The National Department of Health (NDoH) and the South African Health Products Regulatory Authority (SAHPRA) are currently in the process of reviewing all medication containing an ingredient linked to a Chinese manufacturer.

The United States Federal Drug Administration and the European Medicines Agency recently recalled medication containing valsartan, linked to the Chinese manufacturer Zhejiang Huahai Pharmaceuticals – and South African authorities have followed suit.

Swift recall of all affected products

This ingredient is believed to contain N-nitrosodimethylamine (NDMA), which is classified as a carcinogen. Carcinogens are substances which may cause cancer when exposed to living tissue.

Many pharmaceutical companies use valsartan as an active ingredient in medication meant to control blood pressure and prevent heart failure, but in South Africa only Pharma Dynamics is affected, and the company is working with SAHPRA to recall their variants, Dynaval Co.

In a statement, Erik Roos, Pharma Dynamics CEO, said that they have been actively working with SAHPRA to ensure a swift recall of all affected products and that they will issue a full refund for all returned Dynaval Co products.

“Pharma Dynamics is South Africa’s leading provider of cardiovascular medication, both in terms of value and volume, and we remain committed to providing the highest quality of care to patients. The organisation has a proud 17-year history of providing quality medicines without a single class one product recall,” said Roos.

Adcock Ingram also has medication containing the ingredient valsartan, but it isn’t currently available on the market.

There are not yet any indications whether any other medication would need to be recalled.

Not all valsartan-containing meds recalled

In a statement, the health department says that the active ingredient is sourced from Zheijiang Huahai Pharmaceuticals, and it is believed that the presence of NDMA is due to a change in the way the ingredient was manufactured.

Authorities add that recall letters have already been circulated to healthcare professionals, but they add that not all valsartan-containing medicines are being recalled.

Recalled in over 20 countries

Authorities add that patients who are currently taking the medication may be given a different valsartan-containing medicine or an alternative treatment altogether after consulting their doctor or pharmacist.

They add that patients who are in a clinical trial with valsartan should speak to the doctor treating them in the trial. SAHPRA will, in the meantime, continue to investigate and assess whether the impurity may pose any risk to patients and collect more data regarding the safety of valsartan-containing medication as it becomes available.

Medicine agencies in Europe and America were the first to sound the alarm on the impurity in the medication after conducting several tests. The medication containing valsartan, sourced from Zhejiang Huahai Pharmaceuticals, has since been recalled in over 20 countries.

South African healthcare professionals are urged to report any adverse reactions, particularly those associated with valsartan-containing medicines to SAHPRA’s Pharmacovigilance unit at (012) 395 9133 or the National Adverse Drug Event Monitoring Centre at (021) 447 1618.

Alternatively, healthcare professionals can complete the Adverse Drug Reactions Reporting Form and email it to adr@health.gov.za.

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Compiled by Stefni Herbert

Few body-weight moves are as impressive as this one, which has you briefly taking flight – just like the man of steel. You can do it: Follow our five-week plan to lift-off.

Read more: Build quads of the gods with these 6 moves to killer legs

Backup plan: Strong middle-back muscles will help you elevate your arms. Keep doing prone Supermans.

In a row: Use dumbbell rows to build the strength you’ll need to pull your arm backwards.

Butting edge: Your glutes help elevate your legs in flight. Train them with three sets of 10 glute bridges.

Before starting week one, do one set of 10 explosive push-ups, pushing your hands off the floor on each rep.

Week 1:

Do clap push-ups: At the top of the move, push off the floor and clap your hands together; descend.

Day 1: 5 sets of 6

Day 2: 5 sets of 6

Day 3: 5 sets of 8

Day 4: Prone Supermans. Lie on your belly, arms extended forward. Lift your legs and arms. That’s one rep; do five sets of 10.

Day 5: 5 sets of 10 claps

Day 6: 5 sets of 12

Day 7: Test – do 15 straight clap push-ups. Can’t? Re-do week 1.

Read more: Take this 3 minute push-up test to find out how fit you really are

Week 2:

Move on to shoulder-slap push-ups, slapping your shoulders with both hands at the top of the rep.

Day 8: 5 sets of 4

Day 9: 5 sets of 4

Day 10: 5 sets of 6

Day 11: Prone Supermans. Five sets of 10

Day 12: 5 sets of 6 shoulder-slap push-ups

Day 13: 5 sets of 8

Day 14: Test – complete 10 shoulder-slap push-ups, back-to-back. Not there yet? Week 3 again.

Read more: The only type of cardio that gets you jacked

Week 3:

Do hands-flying push-ups, extending your arms forward at the top of each rep before descending.

Day 15: 4 sets of 3

Day 16: 4 sets of 3

Day 17: 4 sets of 4

Day 18: Prone Supermans, this time holding for 2 seconds. Do 4 sets of 8.

Day 19: 4 sets of 6 hands-flying push-ups

Day 20: 4 sets of 6

Day 21: Test – perform 1 set of 8 hands-flying push-ups. Can’t? Try week 3 again.

Read more: These 3 cardio lessons will make you train harder and better

Week 4:

Do full-body explosive push-ups, “jumping” your whole body off the floor on each rep.

Day 22: 3 sets of 2

Day 23: 3 sets of 2

Day 24: 3 sets of 3

Day 25: Prone supermans, holding for 2 seconds, 4 sets of 8.

Day 26: 3 sets of 4 full-body explosive push-ups

Day 27: 3 sets of 4

Day 28: Test – do 5 full-body explosive push-ups. Missed it? Repeat week 4.

Week 5:

Day 29: Superman push-up. Lower your body, then explode into the air. Extend your arms; squeeze your glutes. Land. Reset. Smile.

^{This article was originally published on www.mh.co.za}

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Jay Maryniak

Where you live in the world may determine whether you’ll survive a snakebite.

About 93 million people worldwide live in remote regions where there are venomous snakes. If bitten, these folks are at increased risk of death due to limited access to anti-venom drugs, researchers said.

In South Africa poisonous snakes are straying into urban backyards with alarming frequency, and a bite from one can send you to hospital, or worse. To protect your loved ones and yourself against snakes and snakebites you need to know your local snakes and what to do if a bite occurs.

Extremely high-risk regions

“Understanding where venomous snakes live and people’s proximity to effective treatments are the two most important steps toward reducing deaths. Our analysis identifies communities in greatest need,” researcher David Pigott said in a University of Washington news release.

Pigott is an assistant professor at the university’s Institute for Health Metrics and Evaluation (IHME).

The study was published in The Lancet.

Africa is home to most of the nations where people are more likely to die from a snakebite, Pigott’s team determined. Those countries include Benin, Congo, Ethiopia, Nigeria and South Sudan.

Black mambas, cobras, vine snakes and carpet vipers are just a few of the deadly snakes on the African continent.

Myanmar in Asia – home to Russell’s viper, banded krait and king cobra – and Papua New Guinea are other extremely high-risk regions, the researchers found.

Major neglected tropical disease

For the study, the researchers identified regions where it is hard to receive treatment. Then they generated range maps for 278 species of venomous snakes.

Previous research estimated that 5 million people worldwide are bitten every year by poisonous snakes, and about 125 000 of them die.

According to a previous Health24 article, staying calm and getting to a medical facility as quickly as possible will give you the best chance of surviving a venomous snakebite. Even if a hospital doesn’t have antivenom, in most cases there will be enough time to order it in and provide supportive care in the interim.  

“In spite of the numbers, snakebites received relatively limited global attention,” said study co-author Simon Hay, director of geospatial science at IHME. “We hope this analysis can broaden the discussion about snakes.”

Last year, the World Health Organization categorized snakebite as a major neglected tropical disease. Subsequently, the WHO said a plan must be developed to help countries provide greater access to snakebite treatment.

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A new report, released by the Human Science Research Council, into HIV prevalence and incidence in South Africa, has shown a significant decline in new infections in 2017, compared to a similar survey five years ago.

But more concerning for researchers was the occurrence of risky behaviour among respondents.

It found that consistent condom use was low, early sexual debuts before the age of 15 had increased among males, and more than a third of young women had sexual relationships with older men.

“It is concerning to find very little behaviour change seems to have occurred since 2012,” said Dr Mpumi Zungu, from the HSRC’s HIV/Aids, STIs and TB (HAST) Research Programme, and a co-principal investigator (PI) of the survey.

“This suggests that most of the reduction in new infections was likely due to the impact of the expanded ARV treatment programme,” she said.

Decline in incidence rates

The survey was based on interviews with 33 000 people between January and December 2017, with 24 000 of them agreeing to be tested for HIV.

The survey found there had been a significant decline in incidence rates, but that there had been an estimated 231 100 new HIV infections in SA in 2017.

The researchers said, although still high, it was a significant decline compared to 2012.

The survey found that the HIV incidence rate was higher among females aged 15-24 years old, where it was three times that of their male counterparts.

Dr Sizulu Moyo of the HAST Research Programme, and one of the co-PIs of the study, said the survey had found that more than 60% or an estimated 4.4 million people living with HIV (PLHIV) were on antiretroviral treatment (ART).

She said the study had also found that viral suppression was 87.3% among PLHIV who were on ART, with females generally being more likely to be virally suppressed than males among those aged 15 to 64 years old.

Campaigns are helping 

“This suggests that progress is being made in increasing ART coverage, however, more needs to be done to link those who test HIV positive to care as soon as they are tested, in line with the current policy of test and treat,” Moyo said.

The survey did, however, find that social and behaviour change communication campaigns – such as those implemented by Soul City, Centre for Communication Impact (CCI), LoveLife and Community Media Trust campaigns – were reaching South Africans.

The study found that people who were highly exposed to these campaigns reported higher HIV testing, condom use, and correct knowledge of HIV compared to those who had lower or no exposure.

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Jan Bornman

Testosterone is one of the most spoken and thought about hormones among men.

It’s the subject of much curiosity and misunderstanding, and the scapegoat for that aggressive guy at the bar. It’s responsible for muscle-building and sex drive; and men shudder at the thought that their T levels may not be up to scratch.

Read more: Are your testosterone levels normal?

The reasons for differences in testosterone levels from man to man have long been debated across weight racks and doctor’s desks. But a new study has shed light on why you might have low or high T.

The study published in Nature Ecology and Evolution found that men’s testosterone levels are determined by environmental conditions experienced in early childhood rather than genetics or race, a popular belief.

The low down

According to the new study from Durham University, men who grew up around infectious diseases and in challenging environments are more likely to have lower testosterone levels than men who grew up in healthier environments.

The study examined men who were either born in Bangladesh and still lived there, born in Bangladesh and then moved to the UK as children, born in Bangladesh and then moved to the UK as an adult, born in the UK with parents who were born in Bangladesh or born in the UK who were ethnic Europeans.

Read more: Three steps to more testosterone

The men who grew up and lived as adults in the UK had much higher levels of testosterone compared to those who grew up and lived in Bangladesh as adults. The researchers contribute this to the fact that in more challenging environments such as Bangladesh, men’s energy is expelled on fighting infections because they are more exposed to disease and may have poorer nutrition. There are more demands placed on the body in challenging conditions, so developing males spend their energy on survival at the cost of testosterone levels.

So what?

Although the effects of having low testosterone are often emphasised because they impact your sex drive, muscle growth and mood; high testosterone levels pose some serious health threats. If you have high testosterone levels you’re at an increased risk of an enlarged prostate and cancer. It’s also linked to increased muscle mass and aggression.

Read more: 8 steps to prevent prostate cancer

“Very high and very low testosterone levels can have implications for men’s health and it could be important to know more about men’s childhood circumstances to build a fuller picture of their risk factors for certain conditions or diseases,” said co-author Professor Gillian Bentley.

This means that when men are screened, their childhood environments need to be taken into account.

What now?

Do an audit of your lifestyle and your environment as a child. This could give you insight into what your testosterone levels may be like. But this will be subjective. A more objective way? If you’re concerned, look out for symptoms or get checked out by a doctor.

Signs of low T: Decreased sex drive, shrinking muscles, smaller penis, increasing belly, faltering memory, tanking mood or weaker bones.

Read more: Warning: This type of exercise can kill your sex drive

Signs of high T: Low body fat, increased aggression, very high sex drive, acne or shrinking testicles.

If you suspect your testosterone levels may not be normal, head to your doctor. They will usually perform two blood tests before they make an official diagnosis, says Dr Anawalt, a spokesperson for the Endocrine Society.

^{This article was originally published onwww.mh.co.za}

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