Medtalks with Dr KK

1. Diabetic nephropathy is defined by an eGFR of 30 to < 90 mL/min/1.73 m2 and modest proteinuria of > 300 mg per gram of creatinine.
2. Most ST-segment elevation MI (STEMI) patients received unnecessary intensive care after undergoing uncomplicated primary percutaneous coronary intervention (PCI) in 2011-2014, Medicare data indicated.

Paracetamol can reduce feelings of empathy

Investigators showed scenarios of positive experiences to 114 college students who had taken either paracetamol (1000 mg) or placebo and found that those who had taken acetaminophen experienced less pleasure and empathetic feelings toward the hypothetical characters in comparison with those who had taken placebo.

Paracetamol reduced the affective, although not the cognitive, side of empathy. [Dominik Mischkowski, PhD, visiting assistant professor, Department of Psychology, Ohio University, Athens].

The study was published online March 29 in Frontiers in Psychology.

Not Eating Good Food vs Eating Bad Food

Of the 11 million deaths in 2017 attributed to dietary factors, more were associated with inadequate intakes of healthy foods than with superfluous consumption of unhealthy ones, according to the Global Burden of Disease 2017 (GBD 2017) study, published online April 3 in The Lancet.

Globally, the largest deficiencies in healthy food consumption were related to nuts, seeds, milk, and whole grains, whereas sugary drinks, processed meats, and sodium were overconsumed.

Leading dietary risk factors for mortality are diets high in sodium, low in whole grains, low in fruit, low in nuts and seeds, low in vegetables, and low in omega-3 fatty acids.

Nonoptimal consumption of whole grains, fruits, and sodium accounted for more than 50% of deaths and 66% of disability-adjusted life years (DALYs) attributable to diet.

15 relevant dietary factors as:

• diets low in fruits, vegetables, legumes, whole grains, milk, nuts and seeds, fiber, calcium, seafood-derived omega-3 fatty acids, and polyunsaturated fatty acids
• diets high in red meats, processed meats, trans fatty acids, sugary drinks, and sodium

Healthcare News Monitor

Dated: 19th April, 2019

Pharma News

Categorise all medical devices as drugs: Panel

Deccan Herald-Kalyan Ray

New Delhi: India’s topmost advisory body on pharmaceuticals has recommended regulating all medical devices as “drugs” for better safety, quality and performance of the devices, ranging from syringes at one end to implants and pacemakers on the other side. The Drugs Technical Advisory Board (DTAB) has agreed to notify all medical devices as drugs in its last meeting. At the moment 23 medical devices are regulated as “drugs” — ranging from hypodermic needles and condoms to cardiac stents, heart valves and orthopaedic implants — under the law.

The need to consolidate the CDMO industry

Forbes India-Vivek Sharma

Pharmaceutical research and development (R&D) is a long, complex and resource-intensive process. While the cost per New Molecular Entity (NME) approval has increased by 50 percent between 2014 and 2017, the median peak sales value per FDA approval has remained fairly constant at $1.0 billion during the same period. For pharmaceutical companies, innovation and speed are more critical than ever and there is a need to drive more programmes through the clinic, to alleviate the impact of clinical attrition. Large pharmaceutical companies are striving to de-risk R&D efforts and improve the speed-to-market of their life-changing drugs, while at the same time, reducing their development and manufacturing costs.

Can India lead the way in managing cardiovascular disease?

Medical Xpress-Mandira Banerjee

There are more than 55 million people in India with cardiovascular disease. As India considers a national Essential Diagnostics List, University of Michigan researchers Lee Schroeder and Ahmad Abdul-Aziz take a deep dive on how this list might provide much-needed help for tackling the burden of cardiovascular diseases in India.

Granules India gets USFDA nod for pain relief drug

The Economic Times 

New Delhi: Drug firm Granules India Thursday said it has received approval from the US health regulator for Acetaminophen tablets, used for temporary pain relief. The approved product is bioequivalent to the reference listed drug product (RLD), Tylenol tablets, extended release. The US Food and Drug Administration (USFDA) has approved its abbreviated new drug application (ANDA) for Acetaminophen 650 mg tablets, extended release, Granules said in a BSE filing.

‘Pharmacy’ to be used in place of ‘chemists & druggists’

Hindustan Times-Rhythma Kaul

New Delhi: The words “chemists and druggists” appearing on the signboards of medical shops will soon have to be replaced with the word “pharmacy” following an order by the government’s top advisory body on drugs. Dr S Eswara Reddy, drugs controller general of India, said, “Stores are using different nomenclatures and there was a need to bring in uniformity. Globally, the word pharmacy is used and widely accepted, so we decided to do the same.”

Curb drug abuse with focus on public health

The TribuneGuest Article

GRAPPLING with drug abuse, countries are realising that the only way to progress is to focus on people rather than drugs. As per the UNODC (United Nations Office on Drugs and Crime) World Drug Report-2017, around 2.95 crore people or 0.6 per cent of the global adult population suffers from drug use disorders, including dependence. Around 20 per cent of the world’s prison population takes drugs, compared to an estimated 5.3 per cent in the community. As Punjab confronts a growing epidemic of drug and substance abuse, policy-makers, law enforcers and public health officials need to pay heed to the International Guidelines on Human Rights and Drug Policy (2019). These introduce a comprehensive catalogue of human rights standards. India needs to learn lessons from other countries which have dealt with drug abuse. Policy-making requires a clear understanding of whether, how and to what degree imprisonment for drug offences affects the nature and extent of the drug problem. A ‘zero tolerance and deterrence’ approach hasn’t worked. The US could not win the war against drugs, launched in 1971 by then President Richard Nixon. It was extended by then President Ronald Reagan to the demand side; during his rule, the Crime Bill led to a crackdown on addicts. The stiffer prison terms did not curb drug abuse.

DCGI directs drug manufacturers to incorporate adverse effects in leaflets

Mint-PTI

New Delhi: The Drug Controller General of India (DCGI) has written to all state drug regulators to direct manufacturers of certain antibiotics and anti-psychiatric drugs to include their new recorded adverse effects in the leaflets inside the package to promote patients safety. The aim is to make the patients and doctors aware of the new adverse reactions of certain drugs which are prescribed frequently for certain conditions and also to stop indiscriminate use of such medicines, a senior health ministry official said. The move comes following a report of by the Indian Pharmacopoeia Commission (IPC) which collected and analysed reports of adverse events associated with the use of certain drugs and then based on scientific findings sent recommendation to the Central Drugs Standard Control Organization for regulatory intervention. "The National Co-ordination Centre or Pharmacovigilance Programme of India, functioning at IPC Ghaziabad, has forwarded their recommendations based on adverse drug reaction (ADR) reports on certain medicinal products with an objective to prescribe information leaflet change from Indian database and promote patient safety," the official said.

After J&J case, govt. treads carefully

The Hindu-Bindu Shajan Perappadan

New Delhi: The government may make it mandatory for import license holders to maintain control samples of imported drugs. The Drugs Technical Advisory Board (DTAB) has recommended amendment to Rule 26 of the Drugs and Cosmetics Rules, 1945, which deals with conditions under import licences. The DTAB says of the proposed change: “The licensee shall maintain reference samples from each batch of the drugs imported by him in a quantity which is at least twice the quantity of the drug required to conduct all the tests performed in the batch.” “In case of drugs bearing an expiry date on the label, the reference samples shall be maintained for a period of three months beyond the date of expiry or potency. In case of drugs where no date of expiry or potency is specified on the label, the reference samples shall be maintained for a period of three years from the date of manufacture.” A senior health official explained that, previously, the rules applied to indigenous manufacturers marketing drugs in the country, adding, “There was no such condition available in the import licence under the Drugs and Cosmetics Rules, 1945.”

Tribal Girl Opens Maoist Area’s First Medical Shop

Northeast Today 

NET Bureau: A 23-year-old tribal girl has opened the first medical store in Chhattisgarh’s remote Abujmarh forest, a Maoist stronghold, reported Times of India. It’s a boon for the locals who had to travel 70km to find a proper pharmacy in the dense woodland of about 3900 sq km. Kirta Dopra belongs to the Muria tribe and with the help of the local sarpanch, panchayat secretary and local residents, she was able to set up shop in the middle of the forest, in Orcha at the Narayanpur district. The forest had been declared as a “liberated zone” by the Maoists and had few government facilities. When the Jan Aushadi Kendra in the area was shut down, Kirta started asking the locals what medicines they require so that everything is need is available. Kirta told TOI "It was not easy to set up a medical store in such an inaccessible region. We fought hard to make it happen. I feel happy that my people and residents of this region won’t have to travel long distances to buy medicines. It will save time, money and perhaps lives.” Though the Orcha community health centre is responsible for giving out free medicines, it’s usually not well-stocked. It is difficult to successfully run a government centre in a Maoist area. The chief medical officer of Narayanpur, Dr Anand Ram Gota, applauds the young girl’s initiative.

Healthcare News

Diabetics not aware about effects of fasting, warn experts

Daily News & Analysis 

If you are diabetic and are planning to fast, you might want to consider consulting the doctor first. For, the benefits of fasting, religious or otherwise, may turn out to be counter-productive for diabetics, experts have warned. Endocrinologists in the city say awareness about impacts of fasting on diabetics is very low and patients often underestimate the risks involved, leading to high or low blood sugar. Those that suffer from other ailments such as kidney diseases and blood pressure also run the risk of dehydration and other conditions.

PGI to hold free screening for Hepatitis B & C patients today

The Tribune 

Chandigarh: The PGI will hold a free screening for Hepatitis B and C patients on the occasion of World Liver Day at the liver clinic on the fourth floor of the new OPD here on Friday. “It is essential to maintain body weight by doing exercise regularly and having a balanced and healthy diet (less sugar and more of proteins and fibres). This is a major intervention for maintaining a healthy body and a healthy liver. Also vaccinate yourself against Hepatitis B,” said Prof RK Dhiman, HoD, Hepatology.

Doctors notice spurt in cases of non-alcoholic fatty liver disease

The Hindu-Khevna Pandit

Mumbai: There has been a hike in cases of non-alcoholic fatty liver disease (NAFLD) this year as compared to 2018. While no definite statistics are available yet, doctors say they are observing at least 10 to 12 new cases every month, with patients being across age groups. Fatty liver disease is a disorder that occurs due to excessive build-up of fat, which leads to scarring of the liver. April 19 is observed as World Liver Day.

Doctors and paramedics at highest risk of violence at workplace

The Week-Namita Kohli

This week, the Delhi government passed an order that brought some relief to doctors in the city. According to the order, passed by the state health ministry, hospitals are now required to file an FIR or complaint, in case of an incident involving abuse or violence by patients or their attendants. However, individual doctors, paramedics, nursing or administrative staff cannot be asked to lodge this FIR/complaint with the police. Violence against doctors by patients and their attendants is an issue around which doctors in the country have successfully mobilised around. Seeking redress against the “rising incidents” of violence perpetrated on them, doctors have staged several protests on this issue, and even demanded policy measures to address the issue.

NATCO sets up sleep lab at govt hospital

The Hans India 

Hyderabad: Tucked away in a cozy corner of the vast premises of the Guntur General Hospital, Andhra Pradesh, a sleep lab tries to understand the mechanisms of one of the most fundamental needs of any human being – sleep! Funded by the Natco Trust in 2017, it is one of the few sleep labs available in Indias government hospitals and provides free services to common people suffering from disorders like insomnia and sleep apnea amongst others. This is the only government run sleep lab in Guntur apart from a couple of private facilities. Sleep deprivation has a huge impact on a persons health and can lead to many complications including depression, hypertension, metabolic and physiological disorders.

Government Medical College’s cardiology wing among nation’s top 10

The New Indian Express 

Thiruvananthapuram: In a major achievement for the Government Medical College, its cardiology department figures among the top 10 cardiology wings in the nation. It was during the National Intervention Council of the Cardiological Society of India’s mid-term meet at Lucknow that the list was announced. The department was felicitated for successfully carrying out 3,924 coronary angioplasty surgeries. It also received special mention for its excellent record keeping. “In 2018, we had handled around 1,200 angioplasty cases for heart attack. The department on an average handles 450 to 600 angioplasty cases a month. Other than angioplasty, procedures like pacemaker installation, heart hole treatment, rectification of heart muscle problem are carried out by the department,” said Dr Sunitha Viswanathan, head of cardiology department.

Dated: 19th April, 2019

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 18 th April to 0830 hrs IST of 19th April, 2019)

Heat Wave: 

Nil (Annexures 1 & 2).

Maximum Temperature 

Maximum Temperature more than 40.0°C was recorded at many places over Rayalaseema; at a few places Vidarbha, Telangana, North Interior Karnataka and at isolated places over Odisha, Marathawada and Kerala.

Maximum temperature departures as on 18-04-2019: Maximum temperatures were above normal (1.6°C to 3.0°C) at many places over Kerala and Lakshadweep; at a few places over Tamilnadu & Puducherry; at isolated places over Odisha, Sub- Himalayan West Bengal & Sikkim and Assam & Meghalaya. They were markedly below normal (-5.1°C or less) at most places over Uttarakhand, Punjab, Rajasthan, Haryana, Chandigarh & Delhi and West Uttar Pradesh; at a few places over Himachal Pradesh; at isolated places over Jammu & Kashmir and Madhya Pradesh; appreciably below normal (-3.1°C to -5.0°C) at most places over East Uttar Pradesh; at many places over rest Madhya Pradesh; at isolated places over Gujarat region; below normal (- 1.6°C to -3.0°C) at many places over Gangetic West Bengal; at isolated places over Saurashtra & Kutch and Madhya Maharashtra near normal over rest parts of the country.

The highest maximum temperature of 42.1°C was recorded at Bramhapuri (Vidarbha) over the country.

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 19 th to 0830 hrs IST of 20th April 2019):-

Nil