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Medtalks with Dr K K
ICMR launched ‘Mission DELHI’, an emergency medical service, as part of which a motorbike-borne assistance unit can be quickly summoned for a person suffering heart attack or chest pain.
The pilot project has been launched in a radius of three kilometres around the AIIMS.
Under Mission DELHI (Delhi Emergency Life Heart-Attack Initiative), a pair of motorcycle-borne trained paramedic nurses would be the first responders for treating heart attack patients.
On getting a call, the pair would rush to the spot, gather basic information on the patient’s medical history, conduct a quick medical examination, take the ECG, and establish a virtual connect with the cardiologists at AIIMS and deliver expert medical advice and treatment.
While the emergency treatment is being provided, a CATS ambulance will arrive and take the patient for further treatment.
Even as the patient is on way to the hospital, doctors at AIIMS control centre will evaluate the data received from the nurses to establish further course of treatment.
The attempt is to reach patients within 10 minutes. In this project, the clot buster will be given very soon even at home.
Paint your plate with the colors of the rainbow
Adding color to your meals will help you live a longer, healthier life.
Phytonutrients have potent anti-cancer and anti-heart disease effects.
The American Cancer Society recommends 2 1/2 cups per day of fruits and vegetables. The most recent US Dietary Guidelines recommend consuming even more: 2 1/2 cups of vegetables and 2 cups of fruit, based on a 2,000-calorie diet.
Phytonutrients in every color
Red: Rich in the carotenoid lycopene, a potent scavenger of gene-damaging free radicals that seems to protect against prostate cancer as well as heart and lung disease [Strawberries, cranberries, raspberries, tomatoes, cherries, apples, beets, watermelon, red grapes, red peppers, red onions]
Orange and yellow: Provide beta cryptothanxin, which supports intracellular communication and may help prevent heart disease [carrots, sweet potatoes, yellow peppers, oranges, bananas, pineapple, tangerines, mango, pumpkin, apricots, winter squash (butternut, acorn), peaches, cantaloupe, corn]
Green: These foods are rich in cancer-blocking chemicals like sulforaphane, isocyanate, and indoles, which inhibit the action of carcinogens (cancer-causing compounds) [spinach, avocados, asparagus, artichokes, broccoli, alfalfa sprouts, kale, cabbage, Brussels sprouts, kiwi fruit, collard greens, green tea, green herbs (mint, rosemary, sage, thyme, and basil)]
Blue and purple: Antioxidants called anthocyanins believed to delay cellular aging and help the heart by blocking the formation of blood clots.[blueberries, blackberries, elderberries, Concord grapes, raisins, eggplant, plums, figs, prunes, lavender, purple cabbage]
White and brown: The onion family contains allicin, which has anti-tumor properties. Other foods in this group contain antioxidant flavonoids like quercetin and kaempferol [onions, cauliflower, garlic, leeks, parsnips, daikon radish, mushrooms]
[Harvard Katherine D. McManus, MS, RD, LDN]
NIH statement on World Malaria Day 2019
Statement of B.F. (Lee) Hall, M.D., Ph.D., and Anthony S. Fauci, M.D., National Institute of Allergy and Infectious Diseases.
Eliminating malaria — one of the world’s oldest and deadliest diseases — remains a critically important public health and biomedical research challenge. Despite remarkable advances in reducing malaria incidence and deaths since 2000, recent progress has become stagnant and has even reversed in some regions. The World Health Organization (link is external) (WHO) estimates that in 2017 about 219 million cases of malaria occurred worldwide and approximately 435,000 people died of the disease. Unfortunately, malaria cases increased from 2016 to 2017 in the 10 highest-burden countries in Africa, and the number of cases per 1,000 in populations at risk remained at 59 from 2015 to 2017.
Today, the National Institutes of Health recognizes World Malaria Day and commits to a reinvigorated malaria research program. This year’s World Malaria Day theme, “Zero malaria starts with me,” encourages governments, companies, academic institutions, philanthropies, and others to prioritize malaria, mobilize resources, and empower communities affected by malaria to lead and coordinate response activities. The National Institute of Allergy and Infectious Diseases (NIAID), part of NIH, is working toward “zero malaria” with coordinated global research projects to better understand the disease, improve diagnostics, treatments, and mosquito control interventions, and develop safe and effective vaccines.
NIAID works directly with scientists in malaria-endemic regions to build specialized local clinical research capacity. The NIAID-supported International Centers of Excellence for Malaria Research (ICEMR) program has more than 50 field sites in 17 endemic countries dedicated to multidisciplinary research on the complex interactions between the human host, mosquito vectors, and malaria parasites. ICEMR investigators share genomic and epidemiological data for parasites, mosquitoes, and human hosts through public databases such as PlasmoDB (link is external), VectorBase (link is external), and ClinEpiDB (link is external) to assist researchers in developing drugs, vaccines and diagnostics, and in improving public health programs.
ICEMR researchers are studying how the malaria-causing parasite adapts to antimalarial drug pressure and how that translates to the emergence and spread of drug resistance. Resistance to artemisinin drugs, used in most endemic areas, is emerging in Southeast Asia and appears to be spreading west. The ICEMRs are evaluating how asymptomatic malaria infections may contribute to persistent disease transmission and risk. Investigators also are studying how the behavior of malaria-transmitting mosquitoes is changing in response to insecticide use and environmental and ecosystem changes.
NIAID investigators and NIAID-supported scientists are helping to inform treatment policies in various countries by tracking genetic mutations in malaria parasites that indicate resistance to certain drugs. A team of experts recently identified a molecular marker of resistance to piperaquine (a combination therapy drug) in Cambodia (link is external) using publicly available genome sequence data.
Another international research team supported by NIAID created mutated versions of nearly all of the 5,400 Plasmodium falciparum (P. falciparum) parasite genes to determine which of the organism’s genes are essential to growth and survival. The information will help investigators prioritize targets for future antimalarial drug development. One investigational drug being evaluated, DM1157, is a modified form of the antimalarial drug chloroquine. Similar to chloroquine, it interferes with the malaria parasite’s metabolism; however, it inhibits the parasite’s ability to expel the drug, thereby avoiding the drug resistance seen with chloroquine. A Phase 1 clinical trial to evaluate the drug’s safety began in September 2018.
Cerebral malaria — a severe form of illness that can lead to brain damage, long-term neurological deficits, and death — remains a significant problem in sub-Saharan Africa. ICEMR investigators and their collaborators identified brain swelling as a potential contributor to the high mortality rate among children in Malawi with cerebral malaria. A clinical trial is underway to assess whether measures to reduce brain swelling can improve treatment outcomes. ICEMR investigators in India are studying whether the same findings are seen in adults with cerebral malaria, while NIAID researchers are working to develop novel adjunctive cerebral malaria treatments.
Certain populations, such as pregnant women, are at higher risk of developing severe disease upon contracting malaria. NIAID-supported researchers in Malawi recently found that administering the drug chloroquine as a weekly chemoprophylaxis (link is external) may prevent malaria in pregnancy. NIAID-supported scientists also found that children with high levels of maternal antibodies to the malaria antigen PfSEA-1 at birth have decreased risk of severe malaria during infancy.
NIAID also supports the development of various investigational malaria vaccines. The Institute has conducted and supported multiple early-stage clinical trials of PfSPZ, a candidate malaria vaccine made of weakened immature malaria parasites. It is designed to prevent malaria infection and is now being evaluated in multiple clinical trials in malaria endemic regions, including in infants and children. Another candidate vaccine based on a recombinant protein is currently in a Phase 1 clinical trial.
NIAID researchers also are working on a vaccine designed to block transmission of the malaria parasite from infected humans to mosquitoes. Although a transmission-blocking vaccine would not prevent malaria infection, by limiting further spread it could reduce new malaria infections over time. Results from a clinical trial in Mali indicate that the investigational vaccine, when formulated with an immunity-boosting adjuvant, shows promise. Plans are underway to evaluate the efficacy of the vaccine in a Phase 2 clinical trial in Mali.
NIAID scientists recently developed a monoclonal antibody from a person vaccinated with PfSPZ that potentially could be used for seasonal control and elimination efforts as well as by tourists, health care workers, and military personnel to prevent malaria infection. A trial evaluating the antibody’s safety and efficacy against a controlled human malaria infection (human challenge study) is planned for early 2020. NIAID experts also are collaborating with Malian scientists to discover additional broadly protective monoclonal antibodies.
Although recent data indicate that malaria control efforts may have stalled, numerous historical examples indicate that with enough commitment and ingenuity malaria elimination can be achieved, even after significant setbacks. NIAID-supported investigators, researchers and their collaborators are accelerating progress toward malaria elimination every day. On this World Malaria Day, we reaffirm our commitment to advancing the best research to reach our goal of “zero malaria.”
Harmful bacteria at 21 percent of ice cream plants in US
The US FDA has released a new report detailing that harmful pathogens were found at 21 percent of ice cream production facilities inspected in a recent, yearlong test, initiated following the national, deadly listeria outbreak in 2015.
The agency announced on Wednesday that researchers discovered listeria monocytogenes in 19 out of 89 ice cream plants in 32 states, inspected between September 2016 and August 2017. As noted by Politico, the plants inspected account for 16 percent of all American ice cream manufacturers.
Only one of the plants tested had salmonella, as per the findings.
The FDA launched the investigation in August 2016, as 16 ice cream products had been recalled since 2013 due to dangerous pathogens, coupled with a deadly listeriosis outbreak – connected to Blue Bell ice cream – that involved three fatalities and sent 10 others to the hospital, Fox 29 and Politico report.
When it came time to investigate, FDA officials wanted to inspect “larger establishments whose product would be expected to reach greater numbers of consumers.”
The FDA launched the investigation in August 2016, as 16 ice cream products had been recalled since 2013 due to dangerous pathogens, coupled with a deadly listeriosis outbreak – connected to Blue Bell ice cream – that involved three fatalities and sent 10 others to the hospital.
The FDA launched the investigation in August 2016, as 16 ice cream products had been recalled since 2013 due to dangerous pathogens, coupled with a deadly listeriosis outbreak – connected to Blue Bell ice cream – that involved three fatalities and sent 10 others to the hospital.[FOX NEWS]
Current Temperature Status and Warning for next five days
Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 24 April to 0830 hrs IST 25 April, 2019)
Yesterday, heat wave conditions observed at isolated pockets over West Madhya Pradesh (Annexure 1 & 2).
Maximum temperatures were markedly above normal (5.1°C or more) at many places over Arunachal Pradesh; appreciably above normal (3.1°C to 5.0°C) at most places over Nagaland, Manipur, Mizoram & Tripura; at many places over Himachal Pradesh, Haryana, Chandigarh & Delhi, West Madhya Pradesh and Assam & Meghalaya; at a few places over Rajasthan; at isolated places over Gujarat region and East Madhya Pradesh; above normal (1.6°C to 3.0°C) at most places over Vidarbha and Marathwada; at many places over West Uttar Pradesh, Madhya Maharashtra and Sub-Himalayan West Bengal & Sikkim; at a few places over Chhattisgarh, Karnataka, Kerala and Lakshadweep; at isolated places over East Uttar Pradesh and Gangetic West Bengal. Yesterday, the highest maximum temperature of 45.6°C recorded at Khargone (West Madhya Pradesh) (Annexure 1 & 2).
Temperatures Recorded at 1430 Hours IST of Today, the 25th April, 2019
Healthcare News Monitor
The Hindu Business Line- S Srinivasan
Both BJP and Congress manifestos do not squarely address concerns such as prices of medicines and hospitalisation costs. Manifestos are promises about how the future will be fashioned for the better if you elect a particular party to power. At the minimum, any manifesto on medicines must contain ideally the party’s stand on at least four measures: drug price control, marketing of medicines only under a generic name, banning all irrational fixed dose combinations, and implementation in all States of the Tamil Nadu/Rajasthan model of free medicines and diagnostics. Both the Congress and BJP manifestos say nothing about any of these basic pharma policy issues. BJP manifesto: The BJP manifesto’s “Health for All” section says: “In addition (to Ayushman Bharat Programme) we have conceived and implemented programmes for controlling prices of medicines…”
The Hindu- Aditya Anand
The Chhatrapati Shivaji Maharaj International Airport on Tursday said that it would soon launch India’s largest temperature controlled solution for the transportation of pharmaceuticals on the tarmac. The GVK-led Mumbai International Airport Limited (MIAL), which became the first airport in India and third in Asia to achieve the International Air Transport Association’s Center of Excellence for Independent Validators in Pharmaceutical Logistics (IATA CEIV) certification, said that temperature-controlled solution will help prevent temperature excursions of pharma products during air transport with the key objective of patient safety and reduction of losses attributed to logistical issues. The ‘IATA CEIV’ certification is an industry recognition, supporting the air transport industry to comply with pharmaceutical manufacturers’ requirements. A MIAL spokesperson said the Mumbai international airport had achieved this quality milestone for pharma logistics following training courses, on-site assessment, and complex validation processes. “Acknowledging the importance of this initiative, MIAL has initiated the certification process in a community approach together with its air cargo supply chain partners,” the spokesperson said.
The Hans India
National Research Development Corporation (NRDC), an Enterprise of DSIR, Ministry of Science and Technology, in association with National Institute of Pharmaceutical Education and Research, Hyderabad, organised a half-day national workshop on Management of Intellectual Property in Academia-Industry Collaboration on Thursday, Auditorium, National Institute of Pharmaceutical Education and Research, Balanagar. On this occasion, the Director of NIPER, Dr Shashi Bala Singh, set the tone for the workshop by emphasising on the importance and need to inculcate the IPR mindset in the potential workforce of the pharmaceutical sector. NRDC Chairman and Managing Director Dr H Purushotham, who was the chief guest, delivered the inaugural address on IP Management in Academia-Industry Collaboration while addressing the faculty members of various pharmacy colleges, Research scholars, students of pharmacy, prospective entrepreneurs by sharing his expertise on routes of commercialisation of an invention, IP and other support from Govt of India etc.
The Pioneer-Archana Jyoti
India may be the largest manufacturer of generic medicines in the world, but cancer-afflicted children, who are among society’s most vulnerable groups, remain a deprived lot as far as availability and affordability of essential anti-cancer drugs are concerned. This has been pointed out by a new study published in the British Medical Journal (BMJ) Global Health, which found that there is a lack of availability of essential anti-cancer drugs, in both public and private sector pharmacies even in the national Capital, for treating childhood cancer, so much so that it is much below the World Health Organisation’s prescribed standards. The study titled, ‘Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, India,’ was led by the George Institute for Global Health in collaboration with the University of Sydney, Cankids India, Max Super Speciality Hospital, and Boston University School of Public Health. Seven hospitals — four public and three private — and 32 private-sector retail pharmacies were surveyed.
Down to Earth- Banjot Kaur
Anti-cancer or chemotherapy drugs for children are cheaper in New Delhi than internationally, but still not cheap enough to be accessible to the poor, according to a study published in journal BMJ Global Health. The study added that a lowest-paid government worker in the country will have to spend wages he earned over 55 days to buy drugs needed to treat a child suffering from Hodgkins lymphoma and 88 days for standard risk leukaemia. “The estimated cost of chemotherapy medicines needed to treat a 30-kg child with standard risk leukaemia was Rs 27,850 and Rs 17,500 for early stage Hodgkin’s lymphoma,” said study collaborator and paediatric oncologist Ramandeep Arora. “If the patient or his/her family is not offered any discount and has to buy the medicines at MRP, they will require extra 12 days’ wages for both diseases. This will increase significantly if the disease is high-risk,” she added. Also, the availability of these drugs in Delhi’s public and private pharmacies do not meet the World Health Organization (WHO) standards. The mean availability of anti-neoplastic essential medicines across hospitals and private-sector retail pharmacies in the Capital was 70 per cent when the WHO availability target is 80 per cent. “Mean availability of anti-neoplastic medicines was 43 per cent and 71 per cent in public- and private-sector hospital pharmacies,” read the paper titled Evaluating Access to Essential Medicines for Treating Childhood Cancers: A Medicines Availability, Price and Affordability Study in New Delhi, India.
The Times of India
Shortage of essential drugs across government medical college hospitals is forcing doctors to use higher spectrum drugs or simply turn away patients for the past 10 days. While doctors at Government Rajaji Hospital (GRH) in Madurai said they were forced to prescribe analgesics (painkillers) instead of simple paracetamol, those in many other hospitals had asked patients to purchase drugs from a private drug store or return to hospital after a week. Senior health officials said the crisis spiralled due to a combination of reasons including lack of bidders for a dozen drugs and inadequate supply of raw material to manufacturers. “There are about 32 drugs in short supply. It will take at least two weeks for the problem to be completely resolved,” said a senior health official.
Pharmacy Business-Lakshmi PS
India’s pharmaceutical exports rose 11 per cent to $19.2 billion in 2018-19, mainly driven by higher demand in regions such as North America and Europe, as per a Commerce Ministry data. The pharma exports in 2017-18 stood at $17.3 billion and $16.7 billion in the previous fiscal. North America constitutes about 30 per cent of Indian pharma exports, followed by Africa and the European Union with 19 per cent and 16 per cent share, respectively, according to the data. According to industry experts, the Chinese market is also gradually opening up and the government is working to push India’s exports there as it holds huge potential. The other important destinations include South Africa, Russia, Nigeria, Brazil and Germany, where exports are registering growth. The sector accounted for about 6 per cent of the country’s total exports of $331 billion in 2018-19. It is one of the top five sectors in the exports segment. Generic drugs form the largest segment of the Indian pharmaceutical sector, with 75 per cent market share (in terms of revenues). India supplies 20 per cent of global generic medicines in terms of volume, making the country the largest provider of generic medicines globally.
The Indian Council of Medical Research (ICMR) launched a pilot project — Mission DELHI (Delhi Emergency Life Heart-Attack Initiative) — in a range of 3 km around All India Institute of Medical Sciences (AIIMS) where people may soon be able to call (toll free numbers 14430 and 1800111044) for a motorbike-borne emergency medical assistance unit in the eventuality of heart attack or chest pain. The project has institutional support from Cardiology & Emergency Medicine departments of AIIMS and funding from the ICMR. Under the project, a pair of motorcycle-borne trained paramedic and nurse would be the first responders for treating heart attack patients, stated the ICMR. On getting the call, the pair would rush to the spot, gather basic information on his or her medical history, conduct a quick medical examination, take the ECG of the patient and establish a virtual connect with the cardiologists at AIIMS, and deliver medical advice and treatment. A release issued by the council added that while the emergency treatment is being provided, a CATS ambulance will arrive and take the patient for further treatment. Even as the patient is on way to the hospital, qualified doctors posted round the clock at the control centre at AIIMS will evaluate the data received from the nurses to establish a further course of treatment as soon as the patient reaches the hospital.
Patient’s basal cell carcinoma was treated in two parts; experts advise against prolonged exposure to sun — a cause of ailment. Doctors from a city hospital successfully performed the Mohs Microscopic Surgery (MMS) to treat 46-year-old’s skin cancer — a procedure that is considered ‘gold standard’. It is used to evict common skin cancers such as the basal cell carcinoma (and others), which had prominently cropped up on the patient’s face. He underwent treatment at Columbia Asia Hospital, which claims that this was the first such surgery performed in the city to cure skin cancer. A team of doctors, led by dermatologist and cosmetologist Dr Kusumika Kanak, plastic surgeon Dr Sumit Saxena, and consultant—internal medicine Dr Prathibha Walde performed MMS on Prashant Patil (name changed). He said that initially, lesions and sores appeared on his head and neck, following which there was a change in the skin. “The sore did not heal and so, I approached the doctors. I was shocked on hearing that it was a kind of cancer. They informed me that the lesion may sometimes rupture and bleed,” he said.
The Telegraph-Ritu Basu
Doctors, nurses, students and employees of SSKM Hospital donated blood on Thursday to replenish the stock of their blood bank. SSKM and other government hospitals in Calcutta is running short of blood as donation camps cannot be organised because of the Lok Sabha elections, a hospital official said. The situation has been “bad” for the past two weeks and patients have been suffering. Which is why the hospital organised the camp on Thursday, the official said. Pratik Dey, the blood bank in-charge at SSKM, said there were several occasions recently when the hospital could not provide blood to relatives of patients. The blood donation started at 9.30am on the hospital premises on Thursday and by the time the camp was wrapped up around 5pm, 678 people, including MBBS students, junior doctors, professors, nurses and other employees, had donated blood, Dey said. Relatives of some patients wanted to donate blood but Thursday’s camp was restricted to hospital employees. “There is a deficit at all the blood banks in the state; so, we sent 150 of the 678 units collected to the Central Blood Bank at Maniktala,” said Dey. At times during shortage, negative blood groups are hard to get but this time the problem is so severe acute that even positive blood groups are not available, a Belle Vue Clinic official said.
As people become more aware of the overuse of antibiotics, doctors are turning to antibiotics alternatives to heal acne, a study has revealed. The findings, published in the journal Dermatologic Clinics, surveyed studies on acute and long-term acne treatments over the past decade to identify trends. "People are more conscious about the global health concern posed by the overuse of antibiotics and that acne is an inflammatory, not infectious, condition. Overuse of antibiotics can also promote the growth of resistant bacteria, which can make treating acne more challenging," said Hilary Baldwin, a researcher. Prolonged use of antibiotics can affect the microbiome (trillions of bacteria, viruses and fungi that inhabit our bodies) in areas other than the skin, resulting in diseases. The report noted that people who use topical and oral antibiotics were three times as likely to show an increase of bacteria in the back of their throat and tonsils compared with non-users. Long-term use of antibiotics in acne treatment is also associated with an increase in upper respiratory infections and skin bacteria and was shown to affect a users blood-sugar level.
With latest technological advancements and innovative practices, Apollo Hospitals is trying to boost patient care in rural areas. It is the largest telemedicine provider in India, enabling people to avail tele-emergency services in inaccessible regions, says Dr K Hari Prasad, President, Hospitals Division, Apollo Group, in conversation with Sudheer Goutham of Elets News Network (ENN).Dr K Hari Prasad Q Apollo Hospitals has been at the forefront in adapting and integrating technologies to enhance patient care. Tell us about some recent breakthroughs? We, at Apollo, always believe in getting the best for our patients – clinical teams, processes, and technology. Some of the recent breakthroughs include Proton Beam Therapy where high-energy proton beam is used for cancer treatment. It is one of the most superior forms of radiation therapy in the world. The therapy will usher in a paradigm change in cancer treatment. Unlike any other radiation treatment, it provides targeted treatment and intensification. Conventional radiotherapy uses high energy X-rays for treatment of cancer and certain benign tumours. In doing so, it damages the surrounding healthy tissue. In contrast, proton beam delivers a high dosage of radiation, targeting the tumour cell. The novel method increases chances of cure and minimises adverse effects to surrounding healthy tissues. Moreover, the biggest advantage of this technology is proper dose distribution. A low dosage of radiation is being emanated at the body surface followed by a sharp burst once it hits the tumour.
Daily News & Analysis
When 31-year-old doctor Auqfeen Nisar was treating patients during her weekly Out Patient Department (OPD) in the poor Srinagar neighbourhood, she was shocked to find out that adolescent girls were using cloth during their periods because they were fed with the notion that sanitary pads lead to infertility. Pained by the poor hygiene, social taboos and lack of affordability, Dr Auqfeen decided to start the crowdfunding to provide sanitary pads to the impoverished girls and combat the related infections. "On Wednesdays, we visit the sub-centre to monitor immunization session and at the same time, we conduct OPDs. During these sessions, I observed that menstrual hygiene among adolescent girls was very poor. I thought of starting the project on an individual level which I named Panen Fiker (lets take care of ourselves). It is a project in social marketing to enhance the use of sanitary pads among the adolescent girls", said Dr Auqfeen, who is pursuing MD in Community Medicine at Government Medical College, Srinagar.
The Hindu Business Line
In a four-way partnership with the Madras Diabetes Research Foundation (MDRF) in Chennai, the KEM Hospital and Research Centre in Pune and the PD Hinduja Hospital and Medical Research Centre in Mumbai, the Hinduja Foundation has teamed up to provide treatment and support to underprivileged patients of Type 1 diabetes, previously known as juvenile diabetes. The aim is to build awareness of the condition and support research into the disease. The project currently has more than 500 patients from poor socio-economic background. As part of the programme, patients in Chennai, Pune and Mumbai will have access to diagnosis, medical consultation and insulin treatment. All clinical data collected, with the consent of patients, will be used for longitudinal reporting and correlation with disease progression, combined with related research for possible future publication in scientific journals. The clinical data will be pooled to build a comprehensive picture of the Type 1 diabetes disease profile in India.