Antagonism between Enalapril and Aspirin
Use of aspirin is now recommended in the follow up cases of acute myocardial infarction (AMI). It improves both long-term and short term prognosis in these cases. ACE-inhibitors are also used after AMI to reduce mortality. Attention has recently been focused on a possible interaction between aspirin and ACE-inhibitors.
A retrospective sub-group analysis was conducted in the Co-operative New Scandinavian Enalapril Survival Study II (CONSESUS II). The effect of the ACE-inhibitor Enalapril in patients using Aspirin at randomization was compared to the effect of the same drug in those not using Aspirin at baseline.
It was observed that Aspirin use at baseline was associated with lower mortality rates of all non-fatal major events. But there was a significant negative interaction between Aspirin and Enalapril in both multiplicative and additive models of analysis. Aspirin antagonized the effect of Enalapril on mortality at the end of the study.
The mechanism of Aspirin-Enalapril interaction is unknown, but prostaglandin synthesis may be involved. In CONSESUS II study, the authors conclude that there seems to be an antagonism between Aspirin and Enalapril in patients with AMI regarding mortality.
Aspirin and Enalapril each given along benefit post infarction patients. However, the negative interaction found in this study suggest that adding Enalapril to patients on Aspirin may be counter-productive to survival and may explain why overall use of Enalapril in post-AMI patients did not concur with other post-AMI trials on ACE-inhibitors.
This observation has important implication in the management of cases of AMI. Of course more research is needed to confirm the drug interaction found in this study, and also to discover whether Aspirin may be replaced by oral anti-coagulant therapy.
Drug Disease Doctor, Vol.11, No.1, 1998.

Indian Women IAS Officer becomes WHO Assistant Director-General
Ms. Poonam Khetrapal Singh, a woman IAS officer from Punjab, is the first Indian to be appointed Assistant Director-General of the prestigious World Health Organization (WHO).
The newly-appointed Director General of WHO and former Norwegian Prime Minister, Dr. Gro Harlem Brundtland has personally selected her for this top job. Ms. Khetrapal was sworn in as Executive Director in Dr. Brundtland’s nine-member cabinet in July. Ms. Khetrapal Singh will be in-charge of Sustainable Development and Healthy Environments. She will look after two WHO divisions: Divisions of Intensified Cooperation with countries and peoples in greatest need and Division of Operational Support in Environmental Health.

The Hindustan Times, New Delhi, 23 July, 1998.

Drug Abuse taking toll on Women
Thousands of women are being sucked into fatal drug addiction with what generally starts as an innocuous intake of sedatives and tranquilizers. A study conducted by Ministry of Welfare and Empowerment shows that drug abuse among women in India has raised considerably over the years.
"There were three million drug addicts in the country lastyear out of which 15,000 were female drug abusers". Women may indulge in substance abuse due to stress, permissive social atmosphere or even increased availability of drugs.
One group takes it to try and get hooked, to experiment. Yet another for peer acceptance. Some merely to make a quick buck or earn extra for that new dress or jazzy bloc heels, says Dr. Aruna Broota, clinical psychologist.
And it is the group of married women in their thirties, who take most to drug abuse. These women feel suffocated in maintaining a feminine identity in a patriarchal set-up. They are often victims of sexual abuse by their in-laws and take to drug to cope with their trauma, says Dr. Broota. Whatever be the causes, the trend is on rise all over the world but more alarming is the fact that there are hardly any rehabilitation facilities available for women drug abusers. There is hardly any social support system to wean them out of this habit. Women abuse drugs more in the form of prescription than hard drugs as these are often the easiest and the most innocent methods of procurement by women.
The increased use of injection drugs has also exposed them to the risk of acquiring HIV infection. A UNDCP survey found that 61 per cent of women AIDS cases in North America were due to injection drug use. Out of 2.22 lakh drug cases registered for detoxification in 400 government drug rehabilitation centres across the country, women account for only 1-2%, as per the study done by the Welfare Ministry.

Rajasthan Patrika, Jaipur, 12 August 1998.

Development Policies threatening Children
Traditional child support systems in India have collapsed due to the impact of development policies. These policies are resulting in intensified migration and breakdown of the family and proliferation of the single parent, women-headed households.
Families’ access to livelihood has been eroded by the liberalization process and the issue of child rights cannot be tackled without first addressing the rights of families, says a new report on the rights of children in India.
Of the 150 million women living on the margins of or below the poverty line, as many as 90 per cent are found in the informal sector. Sixty million children under six years of age belong to the group where mothers have to work for their survival.
Most of these women belong to families of recent rural migrants and reside in slums without kinship-links to take care of their children while they are at work. They have to devise ad hoc strategies for child care, says the just released report prepared by the Delhi based NGO - Butterflies.
It observes that only 18.5 million children are covered under government schemes and 360,000 benefit from government and statutory creche services. Currently only 14,313 creches are run by the government.

Asian Age, Delhi 14 August 1998.

New Blood Policy draft released
The draft National Blood Policy prepared by the Department of Health, recommends the revision of the Drugs and Cosmetics Rules to provide for safe blood and blood products.
The rules will encompass the checking of infrastructure facilities, including donor selection and proper testing and total quality management of blood banks. The new policy would be finalized by the year-end. The draft policy papers have been sent to state governments for their suggestions, to be submitted within two months.
The draft has been prepared following a recent Supreme Court judgment calling for revamping of blood transfusion services in the country. The judgment led to mandatory licensing of blood banks, stopping of the professional donor system, besides addressing revision of the Drugs and Cosmetics Rules.
According to the proposed policy the National and State Blood Transfusion Councils, set up as a result of the Supreme Court judgment, will oversee and co-ordinate the functioning of blood transfusion services and the National AIDS Control Organization will function as facilitator in the blood safety programme.

Statesman, Calcutta, 12 August 1998.

Global decline in Male Fertility
Scientists are bewildered over observations pointing to a declining trend in male fertility worldwide. Studies show that sperm counts are plummeting; the quality of sperm is going down, and there’s a higher incidence of testicular cancer and undescended testicles.
Recent researches showed that men born after 1970 had a sperm count 25% lower than those born before 1959, or an average decline of 2.1% a year. And in what is considered the most comprehensive analysis of the trend so far, a study of 15,000 men from 21 countries undertaken by Danish Scientists noted that there was an "alarming plunge" of nearly 50% in average sperm counts over the past half-century.
It’s not only the declining sperm counts that’s worrying scientists. There are also signs that the quality of sperm (percentage of healthy, vigorous cells vs. malformed, sluggish ones) are also on the decline.
The precise cause of this decline in male fertility is still unknown. Possible explanations that have been offered for this problem include stress, smoking, drug use, having children later in life, the increased incidence of sexually-transmitted diseases, as well as the shift in male underwear fashion from boxer shorts to briefs. A new book, however, points to the possible link that chemical pollutants in the environment may have to the wide range of reproduction-related ills observed worldwide. But the relationship of chemicals to declining fertility trends has not been established.

Health Alert, 16-31 July 1996

Government bans use of Quinacrine
The Union Government has issued a notification banning the use of controversial drug quinacrine for female sterilization/ contraception. The notification bans/prohibits the import, manufacture, sale and distribution of quinacrine in pellet form for its use as a contraceptive. Anyone violating the provision of the Act will be punishable with imprisonment for a term, which may extend to three years or a fine up to Rs.5,000 or both.

The Hindustan Times, New Delhi, 18 August 1998.

Household Insecticides causes childhood Brain Cancers
According to a study published in the Journal of Environmental Health Perspective, children exposed pre-natally to household insecticides may face increased risk of brain cancer later on. This was the finding of a study on 224 children diagnosed with brain tumours between 1984 and 1991 in the Los Angeles County, California.

Utusan Konsumer, June 1998.

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