Doctors’ unusual prescription: Go and ride bicycles

London: A new programme in Wales will allow family doctors to offer patients an unusual prescription for better health: bicycles.

The pilot programme, the first such initiative in Britain, according to the health board that is leading it, reflects an effort by medical professionals around the world to give patients alternatives to drugs, in order to avoid side effects and improve cost efficiency.

Patients at two medical centers in Cardiff, the Welsh capital, will be offered sixmonth subscriptions to a bike-rental service that allows them to make unlimited free rides of up to 30 minutes at a time, and officials hope to expand the programme.

“For the first phase of the pilot, we want to make sure the scheme works as intended and is easy to use for patients and their health professionals, so we’ll be seeking feedback from participants,” Dr Tom Porter of the Cardiff and Vale University Health Board, said in a statement on Wednesday…(ET Health- NYT News Service | May 13, 2019)

US emerging adults with type 1 diabetes face DKA danger

In contrast to youth with type 1 diabetes in Canada, those in the United States are vulnerable to lapses in care at the time of transition from adolescence to adulthood, placing them at risk for the serious complication of diabetic ketoacidosis (DKA) and other adverse outcomes, new research suggests.

Indeed, the study found that as teens became young adults in the United States, hospitalization rates for DKA soared by 90%, compared with a 23% rise for the same age group in Canada.

"The US healthcare system is failing far too many patients, including those with diabetes," said lead author Adam Gaffney, MD, a pulmonary and critical care physician at the Cambridge Health Alliance and Harvard Medical School, Massachusetts, in a press release by the US Physicians for a National Health Program (PNHP). Gaffney and colleagues published their findings online May 8 in the Journal of General Internal Medicine… (Medscape)

Woman fighting to stay in UK for treatment

London: An Indian woman suffering from a rare disease, which left her in a coma after a major surgery, is fighting to stay in the UK and avoid being deported to India.

Bhavani Espathi, who came to Britain as a student, suffers from Crohns Disease, a digestive tract disorder, for which she requires a specific immunosuppressant that she says is currently unavailable in India. "The only thing keeping me somewhat healthy besides constant medical attention are immunosuppressants such as Ustekinumab, which is currently unavailable in India, the country that the British Home Office believes is a place I should return for palliative care instead of living in the UK," says the 31-year-old, who has launched an online campaign to seek support for her case.

The UK Home Office recently issued a letter stating that her application for leave to remain in the UK had been refused and that she was liable to be forcibly removed. The letter arrived as she lay in a coma after a major operation and her fiance, Martin Mangler, appealed against the decision while she was still unconscious.

Medical letters from her doctors stated that her life would be at risk if she were to travel ... (New Indian Express-PTI, May 14, 2019)

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 14 May to 0830 hrs IST of 15 May, 2019)

Heat Wave:

Yesterday, Heat Wave Conditions observed at isolated pockets over Vidarbha. (Annexure 1 & 2).

Maximum Temperature

Maximum Temperature more than 40.0°C were recorded at most places over Vidarbha, Marathwada, Telangana; at many places over Gujarat region, Rayalaseema, at a few places over East Uttar Pradesh, Chhattisgarh, Madhya Maharashtra, North Interior Karnataka, Coastal Andhara Pradesh, Tamilnadu & Puducherry and at isolated places over Rajasthan, Bihar, Saurashtra & Kutch, Jharkhand and Odisha.

Maximum temperature departures as on 14-05-2019: Maximum temperatures were appreciably above normal (3.1°C to 5.0°C) at isolated places over Gangetic West Bengal, Coastal Andhra Pradesh and Tamilnadu & Puducherry; above normal (1.6°C to 3.0°C) at most places over Rayalaseema and North Interior Karnataka; at many places over Nagaland, Manipur, Mizoram & Tripura, Bihar, South Interior Karnataka, Kerala, Lakshadweep and Andaman & Nicobar Islands; at a few places over Jammu & Kashmir, Vidarbha, Telangana and Coastal Karnataka and at isolated places over Odisha, Madhya Maharashtra and Marathawada. They were markedly below normal (-5.1°C and more) at many places over Arunachal Pradesh; at a few places over Himachal Pradesh and Uttarakhand; appreciably below normal (-3.1°C to - 5.0°C) at many places over Punjab and Haryana, Chandigarh & Delhi; below normal (-1.6°C to -3.0°C) at many places over West Rajasthan, West Uttar Pradesh; at a few places over Chhattisgarh; at isolated places over Assam & Meghalaya, East Uttar Pradesh, East Rajasthan, Madhya Pradesh, Saurashtra & Kutch and near normal over rest of the country.

The highest maximum temperature of 45.2°C was recorded at Chandrapur (Vidarbha).

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 15 May to 0830 hrs IST of 16 May 2019):->

Heat Wave Conditions at isolated places very likely over Vidarbha, Telangana and Tamilnadu & Puducherry.

Lybrate Healthcare Monitor

30-40% of State’s population uses tobacco

The Pioneer

India is home to approximately 106 million cigarette smokers, accounting for almost 11.2% of the world’s smokers. In Madhya Pradesh specifically, as per the GATS 2 survey, 30-40% of the State’s population uses tobacco in some form. These numbers are higher than the national average of 28.6%. To strengthen the commitment and collaboratively work towards decreasing the economic cost of tobacco related illnesses and deaths, Heart Care Foundation of India (HCFI), brought together multiple stakeholders on “Tobacco Harm Reduction: A viable alternative to the scourge of combustible cigarettes” in the State. Dr. K.K. Aggarwal, President, Heart Care Foundation of India (HCFI) said that India bears a particularly high non-communicable disease burden, and as per WHO estimates, nearly 61% of all deaths in India can be attributed to NCDs, including heart disorders and cancer. Therefore, reduced harm alternatives such as electronic nicotine delivery systems (ENDS) coupled with behavioural counselling need to be made available as there are several smokers who are unwilling or unable to quit with the help of nicotine gums or patches.

Pharma News

Spiralling input costs hit production of crucial drugs

The Times of India- Pushpa Narayan

As several essential drugs get wiped off the shelves in government hospitals across the country, authorities say they are increasingly finding it difficult to find manufacturers to bid for tenders at existing cost. The cost of active pharmaceutical ingredients that are used as raw materials have gone up to nearly double for some drugs. Indian Drug Manufacturing Association says some companies may not survive the present crisis if the Centre does not allow them to increase the selling price. If that happens, it is likely to cause a shortage of commonly-used drugs such as paracetamol, antibiotics like erythromycin, ofloxacin and azithromycin, and vitamins. At least 80% of the desi manufacturers depend on China for low cost active pharmaceutical ingredient (API). Over the last six months, the Chinese government enforced stricter environment laws and several factories shut down. Those that survived increased cost of APIs have more than doubled for several drugs. The fluctuations in rupee prices against dollar added to the increase.

US pharma scandal: Indian firm Glenmark may face a penalty of up to $873 million

Business Today-Mudit Kapoor

A total of 44 US states on Monday filed a lawsuit against as many as 20 generic drug manufacturers, including seven Indian firms. Among these Indian firms, 5 have been sued by the state attorney generals and 4 are under DOJ (Department of Justice) investigation. The multi-state lawsuit seeks damages and civil penalties against the pharma companies for allegedly running a coordinated campaign to artificially inflate the prices of more than 100 drugs between 2013 and 2015. How will the drug firms be penalised? According to a research report by JM Financial, the investigation against these pharma companies could go on for several years, but they could still face a lot of damage due to the lawsuit. The fines can run into millions of dollars. "Under the Sherman anti-trust Act, a maximum penalty of USD 100 million could be imposed. However, the maximum penalty can be increased to a fraction (c.20%) of the volume of affected commerce during the conspiracy period, if the amount is greater than USD 100 million," the report said. There can be severe penalties levied on the Indian pharma companies too. Glenmark could face the highest penalty of $873.

FDA urged to crack down on European firms shipping abortion pills to US from India

Business Today

A bipartisan group of 117 lawmakers has urged the US Food and Drug Administration (FDA) to crack down on companies, primarily based in Europe, that ship chemical abortion drugs from India to the US. These European companies, like Aid Access, are circumventing the FDAs safety requirements and placing the lives of women and their children at risk, the lawmakers said in a letter to Norman Sharpless, the Acting FDA Commissioner. In the letter dated May 10, the bipartisan group of Congressmen urged Sharpless to crack down on Aid Access and Rablon, two foreign companies known to distribute Mifeprex, a chemical abortion drug, by mail-order to US customers in violation of the FDAs safety protocols. The letter urges Sharpless to take action to stop the illegal practices of Aid Access and other mail-order abortion providers. Aid Access allows chemical abortion pills to be prescribed by an abortionist in the Netherlands, filled by a pharmacy in India and shipped to stateside customers, they alleged.

Understanding the biosimilars opportunity for Indian pharma

The Economic Times- Ranjit Shinde & Divya Rajagopal

Biologics, a category of pharmaceuticals which has been around for more than a decade, is back on discussion forums given the huge global market potential in the next three to five years. Several drugs classified as biologics are expected to go off patent during this period thereby making way for their biosimilar counterparts. Indian pharma companies active in this field are expected to be among the biggest beneficiaries of this opportunity. According to a recent report by Morgan Stanley, as many as nine drugs in the biologics category have either gone off patent or will do so by 2025. Their total revenue was $62 billion (around Rs 4.3 lakh crore) in 2018. This creates a major opportunity for their respective biosimilars. The research firm estimates that revenue of these biosimilars will grow by 24 per cent annually for seven years to $13.3 billion in 2025 (around Rs 93,000 crore) in the US and Europe. That offers a big opportunity for companies focusing on this segment.

A frightening new book on generic drugs in US can vex Indian companies further

Business Insider India-Sriram Iyer

Drug makers in India have relied on Americans to buy a big chunk their produce for a long time now. It had paid off well for many years until recently. Between rising competition squeezing prices, regulatory pressure to keep prices lower, and an expanding lawsuit into a purported conspiracy, Indian companies have found the US market to be a tougher place than it ever was. The controversy that forms the heart of the book is nearly a decade old. Dinesh Thakur blew the lid on an Indian company Ranbaxy for cutting corners and compromising on quality of drugs before quitting the company in 2005. The case unraveled over the years in courtrooms, Congressional hearings, and public discourse that damaged the reputation of India as the pharmacy of the world.

Opinion | An alleged drug cartel awaits trial in America

MINT- Jayachandran

After facing American scrutiny over quality issues, India’s pharmaceutical industry has again landed in the crosshairs of US regulatory action. Forty-four US states have together sued 20 drugmakers, seven of them Indian, for the alleged fixing of generic drug prices at levels higher than what the market would set. Israel’s Teva Pharmaceutical Industries, the world’s largest producer of generic formulations, allegedly underpins a shadowy cartel designed to exert monopolistic power in the US. Fifteen individuals have also been named in the lawsuit filed in a court in Connecticut. The complaint alleges that senior executives of the offending companies often met at trade events, conferences, dinners and even golf outings, and kept in touch via phone and email to raise prices and carve up the market among themselves. According to the charges, collusion peaked between July 2013 and January 2015, a period when prices of more than 100 generics went up sharply, some by over 1,000%. These allegations are serious and, if proven, could deal a severe blow to Indian drug exporters that count the US as a major market for off-patent drugs.

Medicine board approaches TRAI against TV programmes by quacks

The New Indian Express

After Tamil television channels in the State failed to respond to the notices issued by Tamil Nadu Board of Indian Medicine (TNBIM), the board has now written to Telecom Regulatory Authority of India (TRAI) and Advertising Standards Council of India requesting them to instruct these channels not to telecast programmes, both of quacks and qualified. The move came after TNBIM found that a few unqualified Siddha medicine practitioners were found promising miracle cures in television channels. In its recent letter to TRAI and Advertising Standards Council of India, the board said, “As per regulation 24 of Code of Ethics framed by Central Council of Indian Medicine, a practitioner shall not make use of or aid or permit others to make use of him or his name or photograph as subject of any form or manner of advertising or publicity”.

Medicine to treat me unavailable in India, says woman fighting to stay in UK

The Hans India

An Indian woman suffering from a rare disease, which left her in a coma after a major surgery, is fighting to stay in the UK and avoid being deported to India. Bhavani Espathi, who came to Britain as a student, suffers from Crohns Disease, a digestive tract disorder, for which she requires a specific immunosuppressant that she says is currently unavailable in India. "The only thing keeping me somewhat healthy besides constant medical attention are immunosuppressants such as Ustekinumab, which is currently unavailable in India, the country that the British Home Office believes is a place I should return for palliative care instead of living in the UK," says the 31-year-old, who has launched an online campaign to seek support for her case.

"We are registering 20% month-on-month growth:":Pradeep Dadha

Indian Retailer- Shipra Srivastava

Netmeds.com, is India Ki Pharmacy, the first e-commerce site dedicated to sales of prescription medicine and other healthcare products across the country. Pradeep Dadha comes from a family that has been in the pharma business for more than 100 years. His grandfather, Lalchand, founded Dadha and Company in 1914 and his father Mohanchand took over the company and grew it into one of the most trusted pharma companies in South India. Pradeep learnt everything there was to know about the business and then went off to find his own path in the world of e-commerce, digital marketing and global logistics and fulfillment. He had always dreamt of creating a strong Indian-facing consumer brand and in 2015, he felt that both market factors and regulatory climate were favorable for launching what was heretofore the "holy grail" of e-commerce, an online pharmacy.

New nanotechnology-based drug delivered via nose shows promise

Down to Earth

Indian researchers have developed a new nanotechnology-based drug that can be effectively administered through nose. The pain killer potentially reduces the risk of side effects and raises hopes for patients with nerve related pain conditions such as arthritis, multiple sclerosis, diabetes, spondylitis. Drugs are traditionally delivered orally or via injections. Since it may sometimes result in side effects, scientists have been pressing the need for precision drugs. The researchers, from Jaypee Institute of Technology, Defence Research and Development Organization; and Jamia Hamdard University, found that nanoparticles-laden neuropathic drugs via nasal route could be more effective in curing nerve related pains. But, poor permeability of drugs via nasal layer has been a major concern. In the study, the team used nano drug formulation by precipitating lamotrigine with Polylactic-co-glycolic acid (PLGA) polymer to slowly release the pain killer. To analyse the efficacy of reaching brain, rats were administered the nano-drug formulation as well as an aqueous solution of the drug, either orally, by injection in vein or through nose.

Dyadic, Serum Institute to develop affordable antibodies and vaccines

Bio Spectrum

Dyadic International, a global biotechnology company focused on further improving and applying its proprietary C1 gene expression platform to speed up the development, lower production costs and improve the performance of biologic vaccines, drugs and other biologic products, at flexible commercial scales has announced a research and commercialization collaboration with Serum Institute of India Pvt., Ltd, one of the worlds largest vaccine manufacturers, to develop and manufacture up to twelve antibodies and vaccines using Dyadics C1 gene expression platform. This important collaboration is focused on making biologic vaccines & drugs accessible and more affordable to patients worldwide while lowering the financial burden on the global healthcare system. Under the terms of this collaboration, Serum anticipates applying Dyadics C1 technology to express up to twelve proteins - 8 MABs and 4 rVaccines and will undertake commercially best efforts to fully develop and commercialize the proteins expressed from Dyadics C1 technology. Dyadic has agreed to grant Serum the option to obtain an exclusive commercial sublicense for each of the twelve (12) proteins in return for certain research funding, milestone payments and royalties for 15 years from the date of the first commercial sale.

Healthcare News

Pune doctor gets three years in jail in pre-natal sex-determination case

The Times of India- PTI

A court here on Tuesday sentenced a doctor to three-year rigorous imprisonment and slapped a fine of Rs 10,000 on her in a 2011 pre-natal sex-determination case. Judicial Magistrate (First Class) Vishakha Patil convicted Dr Neena Mathrani, a radiologist from the city, under Pre-Conception and Pre-Natal Diagnostic Tests (PCPNDT) Act, 1994. Gynaecologist Dr Makarand Ranade, a co-accused, had died during the trial. Both the doctors were exposed after a couple, who was sent to Dr Ranade as decoy, conducted a sting operation in 2011. "A strong case was made out against both the doctors and there was a strong circumstantial as well as electronic evidence. The court convicted Dr Mathrani and sentenced her to three years rigorous imprisonment and also fined her Rs 10,000," Chief Legal Officer of Pune Municipal Corporation PMC) Manjusha Idhate said. She said Dr Ranade took Rs 9,000 from the couple and sent them to Dr Mathranis clinic for sex determination test. Idhate said that for the PMC, advocate Anant Randive appeared before the court and examined three witnesses.

29 dengue cases in 9 days in Bengaluru

The Times of India

A 16-year-old boy is battling for life at a hospital, a few days after being diagnosed with dengue. He is among a growing number of patients with the disease in the city. Twenty-nine dengue cases were reported within BBMP limits in the first nine days of May, according to figures recorded by the state health department. The high incidence of the disease is directly linked to increasing number of mosquitoes, which have found favourable breeding conditions in several neighbourhoods with sites of stagnant water. Across the state, 796 dengue cases have been reported since January. At 311, Bengaluru accounts for the highest number, followed by Shivamogga (99). The mosquito problem has also lead to over 360 cases of chikungunya in Karnataka.

Fetus found in government hospital toilet

The Times of India

A four-month-old fetus was found in a toilet of government hospital in Hisar on Monday. This is a third such case in last seven months. Hisar police spokesperson said a case has been registered under section 318 (concealment of birth by secret disposal of dead body) of the Indian Penal Code against unknown woman on complaint of Preeti Devi, a woman employee of the government hospital. Preeti said the matter was immediately reported to the hospital administration by her after she found the fetus lying in ladies toilet. Police reached the spot and recorded her statement. Post-mortem of fetus took place at Agroha Medical College. During the investigation, police interrogated a woman on the basis of suspicion who revealed that she was four months pregnant. The woman told the police that she came to hospital on Monday after complaints of stomach ache. The OPD was engaged and she had to wait in a queue for a long time. After that she went inside the toilet and there the abortion took place. The police spokesperson said legal action would be taken in this case as per law after proper investigation.

Kidney racket probe exposes hospital-middlemen links

The Hindu- Sumit Bhattacharjee

In 2014, a big corporate hospital in the city had come under the scanner of the Enforcement Directorate when a case of alleged illegal organ (kidney) transplantation had surfaced. This case was an eye-opener to the people not only in this city but also neighbouring districts and States such as Chhattisgarh and Odisha, as Vizag is considered to be the medical hub in this region. In 2018, PM Palem registered a case against two persons who were caught allegedly trying to lure poor people from JNNURM colonies to donate their kidneys for a sum. A few days ago, another corporate hospital had come under the scanner for reported illegal kidney transplantation and the initial investigations clearly point to a nexus between a few corporate hospitals and middlemen, in the organ transplant racket.

KMC warns doctors against online consultations

The Hindu-Afshan Yasmeen

The proliferation of websites and mobile apps that connect patients with doctors has yet again raised questions about the ethics of the practice. In August last year, the Indian Medical Association had sought clear-cut guidelines from the Medical Council of India (MCI) on the issue of telephonic medication and online consultations, while observing that the practice is illegal and unethical. Now, the Karnataka Medical Council (KMC) has advised doctors against engaging in online consultations stating that it runs contrary to the regulatory body’s code of ethics. “Such consultations are detrimental to both patients as well as the doctor and may lead to many complications, which is nothing but playing with the life of a patient. The KMC can even go to the extent of initiating action (including cancellation of registration) against doctors who take up online consultations,” Veerabhadrappa H., KMC president, told The Hindu.

Big win for common man! Delhi hospital to pay Rs 20 Lakh for pregnant woman’s death due to negligence

Financial Express-Swapna Raghu Sanand

Proving medical negligence is never easy in India but a triumph of justice marks a big win for the common man! A nine-month-old pregnant woman died in a Delhi hospital solely due to medical negligence and the concerned hospital has now been directed to pay Rs 20 lakh for medical negligence, according to a TOI report. That the concerned doctor left a bleeding pregnant patient and left no instructions to the nursing staff indicates the extent of medical negligence that occurred. However, a very serious area of concern remains that in most medical negligence cases, the doctor’s license to practice medicine is not canceled. Now, the Delhi State Consumer Disputes Redressal Commission has directed a hospital to pay Rs. 20 lakh for death on account of medical negligence that resulted in the death of a pregnant woman and her unborn child.

J-K: A doctor’s crowd funding project to ensure sanitary napkins for poor girls

The New Indian Express

Beating societal taboos around menstruation and talking about something that is stigmatised in Kashmir society, a 31-year-old doctor from Srinagar has started a crowd-funding campaign for sanitary pads for the poor. And in this project, her unlikely helpers are the women religious scholars. The idea came up when poor girls from city suburbs visited Dr Auqfeen Nisar, a Doctor of Medicine student at Government Medical College Srinagar, with complaints about irritation and allergy. “A few girls came to me and complained about irritation, allergy and reproductive tract infections. As I enquired, I discovered that they have an extremely poor menstrual hygiene due to the usage of cloth instead of sanitary pads,” says Dr Auqfeen. “When I asked these girls about why they don’t use sanitary pads, they talked about un-affordability and lack of awareness. This is when I thought about crowd funding”.

Mumbai couple sues hospital for failure to detect birth defect in their new born

India Today

A couple has sued Mumbai-based Wadia Hospital for allegedly failing to detect a severe birth defect in their new born child during pre-natal tests. The Mumbai Police has launched an enquiry into the matter, however, the final decision to file an FIR against the doctors will be taken by JJ Hospital. In their complaint, Amit and Shrutika Panchal have said that the doctors at the hospital failed to notice or report any birth defect in their daughter during the course of the pregnancy. "During my wifes pregnancy, we went for regular checkups every three weeks at Wadia Hospital. For nine months, doctors did not express any concern. Just two days before the delivery, they told us that there is slight abnormality which they will correct after birth," Amit told India Today.

Absentee doctors disciplined in Bihar

Health Issue India-Kerean Watts

When it comes to the struggle over access to healthcare, much of the focus is devoted to shortages of doctors. What can be overlooked is the problem of doctor absenteeism. In Bhagalpur, medical authorities have taken action against absentee staff members of one hospital who did not attend a Medical Council of India (MCI) inspection. The Jawaharlal Nehru Medical College and Hospital (JNMCH) was visited by the MCI on April 15th, in connection with plans to recognise 100 MBBS and postgraduate medical seats at the university versus the fifty recognised at present. The visit threw up a different issue altogether, however, with 33 staff members being absent without permission. According to the hospital’s principal, Dr Hemant Kumar Sinha, the absentee doctors included three professors, two assistant professors, an associate professor, eleven tutors, and sixteen resident doctors. According to The Times of India, three heads of department hospital were among those not present during the inspection.

BR Life SSNMC Hospital to offer Holistic Medicare

Bio Spectrum

BR Life SSNMC Hospital, founded by philanthropist billionaire, Dr BR Shetty, has announced its association with Art of Living Foundation with an aim to provide holistic wellness and medical care to its patients. Through this partnership, an amalgamation of Allopathy with Ayurveda with Yoga & Meditation for chronic lifestyle diseases such as Diabetes, Hypertension, Obesity, Migraine, Gastric problems, Cardiac ailments etc., will be offered to patients at BR Life SSNMC Hospital and Art of Living Foundation. A MoU was been signed between both the entities in the presence of his holiness Gurudev Sri Sri Ravi Shankar Ji and Colonel Hemraj Singh Parmar, Group CEO, BR Life Group of Hospitals. With this association, BR Life SSNMC Hospital will be working with SSCASRH, a teaching hospital operating under SSRVM Trust and affiliated to CCIM & Ayush Department, GoI, New Delhi, and Vyakti Vikas Kendra India, an educational and humanitarian NGO that will help BR Life SSNMC Hospital to introduce a cohesive healthcare model.

Doctors at government hospital refused to treat me, says man whose neck was pierced by fallen tree branch

Mirror Now News

Four months after a tree branch pierced his neck, a 40-year-old man from Tumakuru district of Karnataka is now said to be stable. A farm labourer from Amruthur in Kunigal taluk, Nanjesha lived for more than 10 hours with the branch protruding out from behind his right ear. The accident happened when he was riding on his two-wheeler to attend a relatives funeral. The incident took place on December 22 on the Huliyur-Bommanahali Road when Nanjesha was moving towards Kunigal. He was rushed to the Sparsh Hospital in Yeshwantpur where doctors operating on him managed to remove the branch which was 60 centimetres long and 3 centimetres thick following a four-hour long complex operation.