impact on the living environment. The effects in living organisms may range from mild discomfort to serious diseases such as cancer to physical deformities; extra or missing limbs in frogs.

This entire planet is our home. We are the only species that systematically destroy our own habitat. We cause most of the pollution and we will suffer the consequences if we don’t stop. By doing what we can, educating our self, and sharing our awareness, we can make a significant impact. Some of the pollution prevention approaches include: increasing efficiency in energy use; reducing the use of water and chemical input; use of environmentally benign fuel sources; protection of sensitive areas; repairing leaky faucets and hoses; switching to “green” cleaners; modifying a production process to produce less waste; implementing water and energy conservation practices; using reusable water bottles instead of throw-away and many more.

We live in an ecosystem where the action of one has the potential to affect the many. This can be a good or a bad thing, depending on what the action is. Our mistakes have polluted the environment that we live in. We should try to reverse the damage. The good thing is that every positive action counts. The small effort we make towards a greener environment can start a healing ripple effect. We may still save what is left of our natural resources and make the world a better place to live in for our future generation.

Healthy environment reduces pollution, protects unique ecosystems, prevents the extinction of endangered species and conserves resources, such as water, land and air. A healthy environment ensures the protection of biodiversity and ecosystems upon which human life and all other life on earth depends. Environmental pollution is also closely related with the process of overall economic development. Safeguarding the environmental quality by controlling environmental pollution is interlinked with the goal of ensuring environmental sustainability. Thus, it is crucial to control pollution because “if we heal the earth, we heal ourselves”. Moreover nature, wildlife and human life are precious gifts to the mankind.

Aboni Nasir is a graduate pharmacist. She has completed her gradation under department of pharmacy of East West University. She has interest on public health and recent health issues. She can be reached at aboni.nasir92@gmail.com

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“Teixobactin”-An Irresistible Newcomer

priyanka_florina

Since humans started making antibiotics for ourselves from 1940s, bacteria have evolved to counteract our efforts. They are now winning. There are strains of old patterns that withstand with everything we can throw at them. Meanwhile, our arsenal has dried up. Before 1962, scientists developed classes of antibiotics more than 20. Since then, they have made two.

Antibiotics have not only rescued patients; they have played a vital role in achieving major advances in medicine. They have successfully prevented or treated infections diseases those can happen in patients who are receiving chemotherapy as a major treatments; who have chronic diseases such as diabetes, terminal renal disease, or rheumatoid arthritis; or who have had several surgeries such as organ transplantation, joint replacements, or cardiac surgery etc. Antibiotics have also helped to extend expected life spans by changing the outcome of bacterial infections.

Antimicrobial resistance seems when microorganisms (like bacteria, fungi, viruses, and parasites) change when they are exposed to antimicrobial drugs (like antibiotics, antifungals, antivirals, antimalarials, and anthelmintics). Microorganisms those are antimicrobial resistance are sometimes called to as “superbugs or resistant”.
The rapid occurrence of bacteria is seeming worldwide, endangering the efficacy of antibiotics, which have transformed medicine. Many decades after the first patients were treated with antibiotics; but bacterial infections have again get a threat. The antibiotic resistance crisis has been occurred to the overuse and misuse of these medications, as well as a lack of new drug development by the pharmaceutical companies due to reduced economic incentives and challenging regulatory requirement.

And then there’s teixobactin, a still-experimental drug that may make a new era of antibiotic history. A team of scientists led by Kim Lewis from Northeastern University have specified a new agent named teixobactin, which destroyers some bacteria by preventing them from building their outer cellular coats. They used it to successfully treat antibiotic-resistant infections in mice and more importantly, when they tried to deliberately evolve strains of bacteria that resist the drug, they failed.

Teixobactin was highly effective in protecting from such common bacterial as Clostridium difficile, Mycobacterium tuberculosis and Staphylococcus aureus. An estimated 99% of the bacteria that might create antibiotic agents live in earth but refuse to grow in lab. As a result, a world of antibiotic possibilities has been beyond the reach of researchers. So Lewis and his team invented an isolation chip, or iChip, device that “essentially tricks them.

The researchers took bacterial cells and diluted them in media. They made a growing rack that stored huge panels of treated bacterial culture and immersed individual in soil from which the bacteria had originally been collected. Recognizing the familiar surroundings, the bacteria not seems to notice the foreign presence of media and replicated as if they had never been removed from their primordial soup.

Among these new microbes, the team found one species that kills identified bacteria efficiently. It belongs to an entirely new genus and is part of a group that’s not known for making antibiotics. They called it Eleftheria terrae. It yielded a compound—teixobactin—that could kill significant identities like the bacteria causing anthrax and tuberculosis, and Clostridium difficile (which causes severe diarrhoea). The team exposed some of these microbes to minor levels of teixobactin for some weeks, to see if resistant strains would evolve.

Teixobactin works by withholding two molecules—Lipid II, which bacteria required to develop the cell walls around their body, and Lipid III, which stops their existing walls from breaking down. When teixobactin is around, bacterial walls come crumbling down, and don’t get rebuilt. The drug also binds to parts of both Lipid II and III those are remaining across different species. It’s likely that these parts can’t be altered without disastrous events, making it harder for bacteria to skip teixobactin. This might explain why it’s so hard to evolve resistance to the drug. This won’t work on every bacterium. Many of them, like E.coli, Helicobacter  and Salmonella, have another membrane around their cell walls which can be deflected by teixobactin.

The development of resistance is inevitable and need to focus on introducing antibiotics faster than pathogens can acquire resistance. About 25,000 people a year in Europe alone already die from infections that are resistant to antibiotics and the World Health Organization has described the rise of antibiotic-resistance as one of the most significant global risks facing modern medicine.

Teixobactin gives us an example of how we can develop an alternative strategy on developing compounds where resistance is not going to rapidly develop.

Priyanka Florina Karmokar is a graduate pharmacist. She has completed her gradation under department of pharmacy of University of Asia Pacific. She has interest on public health and recent health issues. She can be reached at pinkuflorina@gmail.com

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Nanorobots in the Field of Medical Technology

muhammedullah-rumi

A nanorobot is a tiny machine designed to perform a specific task or tasks repeatedly and with precision at nanoscale dimensions, that is, dimensions of a few nanometers (nm) or less, where 1 nm = 10-9 meter. Nanorobots have potential applications in the assembly and maintenance of sophisticated systems. Nanorobots might function at the atomic or molecular level to build devices, machines, or circuits, a process known as molecular manufacturing. Nanorobots might also produce copies of themselves to replace worn-out units, a process called self-replication. Nanorobots are of special interest to researchers in the medical industry. This has given rise to the field of nanomedicine. It has been suggested that a fleet of nanorobots might serve as antibodies or antiviral agents in patients with compromised immune systems, or in diseases that do not respond to more conventional measures. There are numerous other potential medical applications, including repair of damaged tissue, unblocking of arteries affected by plaques, and perhaps the construction of complete replacement body organs.

Most historians credit the concept of nanotechnology to physicist Richard Feynman and his 1959 speech, “There’s Plenty of Room at the Bottom.” In his speech, Feynman imagined a day when machines could be miniaturized and huge amounts of information could be encoded in minuscule spaces, paving the way for disruptive technological developments. But it was K. Eric Drexler’s 1986 book, ‘Engines of Creation: the Coming Era of Nanotechnology’, which really put the idea on the map. Drexler posited the idea of self-replicating nanomachines: machines that build other machines. Because these machines are also programmable, they can then be directed to build not only more of themselves, but also more of whatever else you’d like. Drexler painted the picture of a world where the entire Library of Congress could fit on a chip the size of a sugar cube and where environmental scrubbers could clear pollutants from the air.

Introduction of nanorobots into the human body has been proposed through the circulatory system which has two considerations. The first is that the size of the nanomachine determines the minimum size of the blood vessel that it can traverse. Not only do we want to avoid damaging the walls of whatever blood vessel the device is in, we also do not want to block it too much, which would either cause a clot to form, or just slow or stop the blood flow, precipitating the problem we want to cure in the first place. What this means, of course, is that the smaller the nanomachine the better. The second consideration is an even simpler one; we have to get it into the body without being too destructive in the first place. This requires that we gain access to a large diameter artery that can be traversed easily to gain access to most areas of the body in minimal time.

There are a number of means available for active propulsion of our device through the circulatory system- a) Propeller, b) Cilia, c) Electromagnetic pump, d) Jet pump, e) Membrane propulsion, f) Crawl along surface. There are various technologies to observe the movement of nanorobots- a) Ultrasonic, b) Nuclear magnetic resonance, c) Radioactive Dye, d) X-ray, e) Radio/Microwave/Heat. To control the movement we can use chemical, Spectroscopic method, UHF sonar for resolution and texture.

Some of the most exciting applications of nanorobots in my eyes are- a) Cancer Treatment, b) Drug Delivery Mechanisms, c) Medical Imaging, d) New Sensing Devices, e) Information Storage Devices, f) New Energy Systems, g) Super-strong Metamaterials, h) Smart Windows and Walls, i) Ocean-cleaning Microsponges, j) Replicators Health, k) Sensors, l) Connecting Our Brains to the Internet. But the most important application can be remove blood clot by nanorobots.

Nanorobot is the most advance technology of modern science. Although scientists yet have to develop this technology a lot, buts they believe that they will be able to successfully implement this technology within 2030. We can say that, future medical technology will be highly dependent on nanomedical technology and this future is not so far away!

Muhammedullah Rumi is a student of Department of Pharmacy, East West University, Bangladesh. He can be reached at rumiroman1732@yahoo.com

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Grow with Plant, plant a birthday tree

arushi-madan

While we have many days to celebrate like Environment day, Earth Day, Water Day, No Tobacco Day, Car free day, International Youth Day etc and we try to be a part of them but besides these important days, everyone has their own special day like our birthdays. As a responsible inhabitant of this planet, I feel, everyone should celebrate their birthdays in an eco-friendly way. Yes, I am talking about Birthday Plantation which is the best way to have green celebration on special days like birthdays or anniversaries.

We all know that global warming is at its peak and is showing its worst consequences in form of increasing disasters like frequent earthquakes/hurricanes/floods/droughts etc. It has reached such an alarming state that we don’t have time to think, we need to act NOW NOW.

Trees are the lifelines or lungs of Earth. They are the best creation of GOD and provide benefits not only for environment but also for humans. Trees are one of the most efficient ways to combat climate change and global warming. It would be a big positive move towards environment protection if we all start planting birthday trees/ anniversary trees and help promote this idea till it becomes the most trending thing.

World population is reaching 7 billion. Imagine, if each of us plant a tree/sapling on our birthday alone, this world will much greener and purer with 7 billion trees in a year. And if parents or elders or married couple do the same on their wedding anniversaries as well, it will be icing on the cake. I plant trees on my birthdays and this year onwards we have started this for my parents’ wedding anniversary as well.

Imagine if parents plant a tree when their new born child is born, take his picture with the tree every year on his birthday. This way watch the tree growing with your child and build a green future. I wish if people start this tradition and make this world a much better and greener place to live for all of us. Change has to begin from us so whoever is reading it, make it a practice to plant a tree from your next birthday onwards and spread the word around till all 7 billion people of this world have at least one tree each.

Arushi Madan is a student of Electronic & Electrical Engineering of University of Birmingham, UK. She is an environmental activist and working on different climate issues and creating awareness to reduce environmental pollution. Besides she has been working as a Regional Ambassador of Tunza Eco- Generation. She can be reached at madhumadan2003@yahoo.co.in

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Infectious Diseases and Non-communicable Diseases the Double Burden Challenge in Bangladesh

md-delowar-hossain

In the 21st century, non-communicable diseases (NCDs) along with the communicable diseases (CDs) are now considered as the reason of severe health problems globally, more predominantly in third world countries like Bangladesh. This double burden of disease places an incredible toll on health and economy of people and general population of Bangladesh. Though very low level of economic development has achieved in Bangladesh but has accomplished remarkable changes in health sectors in the last 40 years. However, the continuance of socioeconomic status (SES) inequities is still interrupting the progression in public health. The epidemiologic transition is occurring from CDs to NCDs in which NCDs are predominant. The poor suffer from CDs in all age groups, whereas those better off suffer more from NCDs than CDs and this difference has established only because of SES inequities. Globalization, improper urbanization and ecological and way of life elements on a foundation of overpopulation have been contributing altogether.

Infectious disease is a type of disorders that can be communicated from one person to another and this transmission occurs due to some kind of contact including eating, drinking, touching, or breathing which contains pathogenic microorganisms such as bacteria, viruses, parasites or fungi. Even pathogens responsible for infections can also be disseminated through animal and insect bites, kissing and sexual contact. Stephen Morse of Columbia University & Mark Woolhouse and Eleanor Gaunt of the University of Edinburgh have estimated that approximately 1,400 pathogens capable of infecting humans, among them 500 are capable of human-to-human transmission, of which around 150 have the ability to cause an epidemic or endemic disease. Professor Kristi Koenig and Professor Carl Schultz of the University of California at Irvine, USA have described that pathogens have been associated with infectious diseases for thousands of years. Smallpox, cholera, malaria, plague, tuberculosis, and syphilis are the examples of infectious diseases that have come with long outbreak history resulting millions of deaths over the world.

On the other hand, NCDs also known as category of chronic diseases those are not moved from person to person but develop in a patient body due to some reasons, some may be under control, and some are not within patient control. Let’s look some statistical data regarding NCDs; World Health Organization (WHO) has estimated that NCDs including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for almost 70% of all deaths worldwide. Right around seventy-five percent of all NCDs and 82% of the 16 million individuals who died prematurely, or before achieving 70 years old, happen in low- and center pays nations. Tobacco uses, physical inactivity, excessive use of alcohol, unhealthy diet are the major risk factors for most of the premature deaths. In a study report has estimated that the most recurrent starting points of death including cardiovascular diseases, diabetes, chronic lung disease, and cancers the main key risk factors were increased blood pressure (responsible for 13% of deaths globally), tobacco use (9%), elevated blood glucose levels (6%), physical inactivity (6%), and overweight and obesity (5%). About 95% NCDs are only because of lifestyle choices.

The prevalence of infectious diseases is still very high, especially in young children, even though the fact that the greater part of the fundamental devices and learning about their anticipation, treatment and control are accessible. Those devices are both powerful and reasonable, yet they don’t reach the individuals who require those. However, NCDs are expanding and will keep on doing so. Let’s take a look at another study performing in Bangladesh; 37% of the deaths caused by NCDs considered as the leading causes, followed by CDs which are responsible for 22% of the deaths. Age-particular mortality exhibited untimely birth, respiratory diseases, and suffocating were the predominant reasons for death for youth mortality (0-14 years), which was contrarily connected with SES. For grown-up and the elderly (15 years and more established), NCDs were the main source of death (51%), trailed by CDs (23%). For grown-up and the elderly, NCDs prevalent among the populace from higher SES gatherings and CDs among the lower SES bunch.

Now, what should do for reducing mortality regarding these double burdened diseases? As infectious and NCD’s are connected to different modifiable hazard variables which are blended with people groups’ everyday way of life incorporate tobacco utilize, liquor mishandle, undesirable eating regimen, physical inertia, obesity, raised blood pressure and blood glucose, abnormal blood lipid, natural cancer-causing agents etc. So, the approach should be taken to grasp a powerful counteractive action program by enhancing attention to individuals about a perfect and healthy lifestyle. Indeed, even policymakers need to consider the social scattering of sicknesses before working up any general wellbeing activity concentrated on towards lessening mortality and the level of double burden in a fair way.

Md. Delowar Hossain is a Student & Undergraduate Teaching Assistant (UTA) at Department of Pharmacy in East West University, Bangladesh. He can be reached at dhdipu030@gmail.com

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Popular Proton Pump Inhibitors linked to higher risk of stroke

s-m-hasan-morshed

Many people all over the world are taking proton pump inhibitors for treating acid reflux and heartburn. These medications are considered very safe and effective and that’s why these are highest-selling classes of drugs in the U.S. Some PPIs such as omeprazole and pantoprazole are available over the counter and people can take these medications without the prescription of doctor. In recent study presented in American Heart Association’s Scientific Sessions 2016, it is showed that these medications increase the risk of Ischemic strokes which is the most common type of stroke. In Ischemic stroke blood clot blocks or plugs a blood vessel in the brain as a result flowing of blood to the brain is stopped and brain cells began to die.

How PPIs work:
Our stomach Produces acid for digesting foods and killing germs (bacteria). Though the acid is corrosive it cannot corrodeour stomach linings because of natural mucous barrier which protects the lining of the stomach. Whenthe barrier is broken acid, it can damage the stomach and cause ulcer. Muscular band (the sphincter) is present at the top of the stomach which keeps the stomach tightly closed and because of problem with the sphincter acid goes to gullet (oesophagus) and cause irritation. It is known as acid reflux which causes heartburn or inflammation on oesophagus.Proton pump inhibitors irreversibly blocks the hydrogen/potassium adenosine triphosphatase enzyme system (commonly known as Proton Pump) of the gastric parietal cell. By inhibiting terminal stage in gastric acid section it reduces acid which helps in the healing of ulcers and reduces the pain of heartburn.

Recent study:
Study was presentedat the American Heart Association’s Scientific Sessions 2016, held in New Orleans, LA by Lead study author Dr. Thomas Sehested, of the Danish Heart Foundation in Copenhagen, Denmark. Danish Heart Foundation funds for these study. The research was performed in Denmark. In this study 245,000 Danish patients participated who were suffering from stomach pain and indigestion and their average age was 57. They had undergone endoscopy to identify the cause of indigestion and stomach pain. One of four PPIs: Prilosec, Protonix, Prevacid orNexium were given to them. In this study researchers saw that stroke risk increased 21% among patients who were taking these medications. In case of the dose is low, chances of stroke is less or none but when the dose is high  they found that stroke risk increased 33% for Prilosec and Prevacid patients, 50% for Nexium patients and 79% for Protonix patients. In another group patients were given H2 blockers as acid-reducing medications and they show no increased risk of stroke. Sehested believes that because of their findings from now on these medications (PPIs) will be used cautiously. “At one time, PPIs were thought to be safe, without major side effects,” he said, “This study further questions the cardiovascular safety of these drugs.” Though they did not find any link between H2 blockers and stroke but they are not claiming H2 blocker as a better option.

Company’s opinion to this study:
Company named P&G the maker of Prilosec emailed to CNN and claimed that their drug is FDA approved safe and effective. This OTC drug has a longest history of safe and effective consumer use. Takeda, the maker of Prevacid, said they will not comment until full data of the study is published and they will ensure patient safety first. AstraZeneca, the maker of Nexium also believes in patient’s safety and they think there PPIs are much safer than others. On the Other hand Pfizer, the maker of Protonix, did not said anything until now.

Alternatives of PPIs:
To treat acid reflux or heartburn PPIs are not the only solution. We can reduce this discomfort by changing our lifestyle such as reducing weight, by stopping smoking and removing fatty foods from our menu. For longer relief H2 blocker can be a good option. Antacids can also be used but it gives short term and instant relief. Always contact with your doctors before taking any medicines.

S. M. Hasan Morshed is completing his undergrad program under department of pharmacy, East West University. He can be reached at s.mhasanmorshed@gmail.com

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The most misunderstood mental illness: Schizophrenia

farhana-farin

Human brain is the most mysterious and complex one to understand, where things to go wrong is very common. About 20% of people have some type of mental disorder and among all of mental disorders schizophrenia is chronic, severe and deteriorating one.  In 1911, the Swiss psychiatrist, Eugen Bleuler, coined the term, “schizophrenia” which translates into “split mind” in Greek. This considerable impact is not only on patients’ health, but also on their surrounding environment. People who have it may hear voices that aren’t there, may think other people are trying to hurt them. Sometimes they don’t make sense when they talk. The disorder makes it hard for them to keep a job or take care of themselves. For some people these experiences or beliefs can start happening quite suddenly, but for others they can occur more gradually. One may become upset, anxious, confused and suspicious of other people. A large number of people worldwide suffer from schizophrenia which is as many as 51 million people worldwide suffer from schizophrenia. 10% of people have a close family member that has it like a parent or sibling. In men, symptoms usually start in the early to mid 20s in women symptoms usually start in the late 20s

Today schizophrenia are key public health issues. It continues to be one of the leading mental disorders in our country, Being a developing country Bangladesh and its prevalence of psychiatric illness is not less than that of any other country in the world , with around 35% of the admitted patients at the National Institute of Mental Health (NIMH) suffering from this illness, according to the health bulletin. Although there is no recent survey data that estimated the current number of people suffering from schizophrenia but by the bulletin of the health directorate showed that 2,140 patients were admitted to the NIMH last year; more than 35% of them had schizophrenia. The percentage had been similar in recent years which is  35.53% in 2009, 37.58% in 2010, 43.47% in 2011 and 38.1% in 2012

Schizophrenia is characterized by distortions in thinking, perception, emotions, language, sense of self and behavior. Hearing voices, delusions, Stigma, discrimination and violation of human rights of people with schizophrenia is common. People with schizophrenia are 2-2.5 times more likely to die early than the general population. This is often due to physical illnesses, such as cardiovascular, metabolic and infectious diseases.

Research has not identified any one single factor behind this disease. It is thought that an interaction between genes and a range of environmental factors may cause schizophrenia. Psychosocial factors may also contribute to schizophrenia.

Now on this era, medications work successfully to control symptoms in the majority of patients. Mostly anti-psychotic drugs of second generation have shown more success with some patient population in treating negative and cognitive symptoms. It is also believed that mental health education for the family members of these patients is useful and effective. But more than 50% of people with schizophrenia are not receiving appropriate care. Lack of access to mental health services is an important issue. Furthermore people with schizophrenia are less likely to seek care and also being expensive majority of people lack access to treatment. There is clear evidence that old-style mental hospitals are not effective in providing the treatment that people with mental disorders need and violate basic human rights of persons with mental disorders. So efforts to transfer care from mental health institutions to the community need to be expanded and accelerated.

Schizophrenia seems to be the manifestation of the human spirit yearning to return to that which is came from. The way western – and many other parts of the world – societies are, it’s not in the least bit surprising that we develop these fantastical, seemingly ‘unreal’ perception. But we need to create awareness; we have to fight to protect our dear ones and ourselves. People will understand the disease only when they will properly know about it. Most often people suffers a lot loose connections for their behavior and gets misunderstood without knowing the reasons but don’t let this continue, lets know this disease so that we can detect it and 24th of May is the schizophrenia awareness day which should be conducted massively creating big events in our country like others which will collaborative venture to raise awareness of schizophrenia and psychosis.

Farhana Farin is an undergrad student of East West University. She can be reached at farhanafarin08@gmail.com

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Insomnia: The Sleep Taking Monster

rafi-ewu

Insomnia is a sleeping disorder which induces difficulty in sleepingthat causes rapid disturbance is daily life. Furthermore as a result people suffering from insomnia feel exhausted when the wake up. This sleeping difficulty brings up a heavy toll on the health of the sufferer. According to Foxnews a research conducted on 1,667 females and 1,498 males in Finland who were part of a long-term study showed that overall 12 percent of women and 15 percent of the men suffered from insomnia. People of various ages are suffering from insomnia but it persists commonly among the adults. Obesity, anxiety and depression can be caused by insomnia. In addition to that irritability, concentration problems, memory problems, poor immune system function, and reduced reaction time are also caused.

Types:
Among many other sleeping disorders insomnia is one of the most acute one. In most of the cases Insomnia comes in three different categories. Such as

  • Transient insomnia–This type happens if only the symptoms are persisted for few days up to a week.
  • Acute insomnia– This type is called the short-term insomnia. In this case the symptom lasts up to few weeks.
  • Chronic insomnia–This is the most dangerous one as the symptoms lastat least a month and in many cases for years. According to the National Institutes of Health,insomnia can be caused by the typically undesirable effects of a drug or medical treatment or other difficulties.

Causes:
There are several causes of insomnia and many of them are psychological or because of the adverse effects of medical treatments. Jet lag, job shift changes, high altitudes, noisiness, hotness or coldness also cause this disorder and psychological issues like bipolar disorder or depression, anxiety can play a very significant role in developing this sleeplessness. Moreover medical conditions including brain lesions and tumors, stroke, chronic pain, congestive heart failure, angina, acid-reflux disease, chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson’s and Alzheimer’s diseases, hyperthyroidism, arthritis also causes insomnia. Some Hormones such as estrogen is also a reason behind this disorder.

Symptoms:

There are many alarming symptoms of insomnia whereas insomnia itself can be a symptom of various medical conditions. Some signs and symptoms can be difficulty in falling asleep at night, awakening up during the night, awakening earlier than desired, still feeling tired after a night’s sleep, daytime fatigue or sleepiness, irritability, depression or anxiety, poor concentration and focus, being uncoordinated, an increase in errors or accidents, tension, headaches, difficulty in socializing, gastrointestinal symptoms, worrying about sleeping.

Tests and Diagnostics:

For diagnostics a sleep specialist is needed who will conduct a session through several questions regarding the previous medical history and sleep pattern. A physician may be consulted to conduct diagnostics as this disorder can be caused by many physical problems.

Treatment Options for Insomnia:

Some types of insomnia are self-limited. On the other hand for other types if the sleeping problems can be solved insomnia can be cured. As adjuvant therapies non-pharmaceutical and medical approaches can be taken.

Non-pharmacological approach include improving sleep hygiene which means no over- or under-sleep, daily exercise, no forceful sleep, maintaining a regular sleep schedule, avoiding caffeine at night, no smoking and making sure the environment is comfortable. Besides relaxation techniques including meditation can be used. Additionally counseling therapies can be applied too. Lastly stimulus control therapy more like going to bed when sleepy, not watching TV, reading, eating in bed, setting an alarm for the same time every morning, avoiding long daytime naps can also treat insomnia.

Medical treatments for insomnia include taking medicines like benzodiazepines, Antidepressants and Over-the-counter sleep aids, Antihistamines, Melatonin, Ramelteon, Valerian officinalis.

Rafi Ahmed is an undergrad student of Department of pharmacy, East West university. He can be reached at powershift.42@live.com

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