UN Secretary-General Antonio Guterres addresses the 77th session of the United Nations General Assembly at UN headquarters in New York City on September 20, 2022. Photo: AFP
The general debate of the 77th session of the United Nations General Assembly (UNGA 77) is currently under way. This is the first entire in-person meeting at the UN headquarters since the outbreak of the COVID-19 pandemic. The meeting is being held when the world is severely divided. It hence should be an opportunity for all parties to strengthen communication, bridge divergences, and join hands to cope with global challenges, while being cautious of certain countries' attempt to turn the general assembly into a tool to create division, and escalate conflicts and confrontation.
In his opening remarks, UN Secretary-General Antonio Guterres warned that progress made on coping with challenges is being held hostage to geopolitical tensions. "Our world is in peril - and paralyzed … No cooperation. No dialogue. No collective problem solving. But the reality is that we live in a world where the logic of cooperation and dialogue is the only path forward," he stressed. Guterres' warning is both a description of the status quo and a concern about the current situation of the UN. However, to what extent can such warning be translated into actions by some key countries remains a big question to be answered.
Several media reports mentioned that this week's UNGA 77 general debate will be dominated by the struggle between the US and its allies on the one side, and Russia on the other, over the Ukraine crisis. The US and its allies are committed to launching a campaign to "isolate Russia." In addition to carry on strong condemnations against Russia, they are ganging up to pressure neutral countries. It is reported that the Russian side will discuss not to allow the US and the West to launch a hybrid war in Ukraine. Many developing countries and aid groups worry that the diplomatic conflict over Ukraine will undermine a key opportunity to address famine, the climate crisis and other issues of concern.
Amid the interwoven changes and chaos of the world, the UN is also undergoing a test about profound differences. Will it let itself be kidnapped by some forces and turned into a tool for targeting specific countries, and promoting group politics and the so-called alliances of values? Or will it hold on to promoting democracy in international relations, adhering to comprehensive concepts of development and security, and uniting the vast number of countries to solve common problems via genuine multilateralism? The history of the development of the UN indicates that these two forces have always had a tug-of-war. Whether the forces of solidarity and cooperation that focus on the future of mankind can overcome the forces of division and confrontation that rest on geopolitical logic will affect UN's role and hundreds of millions of people around the world in the future.
There is one thing that cannot be denied: Although the UN General Assembly general debates have been filled with lots of conflicts and confrontations, the UN remains the core of global governance nowadays and is in a key position to address a range of challenges, and the UN Security Council remains the core of the global system of collective security. It is for this very reason that the international community generally places high hopes on the UN system as a prioritized platform for pursuing a better vision of the world. Under such circumstances, how the UN can build consensus and promote unity requires courage and wisdom, and moreover, new ideas.
In this process, it's significant whether the major powers choose dialogue and cooperation, or division and confrontation. It's learned from the lessons of World War I and II that the rule of "great power unanimity" has become the main operating rule of the UN mechanism. Especially in the current situation where the Russia-Ukraine conflict is escalating and humanitarian disaster is imminent, major powers should take the initiative to safeguard UN's authority and leave an "emergency channel" for diplomatic settlement of disputes through UN mechanisms, rather than instrumentalizing and ideologizing the organization and using geopolitical interests to kidnap it, making the complicated problem even more difficult to solve. This is a moral obligation, and a responsibility as well.
In the statements that have been made during the meeting, representatives of many countries have mentioned "solidarity," showing that the problem has been noticed. However, there are divergences on the path to solve them. At the moment, we need to practice authentic multilateralism and work together to uphold the principles of the UN Charter. We suggest that the representatives of the participating countries carefully read the "Position Paper of the People's Republic of China For the 77th Session of the United Nations General Assembly," which gives a "Chinese proposal" for the current period of turbulent changes, a proposal for building common security and achieving common development.
There lies the desire to pursue an integrated and common view of security, instead of a unilateral view of security dominated by a single power, behind the strong calls at this session from developing countries to focus on famine and climate crisis while preventing the Russia-Ukraine conflict from monopolizing all the attention. We believe that the measure of whether a session of the UNGA is worthwhile should be whether the world is more fractured or less fractured afterward, and if there is more cooperation or less after the session. There could also be identification of responsibility for this.
Ahum, you are wrong about which country is the world’s big bully. It is not China, but the US.
The
US is constantly meddling in the affairs of other countries, creating
political instability in countries that refuse to be their pet-dog, and
even fabricate lies as an excuse to start wars or invade countries.
They even hack their allies, I personally witnessed such a hack as an employee of a European telecom/internet provider. At
the same time, US telecom/internet equipment manufacturers refuse
access to their source code and firmware to do serious security
inspections, while Huawei gives full acc
The
so called genocide on Uighurs (Xijiang)? Or by the media well overblown
dispute over Tibetan territory? Or Arunachal Pradesh (India)? These
disputes go back to the 6 and 7th century (if not further).
Western
world pokes nose to something that started during the reign of well
successful and mighty Tang Dynasty. The so called eastern Turks invaded
China from the east and were pushed back over the border. That happened
several times until the two rival sides signed economic and trade
treaties which allowed Turks to stay at Chinese borders, however,
Chinese never disclaimed the possession of th
Umm….
Surely that's the US you're thinking of? Been bullying threatening and
trying to subvert an island neighbour these last sixty years? You have
heard of Cuba, haven't you?
first
, China isn't the world bully , and have beaten socalled UN army at
Korea in 1950–1953 . Second , China always get the majority ballots even
defamed endlessly by all west medias . last , China have the power to
veto all unfavorable , by war or others like US .
Stop
what exactly? Trading with its neighboring countries? Giving up their
legit claim on their territory? Why don’t you change the subject from
China to any other country to see who will agree that.
I
can't believe how many young people from the new generation of people
raised in the USA actually believe this propaganda perpetuated by the
government that USA is good and everyone else who is a potential threat
to USA is bad. People these days have a very incorrect and missinformed
view of the world. America is not doing peacekeeping, they are just
ordering other countries about how should they live, whom should they do
business with and so on and so forth. America is acting like a bully,
not like a helping hand.
I'm
not going to touch on which countries are or aren't “world bullies” and
state a very simple fact that I don't see in any other answer;
China can veto any UN resolution so would just veto any resolution used to apply pressure to them.
All
5 permanent Security Council members can do this so the UN can't do
anything against China, France, Russia, the UK or the USA because all
these 5 counties can just say no.
“Why
can't the UN pressure China to stop behaving like a world bully and
stop threatening the neighbors with force?” It is because of the nature
of UN who is not a world’s government. The UN’s outcome is just
resolutions which ‘encourages/recommends’, and not forces its members to
do something.
And
even if UN were a powerful world govt then China is is one of most
powerful figure of this govt so there would never been any UN’s
decision/order to stop bad China’s behavior.
Gurjit: My horizons have greatly been broadened through my learning of multiple languages over the years.
With perseverance and a good support system, one can take on any language learning as exemplified by this teen
THERE is a Chinese proverb that says: “To learn a language is to have one more window from which to look at the world.”
I couldn’t agree more as my horizons have greatly been broadened through my learning of multiple languages over the years.
I am fluent in four languages: English, Tamil, Chinese and Malay. Being multilingual in multicultural Malaysia makes it easier for me to interact with others, in addition to helping me better understand their cultures and experiences.
I have my parents to thank for exposing me to the Chinese language from young. They enrolled me in a Chinese-medium kindergarten, which was how I first became familiar with the language. Because both my older brothers could speak Chinese and used it frequently at home, I picked up the language rapi
dly.
My kindergarten teacher made sure my classmates and I learnt how to write and pronounce the Chinese characters properly. Giving us tests every week helped to reinforce what we had learnt. I can still picture myself scrambling to remember the stroke orders that made up each character.
When it was time to sign me up for primary schooling, my parents again opted for Chinese-medium instruction as it was a natural progression from my preschool education.
I continued to hone my Chinese language skills there under the tutelage of teachers who were considerably stricter about using the language properly.
One of the difficulties I ran into when learning the language was using the pronunciation correctly. Chinese is a tonal language in which each tone and pitch stand for a different word. For example, the words “eye”, “salt” and “smoke” in Chinese may sound the same to the untrained ear but if you listened closely, they each have a different tone.
In an effort to overcome this, I practised speaking the language more often with my friends, who would correct me whenever I mispronounced the words. Over time, my command of the language showed improvement. In fact, it was considerably stronger than my command of the Tamil language.
Except for the times when I was interacting with my mother or my uncle and aunties, I hardly ever used Tamil. Not just that, all my cousins spoke Chinese, so we basically ended up speaking in the language whenever we met.
At home too, my siblings and I constantly spoke Chinese to the extent that my mother could make out a few words and understand what we were saying. Apart from my speaking skills, my Chinese essay writing saw improvement, thanks to my teacher in Year Six who would give my classmates and me an essay to complete before the end of schooling hours every Thursday.
On my part, I learnt new vocabulary by listening to Chinese songs and reading the lyrics while singing along to them.
This made it easier for me to recall the new words I had picked up.
I continued learning Chinese as I moved on to secondary school. Because of the different syllabus and the more advanced level, I felt like entering a completely new planet in my Chinese language classes.
My classmates and I had to comprehend and translate classical Chinese literature into modern Chinese text. I struggled greatly with it to the point of seriously considering giving up the subject.
My father, however, advised me to persevere with it as he strongly believed that my Chinese language mastery would help me later in life.
Thankfully, my brothers and friends helped me greatly throughout my journey; they explained to me the meaning of each text and helped me with my homework. Having patient and compassionate teachers eased my experience too.
Early this year, during my school’s orientation for us Form Four students, I learnt that Chinese literature is among the elective subjects offered.
To further expand my knowledge, I made the decision to take up the subject. I have since found Chinese literature to be enjoyable, which surprises me.
It is a whole new world on its own. I really enjoy reading Three Ways of Looking at an Old Pine Tree written by Zhu Guang Qian. It talks about the practical, scientific and aesthetic perspectives of each person looking at an old pine tree.
Chinese literature gets very interesting as you discover how each story unfolds and understand the meaning behind each action. Looking back on my journey as a Chinese language learner, I must say that I am proud of having stuck it out this long despite the challenges.
I believe that by learning each other’s languages, we are breaking the language barrier that is stopping us from having a really enjoyable time with one another.
I hope my experience will inspire more Malaysians to learn another language, be it Chinese or otherwise. Good luck!
Gurjit, 16, a student in Pahang, is a participant of the BRATs Young Journalist Programme run by The Star’s Newspaper-in-Education (Star-NiE) team.
Now that you have read the article, test your understanding by carrying out the following English language activities.
1 Besides language, how do you think one can connect with people from a different community? Discuss with an activity partner.
2 Imagine you were Gurjit and you had been invited to share your language learning journey at your school assembly. This article is your first draft of the speech that you are going to deliver. Shorten it to a length of between 350 and 500 words, before practising your speech delivery. Next, take turns with an activity partner to deliver your respective speeches. Finally, rate each other’s scripts and speech delivery. Have fun!
Since 1997, The Star’s Newspaper-in-Education (Star-NiE) programme has supported English language teaching and learning in primary and secondary schools nationwide. Now in its 25th year, Star-NiE is continuing its role of promoting the use of English language through a weekly activity page in StarEdu. In addition, Star-NiE’s BRATs Young Journalist Programme will continue to be a platform for participants to hone and showcase their English language skills, as well as develop their journalistic interests and instincts. Follow our updates at facebook.com/niebrats. For Star-NiE enquiries, email starnie@thestar.com.my.
The US Federal Reserve will hold a new policy meeting on Tuesday and Wednesday, with the decision on interest rate growth being the limelight. It is widely anticipated that the Fed will deliver at least another 75-basis-point interest rate hike to tame inflation. This might further increase the value of the US dollar against other currencies, which is at its 20-year high. Driven by the Fed's aggressive rate hikes, the US dollar is viewed as "experiencing a once-in-a-generation rally." For many countries in the world, this might be the beginning of another nightmare.
The meeting will witness the fifth time that the Fed will raise interest rates. The direct reason is to ease the high pressure of inflation in the US. But if people dig the root cause, this is an inevitable consequence of US' blind and unlimited money printing to temporarily maintain "prosperity." In other words, in the face of the deep-seated problems exposed by the 2008 financial crisis, Washington has been powerless, and unwilling as well, to solve them. Instead, it was extremely short-sighted to cover up the crisis and curry favor with the Wall Street, while taking advantage of the hegemony of the US dollar to quietly treat the crisis like dumping wastewater - draining it to the world.
A super strong US dollar and the fall of other currencies will, to a certain extent, ease the scorching inflation in the US economy, but the world will have to pay for it, which is often referred to as "when the US is sick, the world has to takes pill." The ensuing severe inflation, economic recession and other problems have already appeared on a large scale in many countries. Thirty-six currencies around the world have lost at least one-tenth of their value this year, with the Sri Lankan rupee and Argentine peso falling by more than 20 percent, since the dollar strengthened.
This has not only worsened the already weak economies of Europe and Japan, but also forced a large number of developing countries to swallow the bitter pills of the economic recession caused by imported inflation. Countless families were impoverished overnight. This is a very abnormal situation that is not supposed to occur, but it is the cruel truth behind the US "containment of inflation."
In fact, since the end of World War II, the US has used dollar hegemony to carry out "financial looting" or "export crises" against other countries several times. As a widely popular phrase in the West goes, the US enjoys the exorbitant privileges created by the dollar and the deficit without tears, and used the worthless paper note to plunder the resources and factories of other nations.
Each round of dollar appreciation in the past decades has been accompanied by extremely bad memories: The Latin American debt crisis broke out in the first round, Japan suffered from the "lost two decades" during the second round and the Asian financial crisis took place during the third. Particularly in the Asian crisis, which is still fresh in many people's memories, more than 100 million middle-class people in Asia fell into poverty, according to the World Bank estimation. The strengthened dollar, time and again, cuts the world like a sharp blade.
Therefore, while the political elites in Washington boast of the "myth of the American system" and take credit for "alleviating the crisis," thousands of poor families around the world are being trampled by them. They are not unaware of this, but still collectively choose to be indifferent and arrogant, as if this is the privilege that the "hegemon" should enjoy. As US former treasury secretary John Connally put it in the 1970s, "The dollar is our currency, but it's your problem." Today, the dollar is once again the world's problem. In a sense, it's hard to believe that the "prosperity" of the US is clean and moral.
However, the crisis cannot be covered up forever. Washington keeps laying mines but never removes them, which will eventually explode the US itself. The incompetence of US financial policymakers has been exposed by the consecutive interest rate hikes that have contributed to the abnormal appreciation of the US dollar with the purpose of defusing the severe inflation.
For the US itself, what will rise accordingly are the cost of corporate financing, the pressure on residents to repay their loans, and the price of export production among others. Meanwhile, the credibility that the US dollar has as a global currency is being continuously exhausted by the US "beggar-thy-neighbor" policy. Now the anxiety and insecurity brought by the US dollar to the world has heralded the beginning of the decline of its hegemony - regarding Washington's insatiable exploitation, Europe, Asia, the Middle East and other regions have explored the path of "de-dollarization," leading to the inevitable diversification of the international monetary system.
The best way to restrain the rampaging hegemony is to practice true multilateralism. Whether it was the Asian financial crisis in 1997 or the global financial crisis in 2008, the world seemed to have stumbled more than once by the same stone, which, however, is not that firm anymore. The instability and fragility of international financial markets have once again become prominent. It is precisely at such times that the international community should be more determined to cooperate and build a reliable, systemic and long-term multilateral international financial system. This cannot wait.
The United States of America is in big trouble, short term and long term. In 2022, the stock market is crashing, bond market is down the most in 40 years, housing bubble is bursting, inflation is skyrocketing, debt is exploding, and GDP is shrinking. These are not temporary crises. Instead, they reveal systemic flaws in the American economy that is propped up by a rigged global financial system.
However, that fraudulent system is starting to crumble and the primacy of US dollar is in serious trouble, thanks to an emerging multipolar world. (Don't believe the nonsense that the US can keep printing infinite amount of dollars).
The US needs to default on its debt and start new. Declare bankruptcy and yet remain the #1 country. This will be the "Bretton Woods III" agreement.
Sounds ridiculous? Well, it's possible only if all the other countries are weak and nobody is strong enough to challenge the US.
This is why the US must not only crush Russia and China — its two biggest geopolitical rivals, but also weaken Europe. This paves the way for the US to establish a new global order which is similarly rigged and just as deceitful and corrupt — in order to prolong the American Century.
Dollar Hegemony
America's extraordinary power comes from the power of US dollar, which is the established global currency for trade. This also means that countries around the world have to accumulate US dollars in their foreign exchange reserves. But the US has been abusing its power by weaponizing the dollar through sanctions and confiscations of hard-earned reserves.
No wonder that China, Russia and others are seeking ways to circumvent the dollar in trade. Since 1999, the share of US dollar assets in central bank reserves has dropped by 12 percentage points—from 71 percent. Hence the share of US dollar in global reserves is now only 59%. When that number falls below 50%, the tectonic shifts in global finance will become more apparent to Americans.
To fully grasp the nature of the current world order, let's see how the US established the dollar as the world currency, carried about the biggest gold heist in human history, then defaulted on its obligations, but revived the moribund dollar with a clever deal. That's the story of Bretton Woods I and II.
Bretton Woods I - Gold-backed Dollar
WW2 was a wonderful thing for the US. First, it took the US economy out of the Great Depression. The US played the role of arms supplier and gladly watched European empires destroy themselves. Even before the war was over, the US brought in all the allies to Bretton Woods, New Hampshire, and said, "When the war is over, you will all be weak and broke. I will be the new empire and my dollar will be the global currency. And it will be as good as gold -- a guaranteed rate of $35 per ounce of gold."
This meant that if you have $35, you can go to a bank and get an ounce of gold!
The world agreed. When the war was over, everyone bought US dollar with gold and used it for trade. Huge amounts of gold were also physically transferred from Japan, Germany and other parts of the world into the vaults of the Federal Reserve Bank in New York.
This system worked until 1971 when the US suddenly declared that, "Oops, the dollar is not backed by gold anymore. If you have US dollars, they are just pieces of paper now. You cannot get your gold back!" People called it the "Nixon Shock."
1970s - When Fiat Dollar almost died
This was also the biggest gold theft in human history. But what could the world do? America had nuclear weapons and the mightiest military.
Of course, the switch to a fiat currency caused havoc. The value of US dollar fell precipitously and inflation skyrocketed. The US economy was in deep trouble. That's when the US elites came up with a clever idea to rescue the dollar and restore its primacy.
Bretton Woods II - The Birth of Petrodollar
How to make the dollar relevant? Hmm...What if everyone needed US dollar to buy something essential?
Like ... OIL. Brilliant!
This was the birth of Petrodollar.
Basically, the U.S. used Saudi Arabia’s oil to save the dollar. That is, Saudi Arabia (and other smaller producers) would sell oil only for US dollars. And to make sure that the Saudis don't get too powerful, they will be forced to recycle most of their profits back into the US economy. It was also a protection racket, which meant the US military would occupy Saudi Arabia and protect it from enemies.
Saudi King Faisal with Kissinger. Birth of Petrodollar. But why would the Saudis agree to this? Because the U.S. make Saudi Arabia the new king of oil and the most influential Middle East power ... after crippling Iran.
Win-win for the US.
Thus, the U.S. armed and funded Saddam Hussein of Iraq to wage a decade-long war on Iran. US provided arms/intelligence. Germany and France provided deadly chemical/biological weapons to Iraq. Here’s Donald Rumsfeld with Saddam in 1983.
Of course, the same Rumsfeld would bomb Iraq and kill Saddam twenty years later.
Thus, the Petrodollar deal with Saudi Arabia could be called as Bretton Woods II. It extended the life of the American Empire by a few more decades.
Bretton Woods III -
For the last four decades, countries around the world have been foolishly working hard for US dollars, buying US treasuries, and funding the American Empire. But within the next decade, those U.S. treasury bills and bonds might be worthless. Deja vu all over again.
The U.S. needs Bretton Woods, Version 3. Somehow, the world needs to write off all American debt and start the racket anew. But … with America still as #1 How the hell could this happen?? This is how:
If the world is full of weak countries, they will accept the new rules -- just like they did in 1944 and 1974. Imagine a world where Russia and Europe destroy one another. Imagine a world where Japan and India attack China … and they all get destroyed. A world on fire, destroyed by passion and bombs.
In that world, America will come in as the savior at the last moment, stop the war, and make everyone a happy vassal.
Great Reset. Bretton Woods III. New World Order. Call it what you will.
Conclusion
The wheels are in motion. After eight years of provocation, the US successfully forced Russia to invade Ukraine. And the US also brilliantly pulled Europe into the mess. Europe's economy is being crushed and de-industrialized.
As for China, the U.S. is trying its best to start a war using Taiwan as the pawn. Japan is being asked to re-militarize and procure 1000 long-range missiles. The US needs a few more years to manufacture this mother of all wars. A lot depends on India, since Japan wouldn't want to be the only Asian country to attack China.
Four years ago, I predicted all this in the article "The Most Dangerous Decade." However, much of the world is still happy to be mesmerized and led into the slaughterhouse.
Only Russia and China can change how this story evolves. If Putin can quickly and decisively win the Ukraine war, he can force a peace settlement with Europe.
And China needs to accelerate the internationalization of Yuan. There is no de-dollarization without a robust alternative financial system. China also needs to muster the greatest diplomatic efforts to make peace with Japan and India, the two most potent adversaries and puppets of the US.
In the most optimistic scenario, the Global South or the people of the developing nations can bring into fruition a new fair world without catastrophic wars or financial devastation. As Sun Tzu said, "The supreme art of war is to subdue the enemy without fighting."
https://mail.google.com/mail/u/0/#inbox/FMfcgzGqQclQQKsTXRZGBMLRQzQzJwZB
Brent Neiman, a counselor
to US Treasury Secretary Janet Yellen, urged China to "take part in
coordinated debt relief for vulnerable nations to avoid the specter of a
systemic sovereign-debt crisis," Bloomberg reported on Wednesday.
Companies attending the 7th China-Eurasia
Expo in Urumqi, Northwest China's Xinjiang region said the increased
use of the yuan in cross-border trade in Central Asia is making business
more convenient and reducing foreign exchange risks stemming from the
use of the US dollar, and they called for more arrangements to ...
No one likes the idea of popping pills every morning. Take cholesterol-lowering medicines or statins, for example. To get themselves off the hook, many patients with high cholesterol levels tend to believe that diet changes and other lifestyle modifications alone would work.
Interestingly, when it comes to lowering cholesterol levels, being diligent with your medicine is far more beneficial than giving up wagyu beef. A local study by SingHealth Polyclinics (SHP) has found “adherence to medication to be the most critical factor” compared to other considerations such as ethnicity, diet, exercise and smoking.
Just how much more effective? Professor Tan Huay Cheem, a senior consultant with the Department of Cardiology at National University Heart Centre, Singapore, who isn’t part of the study, provided the breakdown below:
Diet: 10 per cent to 20 per cent
Exercise: 5 per cent
Exercise and diet: 10 per cent to 20 per cent
Medicine (oral): 30 per cent to 50 per cent
Medicine (oral and injectable): Up to 85 per cent
Dr Tan Ngiap Chuan, who led the study and is the director of research at SHP, said the findings could prompt doctors to prioritise starting or adjusting medications with their patients. "We usually focus on other lifestyle factors first. We may switch the order now."
HOW DO THESE MEDICINES WORK?
In Singapore, nearly two out of 10 adults aged 18 to 69 have high cholesterol, according to the SHP study.
If you’re one of them, you’re probably put on statins (including atorvastatin and rosuvastatin), the most commonly prescribed medicine, said Prof Tan.
Statins are also known as HMG-CoA reductase inhibitors and they “work in the liver to prevent cholesterol from forming and reduce the amount of cholesterol circulating in the blood”.“They are most effective at lowering LDL (bad) cholesterol, but also help to lower triglycerides and raise HDL (good) cholesterol,” said Prof Tan.
In addition to statins, a new class of injectables have emerged in recent years. They provide an alternative for patients “who are unable to achieve their targeted cholesterol levels, who are statin intolerant, or unable to adhere to regular therapies”, said Prof Tan.
These include the PCSK9 inhibitors (such as evolocumab and alirocumab), which are injected once every two weeks.
There are also the small interfering RNA or siRNA, which requires subcutaneous injection only once every six months. These siRNA include inclisiran, which was recently approved by Singapore’s Health Sciences Authority and the US Food and Drug Administration, said Prof Tan. “The injectables can be used in combination with oral medicines.”
Unfortunately, the commonly prescribed statins have received bad press on social media, said Prof Tan, even though they have been “proven to be effective in preventing heart attacks, strokes and death – even among low-risk patients”. It has led patients to develop “unfounded fears” for statin-associated side effects, he said.
Here, Prof Tan tackles some of the common misconceptions patients have about statins:
MISCONCEPTION 1: Doctors prescribe statins as a catch-all
(Photo: iStock/wutwhanfoto)
Statins are widely used as they satisfy two crucial functions in disease management: Preventing the onset of disease before it begins; and reducing the severity or impact of a disease if it already has by “halting its progress and preventing recurrences”, said Prof Tan.
“Certainly, patients who are at low risk for heart attack and stroke will benefit less from taking statins,” he said. But “among medical experts, there is little debate on whether statins work in high-risk patients”.
Having said that, statins aren’t prescribed indiscriminately. According to Prof Tan, patients are usually started on a course only if they satisfy any of these criteria:
Atherosclerotic cardiovascular disease. This means the patient has pre-existing blockages in the heart, brain or any arteries in the body’s circulatory system.
Diabetes mellitus. Especially those who have been living with diabetes for more than 10 years.
High LDL cholesterol level. Higher than 190mg/dL (4.9mmol/L).
As prevention. These are patients with no established cardiovascular disease but have multiple risk factors that increase their chances of developing it in the future.
MISCONCEPTION 2: Once you start on statins, you have to be on them for life
This is true, though. The cholesterol-lowering benefits conferred by statins will only continue for as long as you take the medicine, said Prof Tan. “The cardio-protective effect is lost when the statins are stopped.” You would have considered to have discontinued your medication if you stopped for more than a year.
Perhaps the more pertinent question is: What are the effects of being on statins in the long run? “Studies have shown that statins are safe and well tolerated. They have been used for more than 30 years to lower cholesterol. In fact, statins work best when you take them for a long time,” said Prof Tan.
Look at it as insurance for a longer life and to prevent heart attacks and strokes, he added.
MISCONCEPTION 3: Statins cause diabetes
(Photo: iStock/hinnapong)
Statins have been found to slightly elevate blood sugar levels in clinical trials, said Prof Tan. And this creates the impression that statins can lead to diabetes.
“However, people experiencing this side effect are already prediabetic or have higher than normal blood sugar. For those who are borderline diabetic, this mild increase in blood sugar can lead to a diabetes diagnosis about five weeks earlier than it would be otherwise,” he said.
But if you’re not already predisposed to diabetes, that is, your blood sugar levels are normal, statins do not induce diabetes, said Prof Tan.
“Additionally, the benefits of reducing cardiac events in someone who has prediabetes or is diabetic greatly outweigh the slight increase in their blood sugar which may occur,” he said.
MISCONCEPTION 4: Statins destroy muscle tissue
(Photo: iStock/Marc Bruxelle)
The muscle-destroying conditions that you might have read about are known as myopathy and rhabdomyolysis. “Serious muscle damage such as myopathy and rhabdomyolysis are rare,” said Prof Tan.
Myopathy refers to any disease that causes the muscles to lose control, leading to muscle weakness. Rhabdomyolysis, on the other hand, results from the disintegration of the muscle fibres. Both conditions have been linked to the frequent use of statins.
Prof Tan said that statin-associated muscle symptoms have been reported in studies in varying frequencies, from 10 per cent to 15 per cent in patients. However, he claimed that the incidence rate may be overestimated due to the nocebo effect.
The cardio-protective effect is lost when the statins are stopped. In fact, statins work best when you take them for a long time.
“This is when a patient with negative expectations of a medicine would experience its potential side effects at a much higher rate than he otherwise would,” said Prof Tan.
If you suspect you have statin-associated muscle symptoms, the ache and tenderness typically involve large muscle groups such as the shoulders and the thighs, and are usually bilateral. They also tend to be more pronounced after physical exercise, said Prof Tan.
Speak to your doctor who can put you on a different statin or reduce the dose, he said.
MISCONCEPTION 5: Statins do not really prevent vascular disease
(Art: iStock/Rasi Bhadramani)
Vascular disease refers to any condition that affects the blood vessels in your body. As you’d already know, having a high cholesterol level means that you have a high amount of fat and cholesterol deposits coursing through your blood vessels that can accumulate and block the vessels. When that happens, you run a high risk for cardiovascular diseases such as heart attacks and strokes.
“Lowering cholesterol levels reduces the risk of such events,” said Prof Tan.
And what about statins’ contribution? “In the high-risk populations studied, those who took statins had 20 per cent to 40 per cent fewer heart attacks, strokes and deaths than those who did not over two to five years,” said Prof Tan.
“Statin therapy is also the standard of care for patients with peripheral artery disease (that is, blockages that occur in the lower limb arteries) in all the international guidelines.”
Brand:Storvas C® Usage:Lowers LDL cholesterol levelsReduces the risk of heart attack and strokeHow to take:1-4 seeds 1 time a day after eating at nightSide effect:Common side effects:Diarrhea (up to 14.1%)Joint pain (up to 11.7%)Muscle pain (up to 8.4%)Stuffy nose or sneezing (up to 8.3%)Please tell your doctor if these side effects persist or worsen.Serious but rare side effects:Allergic drug reaction (rash, swelling of the mouth or eyes, shortness of breath)Unexplained muscle pain or weaknessIncreased liver enzymesBrain hemorrhagePlease tell your doctor immediately if you experience any serious side effects.This is not a complete list of possible side effects.
Please contact your doctor or pharmacist for more information.Use if pregnant:Category X: Avoid use – studies have shown harmful effects and may cause birth defectsUse if breastfeeding:Avoid breastfeeding – there is a risk of harm to the babyContraindications:History of allergic reactions to this drug or ingredients in this drugLiver diseasePersistent elevation of liver enzymes for no known reason
Please
contact your doctor or pharmacist for more informationJenama:
Storvas 40 MG Tablet is a medicine consisting of Atorvastatin. It is used in the treatment of high blood cholesterol and triglycerides (fats) levels. This medicine works by blocking the production of unhealthy fats in your body and prevents the risk of heart problems and stroke (a condition that causes reduced oxygen supply to the brain).
Storvas 40 MG Tablet has some side effects like nausea, weakness, muscle pain, stomach pain, etc. These side effects are mild and may subside by themselves. Consult your doctor if these side effects last for a long time or worsen.
Storvas 40 MG Tablet may be taken with or without food. Take the dose as directed by your doctor. Take it regularly at the same time for the ease of remembering. Avoid taking more than the recommended dose. Your doctor may suggest tests to regularly monitor your lipid profiles (fat levels in the blood) to make sure the medicine is working properly.
Storvas 40 MG Tablet is not recommended for use if you are allergic to it. Avoid taking this medicine if you have liver problems. Use this medicine with caution if you have diabetes, hypothyroidism (low levels of thyroid hormone in the body), or kidney problems. Inform your doctor if you are taking any other medicine as they may interact with this medicine and cause undesired effects.
Storvas 40 MG Tablet is not recommended for use in children below 10 years of age as the safety and efficacy data is not available. Consult your doctor if you are pregnant, planning a pregnancy, or are breastfeeding.
Atorvastatin
Description
Atorvastatin is a cholesterol-lowering medicine. It
works by blocking the action of an enzyme responsible for the production
of cholesterol in the body. Thus, it helps in reducing blood
cholesterol levels. It also prevents the risk of heart problems.
Atorvastatin may cause common side effects such as headache, nausea,
diarrhoea/constipation, indigestion, muscle pain, stuffy nose, etc.
Consult your doctor if these symptoms persist for a long time or if they
become severe.
Atorvastatin can be taken with or without food as instructed by your
doctor. Take it at the same time every day to maintain a constant level
of this medicine in your body. Do not skip a dose or discontinue the
treatment without consulting your doctor.
Atorvastatin is not recommended if you are allergic to it, or
have liver problems. Inform your doctor if you have diabetes as this
medicine may affect your blood sugar control. This medicine is not
recommended for use if you are pregnant or are breastfeeding.
This
count comes from a blood test called a lipid profile. The healthy total
cholesterol level for adults is below 200 mg/dL. It’s the sum of two
types of fats: “bad” (LDL) and “good” (HDL) cholesterol. But even if
your number falls in the desirable range, you still can have too little
of the good kind and too much of the bad, which clogs your blood
vessels. Aim to keep your LDL cholesterol under 100 mg/dL and your HDL
above 60 mg/dL.
Triglycerides
2/11
Triglycerides
can harden your arteries. High levels are linked to a higher risk of a
host of heart problems, like strokes and heart attacks, as well as
obesity and high blood pressure.
These readings are for healthy adults after 12 hours of fasting:
Desirable: Less than 150 mg/dL (1.7 mmol/L)
Borderline high: 150 to 199 mg/dL (1.7-2.2 mmol/L)
High: 200 to 499 mg/dL (2.3-5.6 mmol/L)
Very high: Greater than 500 mg/dL (above 5.6 mmol/L)
Who Needs a Lipid Profile?
3/11
Everyone
over 20 should get a full lipid panel every 4-6 years. Kids should have
a full lipid profile once ages 9-11 and again ages 17-21. That’s partly
because high cholesterol and triglycerides may lead to plaque buildup
in children and teens. Your doctor may want testing more often if you’re
at risk for heart disease or if you’re being treated for high
cholesterol. Acceptable total cholesterol for most people under 19 is
170 mg/dL.
Blood Sugar Test
4/11
It’s
also called a glucose test. High levels, or hyperglycemia, could be a
sign of diabetes or prediabetes. If you’re healthy, yours should be less
than 100 mg/dL after fasting. A reading of 126 mg/dL or higher means
you have diabetes. With two other tests -- glucose tolerance and random
blood sugar -- a level of 200 mg/dL or higher indicates diabetes. And
too low blood sugar may damage your brain or cause other health
problems.
A1c, or Hemoglobin A1c
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This
is a more complex way to gauge your blood sugar than with a blood
glucose test. Your A1c gives you a longer-term view of your average
blood sugar over 2-3 months. That matters because your glucose level can
swing a lot throughout the day if you have diabetes. A1c calculates the
percentage of red blood cells coated in sugar. A healthy level is
usually below 5.7%. If you have diabetes, your doctor will recommend
keeping it under 7%.
Urinalysis
6/11
Your
pee can show you a lot about your health. Its color, pH level, and the
presence of ketones, bacteria, and other substances can reveal diseases
and other problems. A urinalysis is routine if you’re pregnant or having
surgery. Other reasons for it include if your doctor suspects a urinary
tract infection (UTI) or kidney disease. If your urinalysis turns up
too much sugar, protein, or red blood cells, your doctor may need more
tests.
Red Blood Cell Count
8/11
These
cells carry life-giving oxygen throughout your body. If you’re low on
red blood cells, it might be a sign that you’re not eating enough
nutrients, are bleeding internally, or have bone marrow problems. A high
count might stem from heart disease or lung issues, among other causes.
The general range for good health is 4.5 million to 5.9 million cells
in a microliter of blood in men, and 4.1 million to 5.1 million cells in
women.
White Blood Cell Count
9/11
These
cells flood your body when they detect harmful invaders. So a high
white blood cell count may be a sign that you’re fighting an infection,
allergies, inflammation, or even cancer. A low count may mean bone
marrow problems, a weakened immune system from conditions like HIV, or a
poor diet. Stress and even too much exercise also can unleash your
white blood cells. Normal levels for adults are 3.4 billion to 9.6
billion cells/L.
Thyroid-Stimulating Hormone
10/11
Your
doctor might order this test if your thyroid gland is enlarged or has
bumps. Other reasons include a fast pulse, unexplained weight loss, or
other signs of an overactive thyroid. Low hormone levels may mean your
thyroid is sluggish. Symptoms include weight gain, puffy and dry skin,
and constipation. Medications, including multivitamins and supplements,
can affect your test results. So tell your doctor about everything you
take.
Platelet Count
11/11
These
blood cells help heal wounds and stop bleeding. But too many platelets
can form dangerous blood clots in your arms and legs that can cause
heart attacks or strokes. Low platelet counts may make you bruise easily
and to bleed from your gums, nose, and stomach. That may happen because
of bone marrow illness, viral infection, or alcohol abuse, among other
causes. A normal level is 150,000 to 450,000 platelets per microliter of
blood.