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Medical Voice 5th May 2019

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Dr KK Aggarwal    04 May 2019

First FDA-approved vaccine for the prevention of dengue disease in endemic regions

The U.S. Food and Drug Administration announced the approval of Dengvaxia, the first vaccine approved for the prevention of dengue disease caused by all dengue virus serotypes (1, 2, 3 and 4) in people ages 9 through 16 who have laboratory-confirmed previous dengue infection and who live in endemic areas.

The first infection with dengue virus typically results in either no symptoms or a mild illness that can be mistaken for the flu or another viral infection. A subsequent infection can lead to severe dengue, including dengue hemorrhagic fever (DHF), a more severe form of the disease that can be fatal. Symptoms may include stomach pain, persistent vomiting, bleeding, confusion and difficulty breathing. Approximately 95 percent of all severe/hospitalized cases of dengue are associated with second dengue virus infection.

“Infection by one type of dengue virus usually provides immunity against that specific serotype, but a subsequent infection by any of the other three serotypes of the virus increases the risk of developing severe dengue disease, which may lead to hospitalization or even death.

Dengvaxia is not approved for use in individuals not previously infected by any dengue virus serotype or for whom this information is unknown.

This is because in people who have not been infected with dengue virus, Dengvaxia appears to act like a first dengue infection – without actually infecting the person with wild-type dengue virus – such that a subsequent infection can result in severe dengue disease.

Dengvaxia is a live, attenuated vaccine that is administered as three separate injections, with the initial dose followed by two additional shots given six and twelve months later.

The FDA granted this application Priority Reviewand a Tropical Disease Priority Review Voucherunder a program intended to encourage development of new drugs and biologics for the prevention and treatment of certain tropical diseases. The approval was granted to Sanofi Pasteur.

Healthcare News Monitor

Pharma News

Indian-American pharma executive convicted of opioid racketeering

The Times of India- Chidanand Rajghatta

An Amritsar-born Indian-American pharma billionaire has been convicted of racketeering conspiracy that underscored a nationwide opioid crisis in which thousands of Americans have died. After two weeks of deliberation, a jury in Boston concluded on Wednesday that John Nath Kapoor, Founder and CEO of the pharma company Insys, and four other defendants, are guilty of running a bribery scheme in which they paid doctors to prescribe its potent and highly addictive opioid medication Subsys. They then lied to insurance companies to ensure that the expensive fentanyl-based painkiller would be covered. The bribery scheme included such marketing tactics as using a stripper-turned-sales-rep to give a physician a lap dance, and sham seminars. Although, it was meant for cancer patients in severe pain, Insys executive aggressively pushed doctors to prescribe Subsys, which can cost as much as $19,000 a month, even to non-cancer patients, prosecutors said.

Pharmacists want bridge course to serve at HWCs

The Times of India

Registered pharmacists in Maharashtra have demanded that they should be included in cadres eligible for the bridge course on community health and allowed to manage Health and Wellness Centers (HWCs) being established under the Ayushman Bharat Yojna. The state government had earlier decided to appoint Ayurveda graduates (BAMS) doctors for these posts. The decision had received staunch opposition from Indian Medical Association (IMA) due to which the state had to withdraw recruitment advertisement of more than 9,000 such posts. Now, after Lok Sabha elections, the government will re-introduce these recruitments with some fundamental changes. Pharmacists have taken this opportunity to raise their demands.

Easy access to drugs leaves students vulnerable

The Times of India- Gokul Rajendran & K Sambath Kumar

The arrest of three drug peddlers a few days ago who confessed to supplying drugs to students of leading colleges in Trichy has become a serious cause of concern. The youths were caught red-handed injecting diluted painkillers near National College on April 30. One of the accused, S Kaja Mohideen, 22, was caught injecting the drug while two others looked on. Kaja had admitted to have sold drugs to students of National College, Jamal Mohammed College and Bishop Heber College in the city. The police suspect that students of other colleges in the city too may have been targeted by the drug peddlers. Kaja used to get drugs from Puducherry for Rs 700 per 10 tablets. The police seized Tapentadol 50 mg (an analgesic), syringes filled with drugs, Rs 2,000 in cash, the car and few other materials from them.

GU researchers find new indicator of leukaemic drug resistance

The Times of India- Parth Shastri

About a quarter of the patients undergoing treatment for chronic myeloid leukemia (CML) worldwide show resistance to the most prevalent drugs within one year of therapy. A team from bio-informatics department of Gujarat University (https://timesofindia.indiatimes.com/topic/gujarat-university) (GU) has devised a mechanism to understand the specific drug resistance even before the treatment is commenced. The study was conducted by a team consisting of Dr Saumya Patel, his guide Dr Rakesh Rawal and doctoral student Krupa Shah. Dr Patel, assistant professor, has received the American Association of Cancer Research (AACR)’s Global Scholar-inTraining Awards (GSITA) for this work.

‘Spurious’ drugs worth lakhs seized

The Tribune

A joint team of the Drug Department of Chandigarh, Karnal and Bhiwani seized spurious medicines worth lakhs from an “unregistered” factory located at Jundla Gate here today. It collected nine samples, which will be sent to a lab for testing. Acting on a complaint received by the Karnal office, the State Drug Controller constituted a team led by Manmohan Taneja, Assistant State Drug Controller. “During the raids, we found that the unit was not duly registered. We seized spurious medicines worth lakhs and collected nine samples,” Dahiya said. “We have also seized printing material, stamps, and other equipments.” He said a notice would be issued to the firm owner. — TNS.

Ayush Min, CSIR pact to boost Indian herbal drug industry

Outlook - PTI

The Ayush Ministry and the countrys premier research agency, the Council of Scientific and Industrial Research (CSIR), have joined hands to explore modern scientific methods for integration with traditional medicine to boost prospects of Indian herbal products in the global market. According to the MoU between the two organisations, emphasis will be on research and development, ayush-specific diagnostic tools, multi-ingredient herbal formulations and their standardisation among others, said a ministry official. Various CSIR labs have already taken initiatives in this direction in the past too, for instance, scientists from the Central Institute of Medicinal and Aromatic Plants (CIMAP) and the National Botanical Research Institute (NBRI), had jointly developed anti-diabetic herbal drug BGR-34 a few years ago, another official said. The scientifically validated poly-herbal ayurvedic blood glucose regulator BGR-34 has been prepared from six medicinal plants including Daruharidra, Giloy, Gudmar and bitter gourds which are known for their anti-diabetic and anti-hyperglycemic properties. It is being marketed by Delhi-based AIMIL Pharmaceuticals.

Taking pot shots: It’s high time we legalised cannabis

First Post- Priya Mishra

Ness Wadia should consider himself lucky that he got caught with his hash stash in Japan rather than in India. Unless he gets himself into trouble in Japan again, his suspended sentence of two years will not result in any prison time. India, though, does not do suspended sentences, and if you get convicted under the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985, you’re looking at as many as 20 years behind bars for the manufacturing, possession, selling, or purchase of cannabis. That, to me, is insane. Cannabis is a part of Indian culture, with blessings dating back to the Vedas, which called it one of the five sacred plants and a giver of joy. We even escaped typical British attempts to criminalise a good thing, and continued smoking up peacefully until 1985, when after decades of pressure we decided to trot behind America’s footsteps and come down hard on all recreational drugs with the NDPS Act.

Healthcare News

Kolkata: FIR against doctor for molesting patient

The Times of India- Dwaipayan Ghosh

The Shyampukur police has registered a case against a doctor of a private nursing home for allegedly molesting a female patient and then clicking objectionable photographs of her to extort money. The cops said the FIR — drawn on Thursday — was registered following a court petition moved by the victim’s friend. Police have named a doctor working with the nursing home as the prime accused. The FIR has also mentioned that the doctor who carried out the “routine test” on the victim at the nursing home did not possess a MBBS degree. Police, after preliminary probe, however, said the doctor indeed had a valid MBBS degree

Doctors protest against ASRAM management

The Times of India- TNN

The Andhra Pradesh Junior Doctor’s Association (APJUDA) has written to the Director of Medical Education (DME) about police action on medical students at Alluri Sitarama Raju Academy of Medical Sciences (ASRAM) on May 1. In the letter given to the DME on Friday, representatives of APJUDA claimed that the ASRAM college management was giving 15 days as summer vacation instead of 30 days. When the students approached the management with regard to the issue, the management was not ready to address their concern. Thereafter, the students resorted to a protest in campus. In response, the college management brought in the police in campus and the police manhandled students and misbehaved with girl students who were agitating, APJUDA representatives alleged. APJUDA also alleged that the college management was threatening students of debarring them from exams if complaints are made to higher authorities regarding the issue.

Niti Aayog, NHM initiate discussions with stakeholders over strengthening health infra

The Times of India-M N Samdani

In an attempt to strengthen the health infrastructure, particularly in rural areas, Niti Aayog and National Health Mission (NHM) has initiated discussions with stakeholders of the system. With Telemedicine emerging as key segment to provide best medicare to the people living in remote areas of the country, Niti Ayog member Dr Vinod Kumar Paul and union joint secretary in the ministry of health and family welfare, Luv Agarwal held consultations with the executives of telemedicine society of India in New Delhi. Dr Paul, who is also National Medical Council (NMC) lead governor, explained the telemedicine society members that Niti Ayog is proposing to set up nearly 1.5 lakh wellness centres across the country and observed telemedicine would play a big role in providing the best health care to the people. He said that wellness centres are being designed to help treat diabetes, blood pressure to reduce the casualties due to heart attacks and brain stroke.

‘Indian adults are unaware they are ailing from hypertension’

The Hindu- Bindu Shajan Perappadan

Despite having a heavy burden of a hypertensive population, the proportion of adults with high blood pressure who are aware of their diagnosis, are treated and achieve control, is dismally low, noted the first large-scale, population-based study of hypertension care in the country. The study, which has been published in PLOS Medicine, was carried out by researchers at the Public Health Foundation of India (PHFI), Harvard T.H. Chan School of Public Health, the Heidelberg Institute of Global Health, the University of Birmingham and the University of Gottingen. According to the study, only 3 out of 4 individuals with hypertension has ever had their blood pressure measured, only 45% had been diagnosed, and only 8% of those surveyed had their blood pressure under control.

Main suspect in Delhi doctor’s murder arrested from Roorkee, was planning to kill himself: Cops

Hindustan Times

The main suspect in 25-year-old Delhi doctor’s murder, who was found dead with multiple stab wounds and her throat slit, was arrested from Uttarakhand’s Roorkee on Friday, two days after the incident. The suspect, Chandra Prakash Verma, also a doctor and victim’s flatmate, had been on the run since the murder and was arrested from near Gang Nahar in Roorkee by a team of Delhi Police crime branch. Police say Verma was planning to kill himself by jumping into the river. He had been staying in different hotels but changing them frequently. Before reaching Roorkee, Verma went to Uttar Pradesh also.

Using AI to detect mental health disorders may be counterproductive

The Indian Express- PTI

Advances in artificial intelligence (AI) technology have made it possible to detect mental disorders such as anxiety and depression from cues in a person’s voice, but doctors warn that adopting such tools in haste may prove to be counterproductive. Despite staggering number of patients being reported to suffer from disorders like depression, India struggles with the stigma of mental health diseases – deterring patients from getting the right help in time. AI-based vocal analytics may allow patients to detect the disease at home by just speaking into a smartphone application – eliminating the need to be physically present at treatment facilities for diagnosis. “This technology will be helpful to people who are bound by the stigma of going to a doctor for therapy or diagnosis,” Dr Rajendra Singh, a psychiatrist based in Bhopal, told PTI.

Countering the Diabetes Burden with Innovation : Dr. Vishwanath Mohan

ET Health World

As the diabetes capital of the world, India currently has about 72 million people with the disease and the number is expected to rise to a whopping 134 million by 2045. The prevalence is not just growing among the older generation but is now hitting the younger generation as well. According to a report by Indian Council of Medical Research, data in its diabetes registry show that one in every four people under 25 with diabetes in India has adult-onset type-2 diabetes, unlike before when type-2 diabetes was seen only in older adults or those with obesity. These statistics are not only worrying from a healthcare perspective, but also from an economic standpoint. What happens when the most productive section of society is affected by a lifestyle disease like type-2 diabetes, where poor diet and lack of exercise contribute to the onset of disease? Patients with diabetes are at risk for long-term complications (damage to the cardiovascular system, kidneys, eyes, nerves, blood vessels, and feet). The economy suffers, as people with diabetes have, on an average, two times higher healthcare costs than the ones living without the disease. This not only threatens the productivity level of our workforce but also means a significant loss of national income.

Doctors dispel myths on asthma treatment

Outlook

In view of rising asthma cases in the country, especially in the city, experts Friday called for more awareness and also stressed upon dispelling myths and fears associated with inhalation therapy. In India, the soaring numbers have reached 15-20 million and the number will continue to grow until adequate emphasis is laid on the importance of identifying the right medication, which can help manage asthma effectively, Dr Anant Mohan, the Head of Department of Pulmonary Medicine at AIIMS, said. The chronic disease affects a large population worldwide and its number is rising every year. According to the WHO Fact sheet, between 100 and 150 million people around the globe suffer from asthma. The reasons for the increasing prevalence of asthma are multifactorial. They include rising air pollution with increase in air particulate matter, smoking, incorrect treatment in children, and viral infections in early childhood.

CBI books ESIC doctors for demanding Rs 1 cr bribe from medicine supplier

Outlook

The CBI has booked two doctors for allegedly demanding a bribe of Rs one crore from a medicine supplier with the assurance of getting him listed as an agent of a noted pharmaceutical manufacturer under central rate contract, officials said Friday. Vikas Gupta and Kajal Goldar, both medical officers of ESI Corporation, now posted at its hospitals in Tirunelveli and Kolhapur respectively, have been booked by the CBI for alleged criminal conspiracy, cheating and under provisions of the Prevention of Corruption Act, they said. The action has been initiated on a complaint from the ESIC which conducted a vigilance probe against the two on a complaint from a Delhi-based medicine supplier. It was alleged that during 2016-17 Gupta, then working as medical officer, and Goldar as Director (medical), Delhi, had allegedly induced the supplier to pay Rs one crore as bribe for awarding a contract in Central Rate Contract (CRC) of ESIC for supply of medicine and dressings by engaging him a agent of a reputed manufacturer during the process of ensuing tender for CRC.

India Number 2 in chronic Hepatitis B infections

The Covai Post

With India at number two position after China in terms of the number of chronic Hepatitis B infections, there was an urgent need for Indians to get tested and avoid risk of its contraction, a leading gastroenterologist of the city said Friday. Nearly 50 million Indians are chronically infected with Hepatitis B, which is not only the most serious type of viral hepatitis but also highly contagious, Dr V G Mohan Prasad of VGM Hospital said here. People with vaccination and timely initiation of antiviral treatment are the pillars of hepatitis b virus prevention and control to prevent the development of major life threatening complications of chronic liver disease–cirrhosis (scarring of the liver) and liver cancer, he told reporters here.

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