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Medical Voice 9th May 2019

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Dr KK Aggarwal    08 May 2019

WHO welcomes industry action to align with global trans fat elimination targets

WHO has welcomed the commitment by the International Food and Beverage Alliance (IFBA) to align with the WHO target to eliminate industrially produced trans fat from the global food supply by 2023.

WHO Director-General Dr Tedros Adhanom Ghebreyesus met with IFBA representatives, including chief executive officers from several of the 12 companies comprising the alliance, on 2 May 2019 to discuss actions to take to eliminate industrial trans fats, and reduce salt, sugar and saturated fats in processed foods. The meeting also stressed the value of regulatory action on labelling, marketing and called industry to full adherence to the WHO Code of marketing of Breast Milk Substitutes.

“The commitment made by IFBA is in line with WHO’s target to eliminate industrial trans fat from the global food supply by 2023,” Dr Tedros said. “WHO will be monitoring the next steps to be taken by companies to help ensure the commitment is realized.”

Of particular note was the decision to by IFBA members to ensure that the amount of industrial trans fat (iTFA) in their products does not exceed 2 g of iTFA per 100 g fat/oil globally by 2023. This is in line with the WHO’s objective and recommendations of its REPLACE action package, which was developed and launched in 2018.

“Eliminating industrially-produced trans fat is one of the simplest and most effective ways to save lives and create a healthier food supply,” added Dr Tedros.

In line with the REPLACE initiative, WHO has called on all food producers and oil and fat manufacturers, not only IFBA members, to commit to elimination of industrial trans fat from the global food supply… (WHO, May 7, 2019)

Emergency risk communication package pioneered by WHO/Europe rolls out globally

WHO/Europe’s 5-step emergency risk communication (ERC) package, first launched in 2018, was rolled out to the global organization on 2nd May this year, following its proven use as an effective tool for numerous countries in the WHO European Region. ERC plays a vital role in health emergencies – from prevention and preparedness to response and recovery. It has the potential to be a life-saving part of any emergency situation and should be considered an important investment in health, safety and security.

The package was tested in 13 countries in the Region before the final version was launched, and it is now being implemented by 20 countries, all using the tool to guide the development of their ERC plans. The five-step package is a unique, sustained, country-tailored capacity-building project in ERC. It comprises:

1.Training

2.Capacity mapping

3.Plan writing

4.Plan testing

5.Plan adoption

(Source: WHO Europe, May 7, 2019)

Everyday stress may augment blood vessel dysfunction in people with depression

A study published in the Journal of the American Heart Association has found that for people with depression, small, everyday stressors may be enough to augment blood vessel dysfunction in otherwise healthy adults. In the study, among adults with depression, those who had experienced stress in the previous 24 hours had worse endothelial function compared to those who had only depression.

Jody Greaney, now an assistant professor at the University of Texas at Arlington, who led this study as a postdoctoral research fellow at Penn Stat said, "Adults with depression also experienced more stress and rated it as being more severe than healthy nondepressed adults, which confirms the link between stress and depression. Additionally, adults with depression may have worse vascular function in general, although endothelial function was worse when depression and stress were combined."

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 06 May to 0830 hrs IST of 07 May, 2019)

Heat Wave:

Yesterday, heat wave conditions were observed in isolated pockets over Coastal Andhra Pradesh and Telangana. (Annexure 1 & 2).

Maximum Temperature

Maximum Temperature more than 40.0°C was recorded at most places over Rajasthan, Uttar Pradesh, Haryana, Chandigarh & Delhi, Madhya Pradesh, Rayalaseema, Marathawada, Vidharbha, Bihar and Telangana; at many places over Rayalaseema, Chhattisgarh; at a few places over Saurashtra & Kutch and Coastal Andhra Pradesh and at isolated places over Odisha, Jharkhand, Gujarat Region, Jharkhand, Punjab, Madhya Maharashtra, North Interior Karnataka and Tamilnadu & Puducherry.

Maximum temperature departures as on 06-05-2019: Maximum temperatures were appreciably above normal (3.1°C to 5.0°C) at many places over Sub-Himalayan West Bengal and Bihar; at a few places over Coastal Andhra Pradesh, Telangana, Rayalaseema, Tamilnadu & Puducherry; at isolated places over Coastal & South Interior Karnataka and Kerala; above normal (1.6°C to 3.0°C) at most places over Nagaland, Manipur, Mizoram & Tripura, Uttarakhand, East Uttar Pradesh and West Rajasthan; at many places over Gangetic West Bengal and Chhattisgarh; at a few places over Assam & Meghalaya, Punjab, Haryana, Chandigarh & Delhi, Himachal Pradesh, Jammu & Kashmir, West Uttar Pradesh, Saurashtra & Kutch and Madhya Maharashtra and at isolated places over Vidarbha. They were below normal (-1.6°C to -3.0°C) at many places over Andaman & Nicobar Isolated, Arunachal Pradesh; at isolated places over Odisha and near normal over rest of the country.

Yesterday, The highest maximum temperature of 45.6°C was recorded at Bramhapuri (Vidarbha) and Khammam (Telangana).

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 07 May to 0830 hrs IST of 08 May 2019):-

Heat wave conditions in some parts very likely over Telangana and coastal Andhra Pradesh; at isolated pockets over interior Tamilnadu & Puducherry, Vidharbha and West Rajasthan.

Healthcare News Monitor

Pharma News

Vivimed recalls hypertensive drugs from US market due to impurities

The Hans India- PTI

Vivimed Life Sciences Pvt Ltd, a city-based pharma company has started recalling 19 lots of Losartan Potassium Tablets USP 25 mg, 50 mg, and 100 mg to consumer level in US, as the product was found to have impurities that may cause cancer, a US Food and Drug Administration said. The product is made by Vivimed at its Plant in Alathur, Chennai and distributed by Heritage Pharmaceuticals Inc, East Brunswick NJ in the US. To date, neither Vivimed nor Heritage has received any reports of adverse events related to this recall, it said. "Vivimed Life Sciences Pvt Ltd (Vivimed) is recalling 19 lots of Losartan Potassium Tablets USP 25 mg, 50 mg, and 100 mg to consumer level due to detection of an impurity N-Nitroso-N-methyl-4-aminobutyric acid (NMBA) that is above the US Food and Drug Administrations interim acceptable exposure limit of 9.82 ppm.

India must stop blind reliance on US-cleared medical devices: Patient groups

Daily News & Analysis

With a report on flawed clearance of medical devices and implants garnering global attention, patient groups have sought stricter foreign regulatory nods for such products before their entry into the Indian market. The report claims 80,000 deaths and 20 lakh injuries in the last decade in the US alone. Citing the case of Johnson & Johnson, involving faulty implants, the groups say India should not blindly rely on foreign approvals to medical products as it has no information system for patients in case of a device failure. After the US Food and Drug Association said last month that there was no guarantee for the long-term safety of the vaginal mesh products, which have existed for decades and are implanted to hold pelvic organs to reinforce the weakened vaginal wall, investigations showed that the synthetic nettings alone have caused 80 deaths till 2018 and over 1 million claims, said a report by the New York Times.

Glenmark halves price of anti-diabetes drug

Financial Expres- Geeta Nair

Globally, SGLT2 inhibitors are emerging as a preferred treatment for management of type-2 diabetes but in India the SGLT2 drug had total sales of Rs 574 crore in three years because of its high cost, said Alok Malik, SVP, president, India Formulations, Chronic Cluster , Glenmark Pharmaceuticals. Glenmark Pharmaceuticals has launched its novel type-2 diabetes medicine, Remoglifozin, at half the price of the similar products available in the country. This is the latest class of oral anti-diabetes drug, SGLT2i (sodium glucose co-transporter-2 inhibitor) and is priced over 50% lower than the existing SGLT2 inhibitors in India. The higher cost of the existing SGLT2 inhibitors has meant that the drug is not accessible to a large section of the affected population and the market has remained small. Globally, SGLT2 inhibitors are emerging as a preferred treatment for management of type-2 diabetes but in India the SGLT2 drug had total sales of Rs 574 crore in three years because of its high cost, said Alok Malik, SVP, president, India Formulations, Chronic Cluster , Glenmark Pharmaceuticals.

US disruption may have singed Indian pharma but it is emerging stronger

Mint- R Sree Ram

An analysis of pharmaceutical sales trends in the US by Nomura Financial Advisory and Securities (India) Pvt. Ltd shows Indian companies are gaining share in the world’s largest drug market. The share of Indian companies in total generic prescriptions rose to 45% in the March quarter of this year, compared to 35% at the end of 2017, shows an analysis of the sales data from IQVIA by Nomura. IQVIA is an information and services provider in the healthcare sector. The rise in market share coincides with the change in the competitive landscape in the US drug market. Consolidation of the market at the purchasers’ end and heightened competition have eroded prices. This crimped prices, impacting the earnings of the generic drugs providers. As a consequence, several market participants, including large drug makers, recalibrated the product portfolios and exited less profitable drugs.

Scientists develop device to detect bacteria in minutes

The Hans India

The era of doctors prescribing patients powerful antibiotics while they wait for lab reports could soon be numbered, with a new device returning results within minutes instead of days. It was invented by a team at Penn State university and described in a paper published in the Proceedings of the National Academy of Sciences on Monday. Co-developed by Pak Kin Wong, a professor of biomedical engineering and mechanical engineering, the device uses microtechnology to trap single bacteria cells that can then be viewed under an electron microscope.

Medlife to reinforce it’s e-Pharma business by acquiring Myra Medicines

Ehealth

India’s largest online pharmacy startup Medlife has acquired Bengaluru-based medicine delivery start-up Myra Medicines. The acquisition will support Medlife’s pharmacy business in accruing profits. At the same time, Medlife will also consolidate and strengthen the delivery of medicines and expand its reach to more Indian cities. Speaking about the acquisition, Tushar Kumar, Founder and CEO, Medlife, said,”They had tried executing a small proof-of concept for express deliveries in Bengaluru last year, but found it challenging — that is when the Myra opportunity came up as a suitable fit. The team at Myra has solved this well and it will add to the overall Medlife customer experience.” The company leverages its express delivery abilities to maintain lowest order level costs. The company claims that its on-demand model is built on the back of a best in class ordering and warehousing system that ensures orders are picked packed and dispatched post compliance and legal in just 5 minutes.

Jacobus Pharma wins USFDA approval for Ruzurgi to treat rare autoimmune disorder

Medical Dialogues

Jacobus Pharmaceutical Co Inc on Monday won U.S. approval for the first drug to treat children with Lambert-Eaton myasthenic syndrome, a rare autoimmune disorder. The drug, Ruzurgi, was approved for use in patients aged between 6 and 17, the FDA said Lambert-Eaton myasthenic syndrome, which affects about three people per million worldwide, affects the connection between nerves and muscles, disrupting the ability of nerve cells to send signals to muscle cells.

Mumbai: Study Finds Multi-Drug Resistant Bacteria in Chicken Meat, Eggs

The Wire

A new study found that samples of chicken liver meat and eggs from 12 locations in Mumbai had ‘multi antibiotic resistant’ bacteria. The samples were tested for their resistance or susceptibility to 12 major antibiotics. One of the bacterial isolates was in fact found resistant to all the antibiotics. “Excessive use of antibiotics in animal feed is one of the prime reasons for such antibiotic resistance,” said Vikas Jha, one of the authors of the study, to Down to Earth. A bacteria is considered ‘multi-drug resistant’ when it is resistant to antibiotics of at least three classes. Because of the bacteria’s resistance, a human infected with it cannot be treated easily. The researchers isolated the Salmonella bacterium – which causes food poisoning – from the samples. This isolated bacterium’s interaction with 12 antibiotics which treat infections in humans such as amoxicillin, azithromycin, ciprofloxacin, ceftriaxone, chloramphenicol, erythromycin, gentamicin, levofloxacin, nitrofurantoin and tetracycline was tested.

With Medlife “Health Comes Home indicate the brand’s new TVCs

Indian Television

MUMBAI: Medlife, www.medlife.com (http://www.medlife.com), India’s largest online pharmacy, has recently released new TVCs highlighting its standing as a holistic healthcare provider. Conceptualized by Lowe Lintas, Medlife’s new campaign unveils its tagline “Health comes Home” and showcases the brand’s various offerings with pithy and humorous messaging. Each TVC underscores the company’s commitment to its core brand value of securing better access to health in all forms for consumers. Medlife is a onestop-shop for everything, giving consumers the benet of better control, accessibility, and transparency. At the heart of each storyline are users with different healthcare needs. While one couple manages to buy healthcare supplies beyond just medicines with the 25% discount offered by Medlife, another family can save a trip to several stores and buy different medicines on a single platform by scanning the prescription. The TVCs present the true concept behind Medlife, and how it goes beyond being just another online pharmacy to a comprehensive platform offering other services also such as online doctor consultations and at-home lab tests. In each case, Medlife makes the process simpler, faster and more convenient.

Healthcare News

Talking Point: Should dentists be allowed to render primary healthcare

The Times of India- Rajlakshmi Ghosh

The government has proposed to allow dental graduates to serve the rural and semi-urban areas as MBBS doctors, on completion of a 3-year bridge course. Education Times talks to stakeholders to find out if the proposed move could address the shortage of skilled doctors in the rural sector. The question of whether dentists should be trained to serve as medical practitioners in the rural sector is a classic case of mixing the apple with the pear. It is better to leave dentists to their jobs and not expect them to fill in for MBBS doctors. The disproportaionate ratio of doctors to patients in the rural sector can be addressed by providing more monetary incentives and better working conditions and infrastructure in the villages. This would help to attract and retain the best MBBS talent. A dentist may not know how to treat dengue, malaria or tuberculosis which are common ailments in the villages since their expertise lies in treating teeth-related conditions. Partial knowledge in the field of medicine can prove hazardous specially since it is a case of human lives.

Maharashtra will be first to erase virginity test from textbooks

The Times of India- Sumitra Debroy

Soon, the controversial ‘virginity test’, or ‘two-finger test’, will no longer be taught to medical students in the state. A curriculum panel of the Maharashtra University of Health Sciences (MUHS) has approved the removal of chapters about the test from textbooks, following a petition by a Wardha doctor that it was unscientific, violates human rights and doesn’t in any way aid a sexual assault investigation. Perhaps the first in the country to do so, the decision was taken in a Board of Studies meeting held in April. The final decision will be taken by the academic council of the MUHS before the change reflects in textbooks. “Yes, a preliminary decision to remove the two-finger test has been taken. The recommendation will be placed before the academic council. The test has long been found to lack a scientific basis,” said Dr KD Chavan, registrar, MUHS.

37% alcohol consumers suffer from anaemia: Study

The Times of India- Shimona Kanwar

A PGI study on anaemia in the elderly found that 37% people who were chronic alcoholic consumers had severe anaemia. Geriatric anaemia is a global health problem because of its high prevalence and associated significant morbidity and mortality in age ranged between 60 years and 92 years. The study showed that in most of the cases, anaemia in the elderly has a treatable cause. Alcohol consumption and medications are important contributors to anaemia in this age group. The study was a hospital-based observational study, conducted in patients aged 60 years and above at the PGI. There were 105 patients. The cause of anaemia was iron deficiency in 26 patients (24.8%), chronic disease in 24 patients (22.9%), haematological disorders in 21 (20%), chronic kidney disease in 13 (12.4%), multifactorial in 8 (7.6%), vitamin B12 deficiency in 2 (1.9%), folate deficiency in 1 (0.9%), and hypothyroidism in 1 patient (0.9%). Common chronic diseases causing anaemia were malignancy (36.6%) and liver disease (29.1%).

Diabetes patients need to manage risks while fasting during Ramzan, say experts

The New Indian Express

Ramzan, the month of fasting in Islam, began Tuesday and health experts have warned those with diabetes to manage risks while fasting as it can complicate the condition. Advertising Diabetes patients need to manage risks while fasting as it adds up to potential health hazards that include dehydration and acute metabolic complications among others, experts said. Dr Satish Koul, senior consultant and director at Narayna Hospital, Gurgaon, said when diabetic patients decide to fast, the importance of practical diabetes and spiritual fasting guidance becomes evident. Potential health hazards include hypoglycaemia, hyperglycaemia, dehydration and acute metabolic complications such as diabetic ketoacidosis.

Post-discharge care vital for heart failure patients

Deccan Chronicle- Kaniza Garari

Thirty-one per cent of patients in South India who suffered heart failure (which occurs when your heart muscle does not pump blood as it should) have succumbed within one year of diagnosis and 45 per cent died within the first three months after being discharged from hospital according to data tabulated by the Trivandrum Heart Failure Registry and published in the American Heart Journal. The initial assessment and statistics have found that there is an urgent need to focus on post-discharge care and treatment protocol for heart failure patients.

Medical advancements are blazing the trail for severe asthma management

ETHealthworld

Among the 20 most polluted cities in the world, 13 are in India. The air pollution in India has triggered a health crisis. A case in point, asthma in India is affective approximately 15 to 20 percent of the population, approx. 30 million people. In the coming years, the rising pollution levels could raise this number to hundreds of millions. Asthma is caused by the inflammation of air passages in the lungs, characterized by recurrent attacks of wheezing and breathlessness. The most dominant causes of asthma is a family history of asthma, however, exposure to air pollution, indoor allergens like domestic mites in bedding, stuffed furniture, etc, tobacco smoke and chemical irritants, are among the major factors that impact the symptoms. Triggered by a variety of reasons, there are different kinds of asthma like adult-onset of asthma, allergic, occupational asthma, exercise-induced asthma and severe asthma to name a few. A chronic condition, asthma is usually treated by continuous medications. But severe cases of asthma require more advanced treatments to control the symptoms. The prevalence of severe asthma is somewhere 8-10% of the overall asthma population. Let’s understand what severe asthma is.

Washing hands regularly can prevent infections from spreading, say experts

The Tribune

Dayanand Medical College and Hospital (DMCH) held an interactive session for patients and their attendants in OPD block today to highlight the importance of hand hygiene on the occasion of World Hand Hygiene Day. The audience was told about importance of six hand washing steps recommended by World Health Organisation. Prem Kumar Gupta, secretary, Managing Society, DMCH, appreciated the efforts of Infection Control Committee in creating awareness. Dean academics Dr Rajoo Singh Chhina, chairperson, Hospital Infection Control Committee, unfolded the theme of World Hand Hygiene Day “Clean care for all-It’s in your hands”.

Continuum of healthcare players in delivering better patient care

Business World- Prerna Lamba

Hospitals around the world are under increasing pressure to improve outcomes because today’s increasingly informed patients are deliberately pursuing treatment at facilities with a reputation for superior care. According to a Lancet study, India ranks 145th among 195 countries in terms of quality and accessibility of healthcare. Despite improvements in healthcare access and quality, India lags way behind on the HAQ index. At the Hospital Summit and Awards organised by BW Businessworld, the eminent panelists gave insights on how they are contributing to improve efficiencies and deliver better patient care in the healthcare industry. The session, moderated by Dr. Ashwani Aggarwal, Principal Consultant - Healthcare, PwC, included Vivek Srivastava, Co-Founder And Ceo, Healthcare At Home; Ajoy Khandheria, Founder, Gramin Healthcare; Dr. DK Gupta, CEO, Felix Hospital and Gautam Chopra, Founder and CEO, BeatO. Gupta stated that globally the home healthcare industry is around $300 million and it is growing at the rate of 8.8 per cent while it is growing around 9 per cent in Asia.

How technology and miracle combined to save a 3-year-old suffering from liver ailment

Zee News- Sidharth MP

Radhesh was just like any other three-year-old kid who enjoyed his time playing with his parents and siblings. However, things totally changed for this Chennai boy in April after he fell ill. What seemed to be like an ordinary fever actually turned out to be liver-related disease and thus, his condition started deteriorating. On consulting the doctors at Chennai’s Apollo Hospitals, Radheshs parents learnt that he was diagnosed with fulminant liver failure, which is otherwise known as sudden catastrophic liver failure. His condition deteriorated within 24 hours of being hospitalised.

Most Indians suffering from hypertension unaware of their condition

The Week

Hypertension prevalence in India is high, but only 45 per cent of people are aware of their diagnosis, according to a first largescale population based study of hypertension care in India. Researchers have used National Health and Family Survey (NFHS-4, 2015-16) data of 731864 individuals aged 15-49 years, which covered each district of 29 states and 7 union territories of India. The study published in PLOS Medicine suggests that 3 out of 4 individuals with hypertension ever had their blood pressure measured, less than half of individuals (45 per cent) had been diagnosed, 13 per cent reported currently taking hypertensive medication, while 8 per cent had their blood pressure under control. The study was carried out by researchers at the Public Health Foundation of India (PHFI), Harvard TH Chan School of Public Health, the Heidelberg Institute of Global Health, the University of Birmingham and the University of Gottingen.

Helping harness the potential of medical colleges to boost maternal, infant and young child nutrition

Outlook

Despite India’s favourable policy environment, the nutritional status of women and children continues to fall short of national targets. Data shows that 38% of Indian children under 5 years of age are stunted, half of pregnant women suffer from anaemia, and almost a quarter of women are underweight. These trailing nutrition indicators can be attributed, in part, to the availability and quality of health services. Key platforms that could promote maternal nutrition (MN) have largely been untapped. For example, only one third of pregnant women consume iron and folic acid (IFA) tablets, while 89% receive tetanus toxoid immunisations during antenatal check-ups. Ensuring access and promoting the consumption of iron and folic acid tablets during routine antenatal care is just one example of a missed opportunity for maternal nutrition (MN) in India’s healthcare delivery system. Medical colleges can play an essential role in addressing the gaps in the system by leveraging their academic, research, and service delivery facilities to build capacity for maternal, infant, young child nutrition (MIYCN).

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