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A Deadly Spill
August 25, 2006
It is the worst oil spill in Philippine history. Last August 11, MT Solar I, an oil tanker hired by Petron Corporation and carrying 2 million liters of bunker fuel sank 24 kms. off Guimaras after encountering some technical problems. According to newspaper reports, the vessel on its route toward Zamboanga del Sur was already leaning on its right side hours before the fateful incident but the crew decided to push through with the voyage. The water began to pour inside and it was not long before it was completely engulfed by the sea.
The result was devastating, endangering the vast marine life and mangroves as well as the livelihood of local fishermen and their families. As of this time, the spill has already hit Northern Iloilo and and threatens to involve the coast of Negros island as well. The rich blessings of Guimaras and Western Visayas which took years to evolve was spoiled in a flash. It is disheartening to see newspapers flooded with pictures of local residents holding up oil-laden dead fish and crustaceans. Even then, there is still the risk of continuing spill from the tanker 900 feet below and some reports claim that it is spewing 100-200 liters of oil per hour. It will take years to renew ecological balance and mend the local economy .
What could have gone wrong? Why had the tanker pushed through with the voyage despite the adverse conditions? Was the tanker overloaded? Were the captain and his crew qualified to operate the tanker and handle the cargo operation? These were the questions being raised by national observers. One leading columnist today lamented the fact that single-hulled tankers are still being used despite being banned by the International Maritime Organization. Clearly there are several issues that need to be resolved after what happened.
This was not the first time a similar incident happened. A few months earlier, a power barge ran aground in Semirara , Antique and also spilled thousands of liters of bunker fuel.
Obviously, we do not have the technological capability and expertise to address the problem. Cleaning the coasts is just a crude way of doing things and doesn't solve the continuing spillage of oil on the seabottom. The tanker has to be either retrieved or the oil suctioned underneath at its source. The affected area has spread to about 5 nautical miles as of this writing. We need to seek the help of international experts in dealing with this problem. Even if it entails a great expense, we need to employ the help of those countries who are well-versed in handling cases such as this.
This is the time for our legislators to make more useful congressional inquiries to look into those who are accountable, to review our maritime laws and their implementation, and to enact laws that would avert or minimize the chance of such disaster from happening again. Our government officials should set politics aside for now and focus on matters which are really more important such as cleaning up this dirty mess.
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Rational Use of Nitrates
In myocardial infarction , nitrates improve coronary blood flow in ischemic regions and reduce ventricular filling pressures and wall tension. This results in a smaller infarct size and lessens the incidence of mechanical complications.
Do nitrates decrease mortality?
The GISSI-3 and ISIS 4 trials looked into the effect of nitrates on short-term mortality. These 2 trials did not prove an effect of nitrates on short-term mortality. However, an analysis of 22 trials including more than 80,000 patients showed a small benefit on mortality with 3 to 4 fewer deaths in 1000 patients (Lancet, 1995).
Precautions with the Use of Nitrates
Care should be taken to avoid precipitous drops in blood pressure or induction of reflex tachycardia..The mean arterial pressure should be lowered by no more than 10% in normotensive patients and 30% in hypertensive individuals. The systolic blood pressure should not drop to less than 90 mm Hg. Heart rate should not exceed 110 beats per minute ( Alexander RW, 2001)
During the acute phase, IV nitroglycerin is preferred because of rapidity of effect and easier titration. Tolerance can later develop and responsiveness can resume after a 12 to18- hour off period. Tolerance is postulated to result from increased vascular production of free radicals and superoxide anions.
Headache, which is the most frequent side effect, generally subside after a few days of treatment. It is therefore prudent not to discontinue it on the first complaint if the nitrate is really necessary.
Avoid administering the nitrate and ACE-inhibitor dose at the same time to avoid postural hypotension. Allow an interval of at least an hour between the two. If postural hypotension supervenes, the diuretic and later, the nitrate dose should be adjusted before reducing or discontinuing the ACE inhibitor.
Do all myocardial infarction patients need nitrates and for how long?
The following patients with myocardial infarctions appear to benefit from nitrates:
- those with ongoing chest pain
- patients with left ventricular failure
- large transmural infarctions especially of the anterior wall to prevent ventricular remodelling (Antman 2005)
Patients with inferior wall infarcts particularly those with right ventricular infarction are sensitive to the decreased preload with nitrates and may experience further reduction in coronary flow (AHA Guidelines 1999).
Nitrates are not continued beyond 48 hours in asymptomatic patients unless they have persistent angina or ventricular failure.
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Views expressed on this column and any other by-lined articles on this site are the authors' own and do not necessarily reflect the views of the organization or its members.
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