Loneliness in older adults: A new epidemic of society

Loneliness is the new epidemic of society today. Loneliness is particularly common in older adults, whose children have grown up and left the nest and are busy with their lives.

The amygdala in the brain plays a key role in regulating emotions and emotional responses.  The dorsal posterior insula regulates perception of pain; it becomes more active when we are lonely, so anything that happens to socially isolated people is more painful.

Cortisol is the fight or flight hormone. Oxytocin along with serotonin and dopamine constitute the happy hormones. Increase in dopamine, serotonin and oxytocin increase the positive emotions in the body.

Brain derived neurotrophic factor is another chemical, which helps the brain to remain plastic, or flexible, so that we can continue to hold on to past memories and create new ones. This chemical is present in low amounts in socially isolated people.

Loneliness is harmful socially; it is also bad for health, a fact which has been corroborated in studies. Loneliness is a strong predictor of heart disease, stroke or premature death.

A new article published April 29, 2019 in the Canadian Medical Association Journal has addressed the effect of loneliness on older patients. As per the article, loneliness is:

·         an emotional state of perceived isolation; it is not a mental disorder

·         common in older adults and linked to declines in health

·         as harmful as other risk factors for death, such as obesity and smoking

·         a significant predictor of health care usage

·         possibly alleviated by "social prescribing" to connect lonely adults with community supports and social networks

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

Hon’ble Delhi High Court sets aside the central Govt’s ban on making & selling of oxytocin by private firms

  

Dr KK Aggarwal & Advocate Ira Gupta

On Friday, 14^th December, the Hon’ble Delhi High Court set aside the Govt.’s decision to ban private firms from producing and selling oxytocin, a drug used for inducing labour contractions & controlling bleeding.

A bench of Hon’ble Justice S Ravindra Bhat and Hon’ble Justice AK Chawla said that the government’s decision was arbitrary and unreasonable.

The bench also said that there was no scientific basis behind the Center’s decision restricting private companies from making or supplying the drug,which helps new mothers lactate, to prevent its alleged misuse in the dairy sector for increasing milk production.

As per a notification dated 27th April, the Ministry of Health and Family Welfare had restricted the manufacture of oxytocin formulations for domestic use to public sector only. It had also banned the import of oxytocin and its formulations. Karnataka Antibiotics & Pharmaceuticals Ltd (KAPL), a public sector company, was solely allowed by the Center to manufacture this drug for domestic use.

The reason for the ban was the misuse of oxytocin in dairy animals to increase milk production.

On 31^st August, the High Court had suspended till 30^th September the Central Government’s prohibition on sale and manufacture of oxytocin by private companies for domestic use. The stay was later extended till 15^th December.

Post-partum hemorrhage, or PPH, is a major cause of maternal death in India accounting for about 38% of all maternal deaths due to hemorrhage. It is also one of the most preventable causes of maternal mortality.

Oxytocin is a time-tested drug that has been used to prevent maternal deaths due to PPH. WHO has also recommended IV oxytocin as the first line uterotonic drug for the treatment of PPH and has included it in the 20th Edition of its Model List of Essential Medicines, amended in August 2017.

In India, oxytocin is also included in the National List of Essential Medicines (NLEM) 2015 under section 26.1 (Oxytocics)

Hence, any difficulty or hurdles in procuring oxytocin would have only increased maternal mortality due to PPH.

Oxytocin is often a life-saving drug; hence, it should be available and accessible in all settings, including remote areas for use by doctors as well as nurses.

(Source: Latestlaws.com)

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA