PTSD is a systemic disorder with comorbidities

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Post-traumatic stress disorder (PTSD) has been traditionally regarded as a psychological disorder. However, the findings of a new study suggest that PTSD should be considered a systemic disorder and not just a psychological disorder as it is associated with several comorbidities independent of exposure to trauma.
Researchers analysed the health status of 298 Australian veterans aged between 60 and 88 years who had fought in the Vietnam War between February 2014 and July 2015. Of these, 108 had confirmed PTSD, while 106 acted as trauma-exposed controls.

Compared to trauma-exposed controls, patients with PTSD had higher frequency (14.1% vs 17.7%, respectively) of comorbid conditions of the gastrointestinal, hepatic, cardiovascular and respiratory systems. It was also associated with sleep disorders. Comorbid depression was found in 22% of subjects with PTSD.
These patients also had a higher prevalence of risk factors such as smoking, alcohol dependence and higher BMI.

Hence, not just psychological health, but physical health including control of risk factors should also be part of management of patient with PTSD to improve their quality of life and survival.
The study is published April 3, 2017 in the Medical Journal of Australia.
(Source: Med J Aust. 2017 Apr 3;206(6):251-257)

Dr KK Aggarwal
National President IMA & HCFI

Two or more drugs may interact with each other

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Two or more prescription or over-the-counter drugs may interact negatively with each other and cause adverse drug reactions. To reduce the risk of drug reactions, one must adopt the following guidelines:

  • Read labels carefully
  • Understand the ingredients in each drug.
  • Understand any possible side effects they can cause.
  • Before taking a drug, speak with the doctor or pharmacist if you don’t understand the drug label.
  • Make sure the doctor is aware of all the drugs you are taking.
  • Don’t mix pills.
  • Don’t break capsules into any food or drink.
  • Don’t take any medication with alcohol.
  • Don’t take medication at the same time as vitamins or mineral supplements.

World Medical Association Council Decisions

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The 200th WMA Council meeting was held in Oslo, Norway (April 16-18) and attended by delegates from more than 35 national medical associations.

The meeting discussed a number of issues, including the following:
Alcohol
A draft Declaration on Alcohol was proposed by the Australian Medical Association aimed at reducing excessive alcohol consumption and supporting WMA members in producing harm-reduction policies. The document, which covers legal and regulatory measures as well as social policy interventions, was approved by the Council for forwarding to the General Assembly in October for adoption.

Mobile Health
A proposed Statement on the opportunities and risks associated with mobile health, was debated and approved by the meeting. The paper calls for regulation to protect patient safety and user data following the enormous growth of mobile health devices such as mobile phones, patient monitoring devices, personal digital assistants and applications. This growth had been largely unregulated, and as a result could have potential patient safety implications. The paper will now be discussed by the General Assembly in Moscow (Oct 14-17).

Social Determinants of Health
President elect Sir Michael Marmot reported on plans for following up the successful conference on the Social Determinants of Health held in London last month. The first aim would be to strengthen global networks, the second would be to build on the evidence base by publishing a supplementary book and the third aim would be to develop educational tools for physicians through online courses and training workshops to learn what they can do to tackle the Social Determinants of Health.

Street Children
Proposed new guidelines for physicians on providing health support to street children were approved by the Council. Delegates agreed that child maltreatment was a world health problem and that physicians had an important role to play in prevention, early identification and comprehensive treatment of child abuse victims. The guidelines will now be considered by the WMA Assembly in October.

Nuclear Weapons
The Council approved a proposed Statement for discussion at the General Assembly requesting all national medical associations to join the WMA in urging their respective governments to work to ban and eliminate nuclear weapons.

Riot Control Agents
The Turkish Medical Association presented a paper on the appropriate use of riot control agents. Following a debate, the Council supported the Statement and this will now be considered by the WMA General Assembly.

Elections
Dr. Ardis Hoven, Immediate Past President of the American Medical Association, was elected Chair of Council.

Prof. Dr. Frank Ulrich Montgomery, President of the German Medical Association, was elected Vice-Chair, and Dr. Masami Ishii, from the Japan Medical Association, was elected Treasurer.

In the committee elections, Dr. Dongchun Shin (Korean Medical Association) was elected Chair of the Finance and Planning Committee, Dr. Miguel Jorge (Brazilian Medical Association) was elected Chair of the Socio-Medical Committee and Dr. Heikki Pälve (Finland Medical Association) was re-elected Chair of the Medical Ethics Committee.

General Assembly
The WMA’s next Council meeting and annual General Assembly will be held in Moscow from Oct 14-17.

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