Kanika Kapoor IANS IANS

QATAR TRIBUNE Publication Wednesday “It’s up to the mother to determine what she thinks 11.05.2016 her children can handle seeing or not...” Hollywood Medicine mess .LYPH[YPJPHUZHUKYLZLHYJOLYZOH]L^HYULKMVY`LHYZHIV\[ [OLWV[LU[PHSOHaHYKZVMWVS`WOHYTHJ`\Z\HSS`KLÄULKHZ [HRPUNÄ]LVYTVYLKY\NZJVUJ\YYLU[S`@L[P[JVU[PU\LZ[VYPZL PUHSSHNLNYV\WZYLHJOPUNKPZ[\YIPUNSÒPNOSL]LSZHTVUN VSKLYHK\S[Z COVER PGSTORY 2&3 02 Wednesday, May 11, 2016 COVER STORY (UHY[PJSLW\ISPZOLK PU1(4(0U[LYUHS 4LKPJPUL\ZPUNH SVUNP[\KPUHSUH[PVUHS Z\Y]L`VMWLVWSL [VTHÒH]LYL ]LHSLK[OLM\SSLYWPJ [\YL4VYL[OHUH[OPYK ^LYL[HRPUNH[SLHZ[ Ä]LWYLZJYPW[PVUTLKP JH[PVUZHUKHSTVZ[ [^V[OPYKZ^LYL\ZPUN KPL[HY`Z\WWSLTLU[Z PUJS\KPUNOLYIZHUK ]P[HTPUZ5LHYS` WLYJLU[[VVRV]LY [OLJV\U[LYKY\NZ A recent study in JAMA Internal Medicine, however, found that more than 42 percent of adults didn’t tell their primary care doctors about their most commonly used complementary and alternative medicines. Ever-mounting pile of pills NYT SYNDICATE renew prescriptions. “Pretty soon, you have an 82-year- “A cardiologist puts someone on old man who’s on 14 medications,” R Caleb Alexander good, evidence-based medications for Alexander said, barely exaggerating. knows how easily his heart,” said Alexander, co-director of Geriatricians and researchers have older people can the US Johns Hopkins Center for Drug warned for years about the potential fall into polyphar- Safety and Effectiveness. “An endo- hazards of polypharmacy, usually de- macy. Perhaps a crinologist does the same for his bones.” fined as taking five or more drugs con- Dpatient, like most seniors, And let’s say the patient, like many currently. Yet it continues to rise in all sees several specialists older adults, also uses an over-the- age groups, reaching disturbingly high who write or counter reflux drug and takes a daily levels among older adults. aspirin or a zinc supplement and fish oil “It’s as perennial as the grass,” Alex- capsules. ander said. “The average senior is taking more medicines than ever before.” But older people don’t take just prescription drugs. An article published in JAMA Internal Medicine, using a longi- tudinal national survey of people 62 to 85, may have revealed the fuller picture. More than a third were taking at least five prescription medications, and almost two-thirds were using dietary supplements, including herbs and vitamins. Nearly 40 percent took over-the-counter drugs. Not all are imperilled by polypharmacy, of course. But some of those 03 COVER STORY Wednesday, May 11, 2016 products, even those that sound natural and are available at health food stores, interact with others and can cause dangerous side effects. “We’re not paying attention to the interactions and safety of multiple medications,” said Dima Qato, lead author of the JAMA Internal Medicine article (Alexander was a co-author) and a pharmacist and epidemiologist at the University of Illinois at Chicago. “This is a major public health problem.” She was stunned to discover, for instance, that the use of omega-3 fish oil supplements had quadrupled over five years. Her research suggests that almost 1 in 5 older adults now takes them. Users probably believe fish oil helps their hearts. But Qato pointed out fish oil capsules lacked regulation and evidence of effectiveness, and can cause bleeding in patients taking blood thinners like warfarin (brand name: Couma- din). Though drug interactions can occur in any age group, older people are more vulnerable, said Dr Michael A Stein- man, a geriatrician at the University of California, San Francisco, who wrote an Not all are imperilled by polypharmacy, of course. But some of those products, even those that sound natural and are available at health food stores, interact accompanying commentary. with others and can cause dangerous side effects. Most have multiple chronic diseases, so they take more drugs, putting them at So he explains the risks and benefits, higher risk for threatening interactions. and negotiations ensue. The consequences can also be more Often, though, patients don’t know threatening. Say a drug makes older that a daily aspirin, Prilosec OTC or patients dizzy. fish oil can interact with other drugs. “They’re more prone to fall, because Or they’re confused about what they’re they don’t have the same reserves of actually taking. balance and strength” as the young or Steinman recalled asking a patient to middle-aged, Steinman said. “And if bring in every pill he took for a review. they do fall because they’re dizzy, they’re He learned that the man had accumulat- more likely to get hurt.” ed four or five bottles of the same drug Some common combinations that without realising it, and was ingesting cropped up in the study and could spell several times the recommended dose. trouble: aspirin and the anti-clotting Ultimately, the best way to reduce drug clopidogrel (Plavix), both blood polypharmacy is to overhaul our frag- thinners that together increase the risk mented approach to health care. “The of bleeding with long-term use; aspirin system is not geared to look at a person and naproxen (Aleve), over-the-counter as a whole, to see how the patterns fit drugs that when combined can cause together,” Steinman said. bleeding, ulceration or perforation of the In the meantime, though, patients stomach lining. and families can ask their physicians Qato recalled reviewing the medica- for reviews, including every supple- tions of a 67-year-old man taking both ment, and discuss whether to continue the cholesterol drug simvastatin (Zocor) or change their regimens. Pharmacists, and the blood pressure medication am- often under used as information sources, lodipine (Norvasc) — the most common can help coordinate medications. combination of interacting drugs that “We spend an awful lot of money emerged in her study. and effort trying to figure out when to Statins, along with their cholesterol- why didn’t he ask me?’” thought they would. start medications,” Alexander said, “and lowering properties, can cause muscle A reasonable question. A recent And they might, especially for older shockingly little on when to stop.” pain and weakness; Norvasc heightens study in JAMA Internal Medicine, how- patients with complex regimens. “I’m that risk. A different blood pressure drug ever, found that more than 42 percent not a big fan of supplements,” Alexander — there are many alternatives — would of adults didn’t tell their primary care tells patients taking lots of vitamins, be a safer choice, Qato said. doctors about their most commonly used supplements and herbal remedies. Moreover, though her patient wasn’t complementary and alternative medi- “I think the vast majority of evidence experiencing problems, he was also cines, including a quarter of those who raises serious questions about their taking garlic and omega-3 supplements, relied most on herbs and supplements. effectiveness or, in some cases, their which can interact with prescription Usually, that was because the physi- safety. They’re less well regulated than medications. cians didn’t ask and the patients didn’t prescription medications. I think you’d “Did you tell your doctor you were on think they needed to know; in a few be better off stopping them.” them?’” Qato recalled asking. “He said, cases, doctors had previously discour- Patients often resist, he said, and ‘No, why should I? If it was important, aged alternative therapies, or patients “they’re the captain of their own ship.” 04 Wednesday, May 11, 2016 BPS student leaders sworn in TRIBUNE NEWS NETWORK IRLA Public School swore in 249 students to the Student Council Band 50 students to the Prefect Board for the academic year 2016-2017 in the presence of the board of directors, parents, guests and the school assembly. Principal AK Shrivastava, reading out the oath of office to the student leaders, urged them to enforce discipline in the school while upholding truth and honour. The Prefect Board is the voice of the Principal and they set for the school standards of exemplary behaviour and conduct besides raising the bar of academic performance for the school to follow. Sherborne Qatar Headmaster and chief guest Michael Weston addressed the students with a quote from Shakespeare: “’We know what we are, but know not what we may be.’” He reminded students that it is important that they realise that they should never stop trying to improve. This is particularly true when faced with disappointment or with setbacks. “There are numerous examples of great men and women who have simply refused to give in and have grown in strength and in stature, overcoming hurdles that might otherwise have become barriers. “William Shakespeare tells us that what we are now is not what we will always be. Remember this and as the academic year progresses, keep this in your minds: never give up, never stop learning, and never give in to disappointment or to setbacks.” In his address, School founder and Di- rector Dr Mohan Thomas said, “A pencil, as it is used up, is sharpened from time to time and its sharpness remains the same all through its use. One who uses it can make mistakes, but such mistakes are cor- rected as they are made and work goes on without let or hindrance. It is this lesson that I would like to remind all of you on this solemn occasion.” Indian National Teacher Award-winner honoured TRIBUNE NEWS NETWORK teaching method through music and says music helps students learn lessons faster IYAS Chola, an Indian school and better. teacher, who is the National Teach- Former KMCC Secretary EK Mayin Ner Award-winner, was honoured in Master presented Niyas Chola with a Doha recently by Kerala Muslim Cultural memento in a function held at the KMCC Centre (KMCC), one of the largest Indian office.

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