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

Thank you for not smoking: Run a positive campaign

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The prevalence of tobacco use in India is very high in India as shown by the Global Adult Tobacco Survey India (GATS India) 2009-2010, more than one-third (35%) of adults in India use tobacco in some form or the other. Of these, 21% adults use only smokeless tobacco, 9% only smoke and 5% smoke as well as use smokeless tobacco. The survey also showed that 52% of adults were exposed to second-hand smoke (SHS) at home.

Tobacco use is associated with many adverse health effects and is a major preventable cause of morbidity and mortality. As per the CDC, smoking increases the risk of coronary heart disease by 2 to 4 times, for stroke by 2 to 4 times, lung cancer by about 25 times. In addition, it reduces quality of life, and increases health care utilization and cost. India has a ‘National Tobacco Control Programme’ in place to make the public aware about the harmful effects of tobacco use, control tobacco consumption and minimize the deaths.

“Smoking kills” has been the message that has been conveyed in the campaigns on tobacco control with the expectation that highlighting the potentially life-threatening health consequences would deter people from smoking or using tobacco products. It’s time to alter the tone of such public health campaigns, from negative to positive. Quite often, we may rebuke a patient for failing in his efforts to quit smoking and say, “If you do not quit, you may die”. A statement worded as this may inadvertently sound discouraging to the patient. While it is important that people know the dangers of smoking or using tobacco products, a positive communication approach may have a more fruitful impact than a critical approach.

Avoid violent communication. Do not condemn, criticise and complaint, the 3 Cs of violent communication. Instead use a nonviolent communication approach to help and support your patient in his efforts to give up smoking. Tell your patient, who is trying to quit smoking or other tobacco products “Thank you for not smoking”. Appreciate the hard work put in by him and his perseverance. This way the patient knows that he has your support and will have trust and faith in you. The chances that the patient would adhere to the lifestyle modifications are higher if communicated in an empathetic and supportive manner. IMA is committed to working closely with all National Health Programs alongside the government. As individual doctors, we too can contribute to the success of National Tobacco Control Program. Counsel your patients who smoke about quitting smoking but with a difference… Turn a negative situation to a more positive action.

Dr KK Aggarwal
National President IMA & HCFI

Smoking may dull taste buds

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Smoking dampens the ability to taste. In a study published in the journal BMC Ear, Nose and Throat Disorders, doctors used electrical stimulation to test the taste threshold of 62 Greek participants. Applying an electrical current to the tongue generates a unique metallic taste.

Measuring the amount of current required before a person perceives this taste enables researchers to determine taste sensitivity. The 28 smokers in the study scored worse on this test than the 34 non–smokers. The doctors than measured the number and shape of a type of taste bud called fungiform papillae.

They found that the smokers had flatter fungiform papillae, with a reduced blood supply. Nicotine may cause functional and morphological alterations of papillae, at least in young adults.

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