Make Chiangmai Mail | your Homepage | Bookmark

Chiangmai 's First English Language Newspaper

Pattaya Blatt | Pattaya Mail | Pattaya Mail TV

 
Update February 2016


Home
Chiang Mai News
Arts - Entertainment for Chiang Mai
AutoMania
Classical Connections
Cartoons
Animal Welfare
Care for Dogs
Community Happenings
Doctor's Consultation
Dining Out & Recipes
Education
Features
Heart to Heart
Life at 33 1/3
Mail Bag
Money Matters
Photography
Social Scene
Sports
Travel & Tourism
Daily Horoscope
About Us
Subscribe
Advertising Rates
Current Movies in
Chiangmai's Cinemas
Classifieds
Back Issues
Find out your Romantic Horoscope Now - Click Here!
Update by Natrakorn Paewsoongnern
 
 
 

Doctor's Consultation  by Dr. Iain Corness

 

Update February 13, 2016

WHO sounds a warning

The WHO Director-General, Dr Margaret Chan, published a statement on the first meeting of the International Health Regulations (2005) Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations.
Dr Chan convened an Emergency Committee, under the International Health Regulations, to gather advice on the severity of the health threat associated with the continuing spread of Zika virus disease in Latin America and the Caribbean. The Committee met in February by teleconference.
In assessing the level of threat, the 18 experts and advisers looked in particular at the strong association, in time and place, between infection with the Zika virus and a rise in detected cases of congenital malformations and neurological complications. The experts agreed that a causal relationship between Zika infection during pregnancy and microcephaly is strongly suspected, though not yet scientifically proven. All agreed on the urgent need to coordinate international efforts to investigate and understand this relationship better.
The experts also considered patterns of recent spread and the broad geographical distribution of mosquito species that can transmit the virus.
The lack of vaccines and rapid and reliable diagnostic tests, and the absence of population immunity in newly affected countries were cited as further causes for concern.
After a review of the evidence, the Committee advised that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes an “extraordinary event” and a public health threat to other parts of the world.
In their view, a coordinated international response is needed to minimize the threat in affected countries and reduce the risk of further international spread.
Members of the Committee agreed that the situation meets the conditions for a Public Health Emergency of International Concern.
Dr Chan has now declared that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern.
A coordinated international response is needed to improve surveillance, the detection of infections, congenital malformations, and neurological complications, to intensify the control of mosquito populations, and to expedite the development of diagnostic tests and vaccines to protect people at risk, especially during pregnancy.
The Committee found no public health justification for restrictions on travel or trade to prevent the spread of Zika virus.
At present, the most important protective measures are the control of mosquito populations and the prevention of mosquito bites in at-risk individuals, especially pregnant women.
This shows the way public health is being monitored in the world by the WHO (World Health Organization) and I commend them for their attention to this latest public health threat, without hysteria, as has sometimes been the case in the past. It certainly does look as if there is an association with this Zika virus and microcephaly (small head).
Zika, usually mild and rarely fatal with symptoms often mistaken for other mosquito-borne viruses such as dengue and chikungunya, has “widespread distribution” across Thailand, according to an article last year in the American Journal of Tropical Medicine and Hygiene. But Thailand has only reported one case this year. But that does not mean there has only been one case -
Zika virus is spread by the Aedes aegypti mosquito, the culprit responsible for dengue, yellow fever and other tropical diseases. Since we have not been that successful in combating Aedes aegypti which breeds in standing water (and there has been plenty of water recently), the potential for an epidemic is quite obviously there.
The big problem here, and one where the WHO is sliding down a knife edge, is if the microcephaly issue turns out not to be a Zika effect, the WHO becomes accused of scaremonger tactics for having brought attention to it. If however it is shown to be a vector in the condition, the WHO becomes accused of not giving the world enough of a warning!
Damned if you do and damned if you don’t!


Update February 6, 2016

Does EBM mean increased ‘benefits’ for you?

The practice of Medicine is a fascinating story over thousands of years. “Healers” have been part of most societies, and in ancient China, for example, you paid the doctor to remain well, not for treatment of your ailment. Now there’s an incentive bonus for you!
Then there are different kinds of “medicine” given such names as “conventional”, “alternative” and “complementary”.
These different ways at looking at the same subject (making you well) can be quite confusing, and for me much hangs on the term EBM, which stands for Evidence Based Medicine.
Mind you, it has also always been the case where people like to throw stones at conventional clinical medicine. Claims of over-servicing, over-prescribing and downright fraudulent practices are thrown about, citing someone whose uncle/friend/mother (delete that which is inappropriate) suffered at the hands of “bad” doctors who misdiagnosed the illness and the patient died.
Now, there are certainly some “bad” doctors out there, just as there are “bad” lawyers, “bad” real estate agents, “bad” mechanics and just about any profession you would like to think of. But they’re not all “bad”.
And me? I am a conventionally trained British/Australian style medical practitioner who has spent a lifetime practicing EBM. Practices that have been proven to work. Call it “good” medicine, if you like.
I am also proud of my final exams taken in the Royal Colleges of Physicians and Surgeons in London. I have the honor to have my name listed in the ‘great book’ with luminaries such as Hunter, Jenner and Lister. I am also indebted to my tutors during the 12 months of ‘pre-registration’, where you apply your knowledge under the supervision of accredited specialists. An arduous road, but one that is a safeguard for you, the general public.
The ‘powers that be’ are also ensuring that we keep up to date with a process called Continuous Medical Education (CME). That medical education continues through to today, with CME lectures being attended by my hospital’s doctors, and myself. Fortunately for me, the slides are in English.
Those ‘powers that be’ also try to ensure that we prescribe drugs that are efficacious, that have been tested, and the evidence points to this. It is not anecdotal evidence, but true scientific evidence shown by research in many countries, with hundreds of thousands of patients. It is following that type of evidence, that I can recommend with all good faith, that 100 mg of aspirin a day is “good” medicine. I also know that if you are prescribed a ‘statin’ drug it will lower your cholesterol levels. They have been tested.
I am also the first to admit that we have sometimes managed to get it wrong. The Thalidomide story still has living examples of this. However, the medical world-wide network is cohesive enough to ensure that this drug was withdrawn. It is the checks and balances system that has kept conventional medicine afloat.
I am often asked my opinion on “alternative” medicine, and I try to avoid direct confrontation over this. If devotees have found that they can diagnose tumors by looking at patient’s auras through their third eye in the middle of their foreheads, then I am genuinely pleased, in fact delighted, provided that they have subjected the method to scientific scrutiny.
If various groups can actually cure cancer, epilepsy, halitosis or lock-jaw by inserting dandelions into a fundamental orifice, then again I am delighted. This is a medical break-through, but as such, must be subjected to medical scrutiny. If the method stands true scientific examination (not to be confused with anecdotal ‘evidence’) then it will be adopted by everyone, complete with thanks to those clever people who picked the dandelions in the first place. Ignore the claims that “Big Pharma” is suppressing cancer treatments. If someone has the answer, they will be multi-millionaires overnight.
As far as the majority of ‘folk’ remedies is concerned, I work on the principle that if you ‘think’ it is doing you good, then it probably is. But don’t ask me to endorse something that has not been scientifically tested.
When the ‘alternative’ group spends more time proving their methods, instead of complaining about non-acceptance, EBM practitioners will give them more credence.


HEADLINES [click on headline to view story]

WHO sounds a warning

Does EBM mean increased ‘benefits’ for you?
 

Advertisement

 



Chiangmai Mail Publishing Co. Ltd.
189/22 Moo 5, T. Sansai Noi, A. Sansai, Chiang Mai 50210
THAILAND
Tel. 053 852 557, Fax. 053 014 195
Editor: 087 184 8508
E-mail: [email protected]
www.chiangmai-mail.com
Administration: [email protected]
Website & Newsletter Advertising: [email protected]

Copyright © 2004 Chiangmai Mail. All rights reserved.
This material may not be published, broadcast, rewritten, or redistributed.