Is the global medicine supply at risk? The hidden cost of political tension

Fitness to practice: why world leaders lack the oversight of doctors

Many professions issue fitness to practice licences of one sort or another, and I’m sure you draw comfort from the fact that your dentist, doctor, even your bank manager are all subject to some kind of external verification from time to time, and will hold some form of fitness to practice license of some sort. Shame this doesn’t seem to apply to leaders of the free world.

The geopolitical fallout: why the Iran situation matters

Speaking personally, I’m furious with the action taken by the United States, or rather their deranged President, regarding the supposed immediate threat to the rest of world posed by Iran. There is no doubt that the past and current regime in Iran treat their own citizens with contempt, and any civilised nation will feel disgust and wish for a fairer, and more humane, society. But the actions taken by the United States, and its supporters, are having real-world impacts for everyone and unlikely to improve the situation for ordinary Iranians.

Trade disruptions: how the straits of Hormuz affect your healthcare

The closure of the straits of Hormoz to commercial shipping and the various restrictions on airspace and overflying are more than an inconvenience; they could seriously impact the lives of vulnerable people all over the world, thanks to the fact that pharmaceuticals are very much a part of globalisation that has evolved over the past thirty years or so.

It might come as a surprise to know that hardly any country is self-sufficient these days when it comes to medicines. Pretty much everywhere imports a substantial proportion of the medicines they require. The disruption to international trade is pushing up costs, and at the same time countries that are being directly impacted are in need of extra stocks, add to that those countries that manufacture certain medicines have decided to suspend exports keeping products for their own, and this may come as a further surprise but many medicines start life with a petroleum product in there somewhere.

Shortage alerts: what patients in the uk and spain need to know

The British Medical Journal has reported that there is already a shortage of certain medicines in the UK. Spain, as things stand at the moment has not formally issued any alerts, but of course that may change. If you are reliant on any long-term medication to help control things like high blood pressure, cardiac conditions, diabetes, or types of anxiety then it maybe an idea to have a chat with your pharmacist the next time you fill a prescription just to find out how things stand. This isn’t something to worry about right now, and if things do deteriorate the Spanish Government have central stocks and also plans in case shortages become severe. As a member of the EU there are also EU-wide contingency plans that are now being activated.

The obvious solution would be for every nation state to be self sufficient and manufacture their own medicines, but this just isn’t practical – nor should it be necessary.

A question of mental fitness: the case for revoking a president’s ‘license’

I referred to the President of the United States as deranged, I think it is important to stick to international conventions and protocol; and so, I should say whilst I have the utmost respect for the Office of the President of the United States, I believe the current holder of that office to be deranged. This is a view that is widely shared within medical circles, although the term most often used is ‘Malignant Narcissism and Paranoia’ which actually includes a broad mix of various personality disorders. This isn’t a case of someone who gets occasionally confused or forgetful, it is someone who compares themselves to messiah-like figures, in unable to experience empathy, and also appears to enjoy sadistic behaviour. In my view, his fitness to practice license should be revoked immediately as he currently poses a serious threat to public safety.

Mr Trump is not only threatening world-wide disruption to pharmaceutical manufacturing and distribution, but he has destroyed medical facilities and killed, and injured, medical personnel. This is a clear violation of the First Geneva Convention. Deliberate violations of any of the Geneva Conventions, there are four of them with two additional protocols, is a war crime.

Normal, balanced, reasonably educated people would not threaten to annihilate an entire population and return it to the Stone Age, nor would they share such a desire on some global media platform, unless they suffered from some major personality disorder. Geneva Convention number four, along with Additional Protocol 1, forbids any deliberate attacks against the civilian population and any civilian infrastructure considered to be essential. This would constitute a war crime.

And now for something completely different: managing hay fever safely

I don’t often stray into politics (or religion for that matter) but things have recently seemed to be getting out of control, so I apologise. Back to more familiar territory and I think steroid nasal decongestants would be as good a place as any.

With the hay fever and general pollen season about to unleash misery upon many people I wanted to share something about popular nasal decongestants that are steroid based, as most are. These sprays are very effective at reducing congestion and people who suffer from pollen allergies find them particularly useful. As with most medications there are some side effects but these tend to be fairly minor and disappear once treatment stops. Nasal steroids are generally considered very safe because the active ingredient (the steroid) is actually delivered to the place where it needs to act which is the lining of the nose. Steroid decongestants which are taken orally, on the other hand, probably don’t actually help that much because once the medication has been swallowed and passed trough the liver before it gets into the bloodstream and then reaches the nose there often isn’t enough left to have any meaningful effect. If you increase the oral dose you run the real risk of causing blood pressure to spike. For this reason, the spays are the best way of safely delivering steroids to the nose.

Understanding the rebound effect: what is rhinitis medicamentosa?

There is one important caveat. Because steroid spays are so good at doing their job, if you use them for a prolonged period of time and then stop you run the risk of something known as ‘rebound effect’. Essentially what happens is when the spay hits your nose the small delicate blood vessels all shrink and contract, this is what gives you the relief. If you continue with the spray for too long your nose gets used to these constricted blood vessels. Stop the spay and the blood vessels quickly relax and fill again with more blood which in itself causes congestion. This is known as Rhinitis Medicamentosa, which as the name implies is a direct result of using the medication. Current advice if you are one of the unlucky ones to suffer from pollen allergies, is to use the sprays sparingly and if you do have to use them for a prolonged period seek advice from your GP about the safest way of stopping use, which usually means a gradual withdrawal combined with saline sprays which allow time for the nasal tissue to recover.

Be prepared: essential items for a home first aid kit

Last week, I was enjoying a pleasant lunch with a group of friends – something I should make time for more often – when one person mentioned they were “stocking up on a few essentials” in case global events took a turn for the worse and local supermarkets began to run short of everyday necessities, and not just toilet paper. The conversation then shifted to what should be kept in a well-prepared home first aid kit.

Regardless of global circumstances, it is advisable for every household to maintain a comprehensive first aid kit. I would recommend including the following items:

• A sufficient supply of adhesive plasters and a range of sterile bandages
• Disposable gloves (they do not need to be sterile)
• Triangular bandages, which can be used as slings or for securing larger dressings
• A variety of sterile, non-adherent dressing pads
• A roll of cling film, useful for covering burns and helping to retain moisture
• Antiseptic lotion
• Antiseptic cream
• Adhesive wound closure strips
• Paracetamol tablets
• Loperamide tablets (for diarrhoea)
• Tweezers (both blunt and pointed) for removing debris
• Scissors, including a pair capable of cutting through clothing quickly
• A reliable torch

In addition, it is prudent to keep a reserve supply of bottled drinking water, as well as any medications that you or your family members regularly require.

For further guidance on general emergency preparedness, you may wish to consult reputable organisations such as the Red Cross or your local Civil Protection office.

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