Rising burden of Diabetes-Public Health Challenges & way out

Secondary prevention by community physician can be provided at PHC & CHC level. Focus should always be on early detection of diseases through screening programmes and prevention of mortality. Prevention of chronic morbidity and functional impairment should be emphasized more. At policy level advocacy should be done for providing essential medication like insulin available and affordable to all who need them. At tertiary level rehabilitation, disability limitation and palliative care of person with NCDs is also needed.

International Variations In Essential Medication Lists

Every nation in the world has established a National Medication Formulary to account for all the medications present in the country. Many countries follow the Essential Medication List provided by the World Health organization (WHO) when making their own National Medication Formulary. Our study looked at variations in the National Formularies when compared to the Essential Medication Lists. Different relationships such as missing and extra medications lists were formulated and the statistics analyzed. It was noted that on average most of the countries studied were lacking 47% of medications, and had 30% additional medications on their national formulary. Further studies need to be conducted as Essential Medications may be lacking, or harmful medications may be present in a country's formulary leading to severe health problems. Type: Commentary

Psychotropic medication in pregnancy

The risks and benefits of psychopharmacological treatment in pregnancy need careful consideration. Conventional antipsychotics and tricyclic antidepressants are relatively safe for the foetus. Selective serotonin reuptake inhibitors appear to be safe, but mood stabilisers such as lithium, sodium valproate and carbamazepine are associated with increased foetal malformations. Benzodiazepines in the first trimester are teratogenic, and in high dosage can also cause withdrawal symptoms, hypotonia and agitation in the newborn. Women taking atypical antipsychotics should be switched to conventional antipsychotics before they conceive. In women with long-term mental illness necessitating psychotropic medication, effort should be made to stop polypharmacy and non-essential medication (e.g. benzodiazepines) and to decrease the dose of essential drugs, after full assessment. There is rarely a valid reason to stop essential drug treatment during pregnancy.