Ms Sona Parmar Mukherjee’s article in Wednesday’s Living Magazine (June 11) in the Daily Nation should not go unchallenged. Under the heading “This is what you need to know about paracetamol”- a pompous header that should only precede a detailed public information article based on solid pharmacology- she proceeds to make a skewed citation of a study published in the American Journal of Respiratory and Critical Care, that showed a statistical link between the use of paracetamol and asthma symptoms. What she doesn’t explain is this kind of link stops short of an actual causal link. The actual conclusion in the abstract of the cited article says: “(Paracetamol) use may represent an important risk factor for the development and/or maintenance of asthma, rhino-conjunctivitis, and eczema in adolescent children.” It is important that a few things are added to the author’s “need-to-know” list for the peace of minds of mothers across the country and the region who read her article. Paracetamol is the preferred fever reliever for children with mild to moderate fever and may be used with other treatments for very high fevers. The method by which the study cited in the article was carried out makes it difficult to know if paracetamol in in fact responsible for causing asthma, hence the reason for the study authors’ more modest and more scientifically sound conclusion quoted above. Aspirin and aspirin-like fever relievers, the everyday alternatives to paracetamol, have a known and well studied mechanism by which they can trigger an asthmatic attack in certain vulnerable asthmatic children. This makes paracetamol the preferred fever reliever for children, especially asthmatic children. The article is likely to cause panic among parents and increase non-compliance to paracetamol treatment prescribed for children among readers. Persistent fever can cause harm to a child’s brain and lead to fever-induced fits (convulsions), these can often be imperceptible to a parent. Sponging and other natural remedies may have limited effectiveness- the effects of sponging may not last a long time, such as at night when a child is sleeping. It is in this respect that I found the article irresponsible. The author, while carrying the professional authority of a nutritionist to unknowing readers, went outside of the scope of her expertise, and made a skewed reading of a scientific article to promote her own lifestyle choices in alternative medicine while bad-mouthing an important medicine that often stands between children and serious harm. Nothing illustrates this more than her tepid attempt to posit a theory as to how paracetamol would cause asthma. The theory of disturbance of gut flora is not one that has even been on the table in the research about paracetamol and asthma. Nutrition is a fairly young regulated medical profession in Kenya and may not have the detailed ethical guidelines that the others such as pharmacy, medicine, nursing or laboratory science do, but Ms Mukherjee will know well the guidelines of the regulatory bodies for nutrition outside this country, and when speaking to the public as a nutritionist (as opposed to any ordinary lifestyle writer) restrict herself to nutrition science and ethical education of the public.
Posted on: Fri, 04 Jul 2014 14:06:28 +0000
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