Checkup Medical Column for Feb 24

A weekly round-up of news affecting your health.

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BRAIN STIMULATION A ‘POTENTIAL’ ANOREXIA TREATMENT

A small study of women with severe anorexia suggests brain stimulation may help treat people with the eating disorder.

The study, published in The Lancet Psychiatry, found that implanting stimulation electrodes into the brains of patients could ease their anxiety and help them gain weight.

While the study only included 16 patients, it suggests that the intervention is safe and could help improve some symptoms of anorexia, but “more research” is needed.

The patients involved were aged 21 to 57 years old who had had anorexia for an average of 18 years. They were severely underweight with an average body mass index BMI of 13.8.

All underwent deep brain stimulation, which involves implanting electrodes and stimulating areas of the brain that control dysfunctional behaviours.

Out of the 16, mental health systems improved for 14.

Mood and anxiety symptoms reduced in five patients and depression reduced in 10 out of 14 patients. They also reported better quality of life.

Importantly, the average BMI of the group increased to 17.3 – an increase of 3.5 points – and six patients achieved a normal BMI of 18.5 or more.

“Anorexia remains the psychiatric disorder with the highest mortality rate, and there is an urgent need to develop safe, effective, evidence-driven treatments that are informed by a growing understanding of brain circuitry,” said study author, Professor Andres Lozano, University of Toronto, Canada.

“While our results show some early promise, more research will be needed before this becomes available for patients with anorexia,” Prof Lozano said.

GASTRIC BAND SURGERY HAS MAJOR BENEFITS: STUDY

An Australian study has found gastric band surgery has significant benefits for moderately overweight people with type 2 diabetes.

Previous studies have focused on obese people.

The five-year study by Monash’s Centre for Obesity Research and Education (CORE), found that gastric or Lap-band surgery improved the patients’ chances of diabetes remission, reduced the need for diabetes medication and dramatically enhanced their quality of life.

The study, led by clinician researcher Dr John Wentworth and weight loss surgeon Professor Paul O’Brien, compared 45 participants: 22 randomised to receive gastric banding combined with medical care, and 23 who received medical care alone.

Both groups received help with lifestyle factors such as exercise and healthy eating.

It found an average weight loss of 12.2 per cent of body weight in the gastric band group compared with 1.8 per cent in the medical care-only group.

Almost a quarter of the gastric band group showed diabetes remission at five years, compared to nine per cent of the medical care-only group.

“We had people who were feeling better, moving better and who were happier because of the surgery,” Dr Wentworth said.

“Their diabetes was better controlled and they needed fewer diabetic medications to control their blood sugar levels,” he said.

BRAINY TEENS MORE LIKELY TO USE CANNABIS

Brainy teens may be less likely to smoke, but more likely to drink and use cannabis, according to new research.

A study of more than 6000 students from 838 state, and 52 fee-paying, schools across England found during their early teens the “brainy” pupils were less likely to smoke cigarettes than their less academically gifted peers.

The research in online journal BMJ Open showed they were more likely to say they drank alcohol during this period too.

They were also more likely to say they used cannabis, but this wasn’t statistically significant.

Those of average academic ability were 25 per cent more likely to use cannabis occasionally and 53 per cent more likely to use it persistently than those who were not as academically gifted.

During their late teens, brainy pupils were more than twice as likely to drink alcohol regularly and persistently than those who were not as clever.

As for the use of cannabis, clever pupils were 50 per cent more likely to use this substance occasionally and nearly twice as likely to use persistently than those who weren’t as clever.

Similar patterns were seen for those of average academic ability.

Despite being only an observational study, the authors say that it does provide evidence “against” the theory that high academic ability is associated with “temporary” experimentation with substance use.

Top Philippine drug war critic arrested, but defiant

In comments to journalists moments before police detained her following an overnight vigil at her office, Senator Leila de Lima insisted she was innocent of the drug trafficking charges that could see her jailed for life.

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“It is my honour to be imprisoned for the things I am fighting for. Please pray for me,” De Lima told reporters outside her Senate office.

“As I have been saying all along, I am innocent. There is no truth to the charges I benefited from the drug trade, that I received money and that I coddled drug convicts.

“The truth will come out at the right time. They will not be able to silence me and stop me from fighting for the truth and justice and against the daily killings and repression by the Duterte regime.”

De Lima on Tuesday branded Duterte a “sociopathic serial killer” as she called for ordinary Filipinos to stand up in opposition to his drug war, which has seen more than 6,500 people killed since he took office eight months ago.

It was the peak of a decade-long campaign by De Lima, a former human rights commissioner and justice secretary, to expose Duterte as the leader of death squads during his time as mayor of southern Davao city and then as president.

Govt want nighttime arrest to avoid publicity. If they want to humiliate Leila in the dark, “we will fight them in the shade”. #OneForLeila

— Edwin Lacierda (@dawende) February 23, 2017

Duterte first raised allegations in August that De Lima had been running a drug trafficking ring with criminals inside the nation’s biggest prison when she was the justice secretary in the previous government.

“I will have to destroy her in public,” Duterte said then as he began a campaign to tarnish her reputation, including by making unsubstantiated allegations about her sex life.

“De Lima is not only screwing her driver, she is also screwing the nation.”

De Lima was last week charged with three counts of drug trafficking, and an arrest warrant was issued on Thursday afternoon — triggering a night of high drama as she initially avoided police by seeking refuge at the Senate.

She slept in her office overnight, then gave herself up to armed police in flak jackets.

‘People are afraid’

De Lima and her supporters insist that Duterte orchestrated the charges to crush her opposition as well as intimidate anyone else who may want to speak out against him or his drug war.

“People are afraid,” Father Robert Reyes, an activist priest who spent the night at the Senate with De Lima and other supporters, told AFP after her arrest.

“If the government can arrest a powerful person like her, what more the little man? That is the implied message of her arrest.”

Amnesty International said Thursday that it would regard De Lima as a prisoner of conscience.

“The arrest of De Lima is a blatant attempt by the Philippine government to silence criticism of President Duterte and divert attention away from serious human rights violations in the ‘war on drugs’,” it said.

But Duterte’s aides said De Lima’s arrest showed even the most powerful people would be brought to justice if they broke the law.

“The war on illegal drugs targets all who are involved and the arrest of an incumbent senator demonstrates the president’s strong resolve to fight pushers, peddlers and their protectors,” presidential spokesman Ernesto Abella said.

Duterte, 71, won the presidential election last year after promising during the campaign to eradicate drugs in society by killing tens of thousands of people.

He launched the crackdown immediately after taking office in June and police have reported killing 2,555 drug suspects since then, with about 4,000 other people murdered in unexplained circumstances.

Amnesty has warned that police actions in the drug war may amount to crimes against humanity.

Duterte has variously denied and acknowledged his role in death squads in Davao. As president he has repeatedly urged police to kill drug addicts as well as traffickers.

But Duterte’s aides insist he has never broken any laws. 

Charges over hotel demolition in Melbourne

Developers are facing huge potential fines for allegedly ignoring a heritage overlay and demolishing a 159-year-old pub in Melbourne.

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Stefce Kutlesovski, Raman Shaqiri and the company that owns the site of 159-year-old Corkman Irish Pub in Carlton face a total of 16 charges after it was torn down in October.

Victorian Building Authority and the City of Melbourne, two of the agencies investigating the illegal demolition, filed the charges on Friday in the Melbourne Magistrates’ Court.

The site’s owner, a company of which Mr Kutlesovski and Shaqiri are both directors, has been fined more than $31,000 by Environmental Protection Authority Victoria.

“Charges include demolishing without a building permit, failing to comply with order to stop building work, (and) carrying out demolition work while unregistered,” the agencies said in a statement on Friday.

Maximum penalties for the charges range from $3,100 to $388,650.

Rubble containing asbestos was also found at a vacant lot in Cairnlea soon after the demolition.

Mr Kutlesovski faces six charges, including holding himself out as a demolisher when he was not registered and carrying out a demolition outside hours.

Mr Shaqiri and 160 Leicester Pty Ltd each face five charges.

The matter will be first heard in court on April 13.

WorkSafe, Heritage Victoria and CFMEU also opened investigations after the 19th-century building was demolished.

The City of Melbourne says its officers issued a stop work order on the Saturday, only for the razing to continue on the Sunday.

The only wall left standing at the Corkman site was this month made safe after a council building surveyor issued an emergency order after finding loose bricks and roof sheeting.

The state government has ordered the developers to rebuild the pub, but they are fighting that order in a tribunal.

Demons beat Blues by six points in AFLW

The round-one loss in atrocious conditions has become a powerful catalyst for Melbourne in the AFL women’s league.

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On Saturday they fought off a last-quarter comeback from Carlton to win by six points.

The 6.6 (42) to 5.6 (36) result on Saturday at Casey Fields was crucial, as it kept Melbourne within one game of top sides Adelaide and Brisbane.

The Blues dropped two games off the pace with three rounds left, meaning they now need other results to go their way if they are to make the grand final.

It was the Demons’ third-straight win since they last played at Casey Fields in round one, against the Lions.

Then, a nearby thunder storm briefly sent the players from the field and Melbourne lost by 15 points.

While the conditions were near-perfect this time, Melbourne had to weather Carlton’s late surge.

Trailing by 19 points at the last change, Carlton kicked three goals to level the scores.

But the Demons rebounded, finding Richelle Cranston on her own inside 50m.

She marked and kicked the goal, with Melbourne then holding on for three and a half minutes until the final siren.

“You can be a little bit disappointed, we let them back in the game, but they (Carlton) were fantastic with their pressure and intent,” said Melbourne coach Mick Stinear.

“I’m more pleased we absorbed that and were able to stick our nose in front right at the end.

“As disappointed as we were to drop the first one (against Brisbane), it’s actually kick-started our campaign.

“It has put us in a good position to keep pushing forward.”

Cranston’s goal was the second of two crucial moments in the match.

In the third term, Blues forward Bianca Jakobsson marked and was awarded a 50m penalty, giving her an easy shot at goal.

But she hit the post – one of three times for Carlton in the game – and Melbourne quickly moved the ball down the other end.

Deanna Berry also was awarded a 50m penalty and she did not miss, meaning a 12-point turnaround for the Demons.

Blues coach Damien Keeping said it would be wrong to blame the loss on moments, noting his team did not take their chances in the first half.

While Melbourne easily won the disposals 386-259, Carlton dominated the inside 50s 28-22.

And Keeping was rapt that his players fought back so hard in the final term.

“They were exceptional in that last quarter, played some really aggressive football and stood for something in the end,” he said.

The Blues were also missing star defender Brianna Davey due to a lower back injury, while Sarah Last is out for the rest of the inaugural season because of a knee reconstruction.

Demons captain Daisy Pearce was best on ground with a game-high 28 disposals

Senior Myanmar police jailed over Rakhine border raids

The attacks left nine officers dead and unleashed a four-month military crackdown as soldiers swooped in to help police hunt for Rohingya militants blamed for the raids.

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More than 70,000 of the Muslim minority have fled the area for neighbouring Bangladesh, bringing with them harrowing accounts of systematic rape, killings and torture at the hands of security officers.

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UN investigators who interviewed escapees said the violence was so severe it “very likely” amounted to crimes against humanity and ethnic cleansing.

On Saturday a police spokesman told AFP that three senior officers were handed between two and three years in jail for allowing the raids to happen under their watch. 

“Police were informed by villagers in advance before the attack. But police commanders failed to take action and rejected the information, assuming it was impossible,” said Police Colonel Myo Thu Soe. 

The International Crisis Group think-tank described the October raids as the start of a new Rohingya insurgency in a region rife with tension between the stateless group and Myanmar’s Buddhist population. 

The group said the attackers were recruited by a Saudi-backed network focused on advancing the political rights of the Rohingya, who have suffered under years of discrimination from a government that denies them citizenship.

After months of waving off allegations that soldiers were carrying out grave rights abuses in the recent crackdown, Myanmar’s government has recently pledged to investigate the claims. 

Yet there has been little fallout for security forces so far.

Five police officers were sentenced to two months detention by an internal police tribunal over a video showing them abusing Rohingya civilians, according to police spokesman Myo Thu Soe.

Three senior police including a major were also demoted and their service terms were reduced for failing to enforce discipline.

Suicide attacks on bases in Syria’s Homs kill 42: monitor

Suicide attacks on two security service bases in the heart of Syria’s government-held third city of Homs killed 42 people on Saturday, overshadowing peace talks in Geneva, state television and a monitor said.

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“There were at least six attackers and several of them blew themselves up near the headquarters of state security and military intelligence,” Syrian Observatory for Human Rights director Rami Abdel Rahman told AFP.

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State television reported that the province’s army intelligence chief, General Hassan Daabul, a close confidant of President Bashar al-Assad, was among the dead when the six suicide bombers struck in the heavily guarded Ghouta and Mahatta neighbourhoods.

Security forces locked down the city centre.

Homs has been under the full control of the government since May 2014 when rebels withdrew from the centre under a UN-brokered truce deal.

But it has seen repeated bombings since then. Twin attacks killed 64 people early last year.

State television paid tribute to the “martyrs” in the latest bombings.

There was no immediate claim for the bombings but they bore the hallmarks of the Islamic State group, which controls swathes of the largely desert countryside east of Homs.

Government forces retook the oasis city of Palmyra and its UNESCO-listed ancient ruins in a much heralded Russian-backed offensive in March last year but were then pushed out by IS in December.

Since then, the focus of government efforts has been further north, on second city Aleppo, which they fully retook after a rebel withdrawal in December, and areas to its east and west.

Saturday’s attack comes as the UN is struggling to get a new round of peace talks off the ground aimed at ending the six-year civil war which has killed more than 310,000 people. 

UN envoy Staffan de Mistura said that despite government and rebel delegations being present in Geneva for the talks there had been little discussion of substance between the rival parties.

“We discussed issues relating to the format of the talks exclusively,” said Syrian regime delegation chief Bashar al-Jaafari after meeting de Mistura on Friday.

IS claimed a Friday suicide bombing that killed 51 people outside the northern town of Al-Bab, which Turkish-backed rebels said this week they had taken from the jihadists. 

The Observatory said that a car bomb targeted twin command posts at a rebel base in Susian, about eight kilometres (five miles) from Al-Bab, which was one of IS’s last remaining strongholds in Aleppo province. 

Separately, two Turkish soldiers were killed in a suicide attack in Al-Bab on Friday as they were carrying out road checks.

Two Vic MPs resign over allowances furore

Victoria’s parliamentary Speaker and Deputy Speaker have resigned their posts after they were found to have claimed a controversial allowance designed to support country MPs.

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This week Speaker Telmo Languiller agreed to pay back $37,000 in second residence allowances he claimed while living on the coast south of Melbourne instead of his western suburbs electorate.

But on Saturday he said offering to repay the allowance was not enough and would resign.

“No matter what difficult personal circumstances I may have been going through, I have to recognise it as an error of judgement and I accept that I should pay the price for that error of judgement,” he said.

By Saturday evening, the Deputy Speaker Don Nardella also fell on his sword after facing similar questions about his second residence allowance.

It was found Mr Nardella claimed about $100,000 in allowances for living an hour away from his electorate in Ocean Grove on the Bellarine Peninsula since April 2014.

Mr Nardella said he had “acted in accordance with all rules regarding Member of Parliament allowances” but had decided to withdraw his position as Deputy Speaker.

The second residence allowance is designed to support country MPs who live more than 80km from the city and who maintain a second home in Melbourne.

Both Mr Nardella’s and Mr Languiller’s electorates are within 80km of the city.

Premier Daniel Andrews said the allowance will be investigated to see if changes need to be made.

“It is self-evident that the second residence allowance is meant for regional MPs who must travel to Melbourne for Parliament,” he said in a statement on Saturday.

“For that reason, I have asked the Special Minister of State to urgently determine what changes are required so what has occurred in these instances does not happen again.”

As Mr Languiller and Mr Nardella move to the backbench, the role of Speaker and Deputy Speaker will have to be filled.

Mr Andrews says the party will nominate candidates at the next regular caucus meeting.

Kohli rages, Smith completes captain’s ton

The showdown between skippers Steve Smith and Virat Kohli was billed as the battle that will all but decide Australia’s bid for a boilover in India.

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It’s far too early to suggest Australia will record the nation’s second Test series win in India since 1970, but Smith’s century in Pune helped them record the nation’s first Test win in India since 2004.

Smith posted his 10th – and arguably most important – Test ton as captain of Australia on day three of the absorbing contest.

Former Australian captain Michael Clarke regarded it as “as good a Test hundred” as any of the 18 that Smith has celebrated.

Smith agreed.

“It’s got to be right up there,” he said.

“It took a lot of grit … it was great to get such a big lead and give our bowlers plenty to bowl at.”

Clarke suggested his successor’s knock was very important in the context of “not only this Test but the series”.

“No matter what conditions are or where he is in the world, he adapts and finds a way,” Clarke said on Star Sports.

“Australia are in an extremely dominant position because of that innings.”

India’s sloppy fielding also helped. Kohli struggled to contain his rage as Smith was dropped on 23, 29, 37 and 67. Jayant Yadav missed a chance to run the skipper out on 60.

“He was getting a little bit angry at fielders for dropping catches,” Smith said.

Kohli and his teammates also straddled the line of dissent after a couple of confident appeals were turned down, including when Smith should have been given out lbw on 73.

The Decision Review System (DRS) is being used but Kohli, who has a history of on-field verbal spats with Smith, had already unsuccessfully used both referrals.

It capped a poor couple of days for Kohli, who was dismissed for his first Test duck at home and criticised by locals for taking the second new ball on day one when Mitchell Starc was teeing off.

The loss was Kohli’s first at home as captain.

Smith’s tenure as skipper started in the absence of an injured Clarke, when he tallied four hundreds and 769 runs at 128.16 against India in 2014/15.

The 27-year-old, who has matured since becoming the nation’s youngest Test captain since Kim Hughes, has produced higher scores and far better looking innings than his milestone in Pune.

But he has rarely had to fight so hard for every run. Smith was in his element as he hammered home Australia’s advantage on a spinner’s paradise produced with the world’s two best bowlers in mind.

Star spinners Ravichandran Ashwin and Ravindra Jadeja both had their moments against the classy right-hander, with the latter finally dismissing him after 260 minutes at the crease.