Antibiotic resistance rising in children too

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Antibiotic resistance is a growing concern and its impact on patients and communities are known to us all. This is a public health problem, one which is rapidly spreading across the globe, with not enough resources to control it. Antibiotic resistance has made it harder for us to treat many infections such as typhoid, pneumonia, tuberculosis. Antibiotic resistance prolongs hospitalization, increased cost of treatment and increases risk of death. Several studies have corroborate the adverse impact of antibiotic resistance on health.

Researchers from the Case Western Reserve University School of Medicine, Cleveland, Ohio examined the prevalence of multidrug-resistant Gram-negative enteric Enterobacteriaceae (MDR-GNE) infection in children between January 1, 2007, and March 31, 2015 and its association with hospital length of stay and death before discharge. This retrospective study observed an astounding 700% increase in MDR-GNE infections in a short period of eight years. A 20% increase in the lengths of hospital stay was observed in patients with MDR-GNE infection. The odds for death also increased, though this did not reach statistical significance. More than 75% of the antibiotic-resistant infections were already present at the time of hospitalization, contradicting earlier studies which showed that such infections were most hospital acquired.” The study is published in the March 2017 issue of the Journal of the Pediatric Infectious Diseases Society.

This study has yet again highlighted the escalating problem of antibiotic resistance. It has shown that antibiotic resistance can affect individuals of any age, even children.

In its first global report on antibiotic resistance, the WHO has warned that “A post-antibiotic era—in which common infections and minor injuries can kill—far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century”. Doctors as well as patients should be aware about and advocate judicious use of antibiotics. Over prescription and self prescription, both, need to be checked.

Taking cognizance of the impact of antibiotic-resistant infections, IMA has proposed several initiatives to tackle this public health threat – “Jaroorat Bhi Hai Kya”, “3A Avoid Antibiotic Abuse campaign”, “Use Wisely not Widely”, “Think Before you Ink”. IMA will also come out with a book on ‘When Not to Use Antibiotics’. We are also concerned about declining research in the field of newer antibiotics and support formulation of a national antibiotic policy.

(Source: Case Western Reserve University School of Medicine, News Release, February 24, 2017)

Dr KK Aggarwal
National President IMA & HCFI

Eating fruits and vegetables may lower risk of dementia in older adults

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A population-based observational study published February 10, 2017 in the journal Age and Ageing has yet again provided evidence for the benefits of eating fruits and vegetables. The study says that at eating least three servings of vegetables and two servings of fruits daily might help prevent dementia in older adults.

Researchers examined the diet of more than 17,000 Chinese older adults who attended the Elderly Health Centres in Hong Kong who did not have at study baseline. Their cognitive status was followed up for 6 years. The cut-off for minimal intake of vegetables and fruits was defined as that recommended by the WHO as at least three and two servings per day, respectively

Compared with adults who did not adhere to WHO recommendations for fruit and vegetable intake, adults who consumed three servings of vegetables and two servings of fruits daily were found to be at lower risk of dementia development over 6 years. Dementia risk was further reduced for adults who consumed an additional three portions of vegetables each day, the team reports.

According to the authors, the study also highlights the importance of daily intake of fruits and vegetables for cognitive maintenance.

(Source: Medical News Today)

Dr KK Aggarwal
National President IMA & HCFI

Food insecurity increases risk of stroke recurrence

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A new study has linked food insecurity to increased stroke risk factors, such as diabetes and high blood pressure increasing the risk of stroke recurrence. Food insecurity is the state of being without reliable access to adequate amounts of affordable, nutritious food.

The study from a Chicago Hospital presented at the American Stroke Association’s International Stroke Conference 2017, evaluated 216 patients in the outpatient neurology clinic using a standardized two-question screening tool and reviewing electronic medical records. Forty-nine (22.7%) of the participants were identified as food insecure. Sixty-four patients were diagnosed with stroke; of these, 18.8% were found to be food insecure.

In the food insecure stroke group, 84.6% also had hypertension; 58.3% had diabetes and 16.7% had a previous stroke. While, among stroke survivors not labelled food insecure, 67.3% had hypertension; 28.8% had diabetes and 21.2% had a previous stroke.

These findings suggest that medical treatment of risk factors like hypertension and diabetes may not be enough to prevent stroke recurrence. Food insecurity may also complicate management of these health problems. Hence, social support is also required in addition to medical management especially for high risk patients. Health policy should be framed keeping in mind the availability of nutritious food to lead a healthy life.

The proposed Sustained Developments Goals (SDG) of the United Nations have included food insecurity under Goal 2 “End hunger, achieve food security and improved nutrition, and promote sustainable agriculture”. SDG 2 aims to achieve ending hunger, and ensuring access by all people, in particular the poor and people in vulnerable situations including infants, to safe, nutritious and sufficient food all year round by the year 2030.

(Source: AHA News Release, February 23, 2017)

Dr KK Aggarwal
National President IMA & HCFI

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