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Update October 2017

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Update by Natrakorn Paewsoongnern

Doctor's Consultation  by Dr. Iain Corness


Update Saturday, Oct. 21 - Oct. 27, 2017

In case you think you’re old?

Death and taxes are touted as the only sureties in this life, but there are some people around who are not quite ready for the pipe, slippers and Labrador, and the record for longevity is held by a French lady, who saw more than the Moulin Rouge in her lifetime.

She was Jeanne Louise Calment who had the longest confirmed human Lifespan on record: 122 years and 164 days. That is some lifetime!

It seems that fate strongly approved of the way Madame Calment lived her life. Jeanne was born in Arles, France, on 21st February 1875.

When the Eiffel Tower was built, she was 14 year old. It was at this time that she met Vincent van Gogh. Her description of the famous painter was, “He was dirty, badly dressed and disagreeable,” she recalled in an interview given in 1988.

When she was 85, she took up fencing, and she was still riding on her bike when she reached 100.

When Jeanne was 114, she starred in a film about her life; at 115 she had an operation on her hip, and at 117 she gave up smoking (having started at the age of 21 in 1896). So much for fears of lung cancer in her life, after smoking for 96 years. It is said, she didn’t give it up for health reasons, but because she didn’t like having to ask someone to help her light a cigarette once she was becoming almost blind.

In 1965, Jeanne was 90 years old and had no heirs. However, she had a very sharp business mind. She signed a deal to sell her apartment to a 47 year old lawyer called André-François Raffray. He agreed to pay her a monthly sum of 2,500 francs on the condition that he would inherit her apartment after she died. However, Raffray not only ended up paying Jeanne for 30 years, but died before she did at the age of 77.

Under French law, his widow was legally obliged to continue paying Madam Calment until the end of her days.

When she was asked on her 120th birthday what kind of future she expected to have, she replied, “A very short one.”

She gave us some rules of life, from her 122 years of experience:

Being young is a state of mind, it doesn’t depend on one’s body, I’m actually still a young girl; it’s just that I haven’t looked so good for the past 70 years.

I’ve only got one wrinkle, and I’m sitting on it.

All babies are beautiful.

I’ve been forgotten by our good lord. (My dear old Mum, who died aged 94 used to say the same thing, adding I’ve gone past my use-by date.)

I’m in love with wine.

Always keep your smile. That’s how I explain my long life. (Thai people who use the famous Thai smile might just be onto something there.)

If you can’t change something, don’t worry about it.

I have a huge desire to live and a big appetite, especially for sweets.

I never wear mascara; I laugh until I cry too often.

I see badly, I hear badly, and I feel bad, but everything’s fine. (Now there’s a positive attitude!)

I think I will die of laughter.

I have legs of iron, but to tell you the truth, they’re starting to rust and buckle a bit.

I took pleasure when I could. I acted clearly and morally and without regret. I’m very lucky.

(At the end of one interview, in response to a journalist who said he hoped they would meet again the following year, she replied “Why not? You’re not that old; you’ll still be here.)

Now, do remember that this was one French lady, not a group of French ladies, so you can’t use her personal history to justify smoking, for example.

Update Saturday October 14 - October 20, 2017

Give the Labrador away to a good home

A Great Aunt of mine is remembered for her distrust of technology. With this new fangled “electricity” being piped into the homes in the UK, in her house, she would put plasters over the power points as she was sure the electricity would leak out of the holes and discolor the wall paper. I wonder what she would have done about SuperSight?

SuperSight Surgery is a revolutionary procedure that has changed the lives of many in Pattaya. In fact, two of my doctor friends here have had this done, and both are very happy with the end result.

So, are you over 50 and using spectacles to read this article? Do you hate your reading glasses? If so, help is at hand!

SuperSight Surgery is in the forefront of ophthalmic procedures. The world leader is Dr. Somchai Trakoolshokesatian and he consults out of the Bangkok Hospital Pattaya. He has been carrying out this procedure for ten years on over 3000 patients and has perfected the technique to ensure good results for each individual patient, with success and satisfaction rates of almost 100 percent.

Unfortunately, the need for reading glasses is a natural progression of aging. The first signs are the fact that you have to hold this newspaper further away to be able to read it, and you also find that you need a good light to be able to see the words clearly. Eventually you succumb and buy reading glasses, to which you become a slave. Eventually you keep one pair at home, another in the car and another in the office. And your nose gets funny indentations either side of the bridge, where the spectacles settle.

As you get older, all the ‘elastic’ tissues in your body become less pliable. Knees, lower back, fingers, neck, the list is endless. However, you have to add to that list, the lens in your eye. The fiddly little lens, supplied at birth as a standard feature, does not have a fixed focus, but under your control you can make it focus close up (to read) and then also focus at a distance. The way you do this is by ‘bending’ the lens to be able to focus on near objects. Unfortunately, as the lens becomes less pliable, the muscles in your eye become unable to bend the stiffening lens enough to produce the near point focus. The near point moves further away, until you have run out of arms, as described previously. We call this condition ‘Presbyopia’.

Unfortunately there is yet another result of aging that occurs in the lens of the eye. This is a gradual cloudiness which lowers the visual acuity, and eventually brings on blindness. This is called a cataract. So not only can you not see well enough to read the magazines, but you also begin to lose your distance vision. Welcome to the wonderful world of white sticks and Labrador dogs. Even the World Health Organization says there are currently between 12 and 15 million people blind from cataracts.

The initial method of treating this was by removal of the now optically inefficient natural lens, and attempting to return some usable vision through the introduction of very thick and heavy spectacles placed before the eye. These glasses looked as if the lenses were made from the bottom of Coca-Cola bottles (registered trade mark and all), and were just as heavy. The patient could see again, but reading required even thicker lenses, or hand-held magnifying glasses. Not all that comfortable, but beats the alternative.

So we come to the development in intra-ocular lenses (IOLs), where the hardened lenses are replaced by other, very special lenses. These are multi-focal lenses, with the brain picking the necessary focus as required. This is SuperSight Surgery and with these lenses you can read your golf scorecard with your near vision, focus on the ball on the tee with your intermediate vision and then using your distance vision watch it gently arcing into the water hazard. (These new IOLs can improve your sight, but not your golf.)

If you want to know more, consult Dr Somchai at Bangkok Hospital Pattaya and reduce your dependence on contact lenses or glasses. You will be amazed.

Update Saturday October 7 - October 13, 2017

The world is running out of antibiotics

The World Health Organization (WHO) released a damning report last month. Their report covered antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline, including tuberculosis, was launched by WHO showing a serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance.

To be frank, I have not always agreed with the WHO, over-reacting with Bird Flu, for example, but this latest report does foretell future clinical problems.

Most of the drugs currently in the clinical pipeline are modifications of existing classes of antibiotics and are only short-term solutions. The report found very few potential treatment options for those antibiotic-resistant infections identified by WHO as posing the greatest threat to health, including drug-resistant tuberculosis which kills around 250 000 people each year.

“Antimicrobial resistance is a global health emergency that will seriously jeopardize progress in modern medicine,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “There is an urgent need for more investment in research and development for antibiotic-resistant infections including TB, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery.”

In addition to multidrug-resistant tuberculosis, WHO has identified 12 classes of priority pathogens – some of them causing common infections such as pneumonia or urinary tract infections – that are increasingly resistant to existing antibiotics and urgently in need of new treatments.

The report identifies 51 new antibiotics and biologicals in clinical development to treat priority antibiotic-resistant pathogens, as well as tuberculosis and the sometimes deadly diarrhoeal infection Clostridium difficile.

Among all these candidate medicines, however, only 8 are classed by WHO as innovative treatments that will add value to the current antibiotic treatment arsenal.

There is a serious lack of treatment options for multidrug- and extensively drug-resistant M. tuberculosis and gram-negative pathogens, including Acinetobacter and Enterobacteriaceae (such as Klebsiella and E.coli) which can cause severe and often deadly infections that pose a particular threat in hospitals and nursing homes.

There are also very few oral antibiotics in the pipeline, yet these are essential formulations for treating infections outside hospitals or in resource-limited settings.

“Pharmaceutical companies and researchers must urgently focus on new antibiotics against certain types of extremely serious infections that can kill patients in a matter of days because we have no line of defense,” says Dr Suzanne Hill, Director of the Department of Essential Medicines at WHO.

To counter this threat, WHO and the Drugs for Neglected Diseases Initiative (DNDi) set up the Global Antibiotic Research and Development Partnership (known as GARDP). On 4 September 2017, Germany, Luxembourg, the Netherlands, South Africa, Switzerland and the United Kingdom of Great Britain and Northern Ireland and the Wellcome Trust pledged more than €56 million for this work. (But that is only 10 million euro each.)

“Research for tuberculosis is seriously underfunded, with only two new antibiotics for treatment of drug-resistant tuberculosis having reached the market in over 70 years,” says Dr Mario Raviglione, Director of the WHO Global Tuberculosis Programme. “If we are to end tuberculosis, more than US$ 800 million per year is urgently needed to fund research for new antituberculosis medicines.”

New treatments alone, however, will not be sufficient to combat the threat of antimicrobial resistance. WHO works with countries and partners to improve infection prevention and control and to foster appropriate use of existing and future antibiotics. WHO is also developing guidance for the responsible use of antibiotics in the human, animal and agricultural sectors.

So how did the antibiotic group begin to lose its power over simple infections? What you have to understand is that antibiotics are not ‘new’. Penicillin was discovered in 1928, the first true antibiotic, by Sir Alexander Fleming, Professor of Bacteriology at St. Mary’s Hospital in London. But at that time its future relevance was not known. The first Sulfa drugs (M&B 693) was one of the early generation of sulphonamide antibiotics developed in 1938.

Once it was seen that these compounds killed bugs they became overused, and the bugs began to develop an immunity. Public demand increased so even more antibiotics were used, including now over the counter in many countries. WHO is just showing the problem, but not the answer, I’m afraid.

HEADLINES [click on headline to view story]

In case you think you’re old?

Give the Labrador away to a good home

The world is running out of antibiotics



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