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Medical Voice 27th May 2019 |
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Medical Voice 27th May 2019
Dr KK Aggarwal,  27 May 2019
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Diet for high uric acid

Harvard: In the past, doctors often handed their patients a list of foods high in purines and instructed them not to eat those foods. By itself, that hasnt been shown to be particularly helpful.

Now experts have begun thinking about diet differently. Instead of trying to figure out which individual foods you should avoid, the focus is on following a healthy diet and trying to lose weight if youre overweight or obese. Just losing weight can lower uric acid levels. Drinking plenty of fluids is also helpful. But limit sweetened drinks and alcohol, which can increase uric acid levels.

A healthy diet emphasizes plant-based foods, such as vegetables, fruits, and legumes. Whole grains are preferred over processed grains. Intake of fat, especially saturated fat (found in red meat), should be reduced. Lean sources of protein, including chicken, turkey, fish, and tofu, are better choices than beef or pork.

Fish, which contains omega-3 fatty acids, is part of a healthy diet. But some seafood also contains high amounts of purines. People with gout dont have to steer completely clear of fish. But try to limit the amount of shellfish, sardines, and anchovies you eat, because they have the highest amounts of purines. A better choice is flaky white fish, such as cod, tilapia, or flounder.

A study published in Arthritis & Rheumatology in 2016 found that people who followed the DASH diet for 30 days lowered their uric acid levels 0.35 mg/dL on average. The higher the starting uric acid level, the greater the decline.

Multiple studies have found lower uric acid levels among people who consume low-fat dairy products. So these products, which contain calcium, may help lessen gout attacks as well as protect your bones.

Vitamin C may lower uric acid levels. People with gout may be helped by adding citrus fruits and other foods rich in vitamin C (such as strawberries and peppers) to their diet.

 

How to deal with leftover food: Tips from the Cleveland Clinic

1.For cookouts and barbeques, when you’re thinking about your leftover food, anything that’s been sitting out for more than two hours, you probably shouldn’t save

2.Avoid letting foods get into the ‘temperature danger zone’, which ranges from 40-140oF. When food has been sitting out in that temperature range, it will begin to grow bacteria, and there’s a higher likelihood of getting sick from eating it.

3.There are some food items that are likely able to be saved such as snacks like nuts or pretzels.

4.If you have a vegetable tray, you can probably save most of it.

5.Items which cannot be saved include pasta salad and potato salad. Those items are more likely to grow bacteria, so you can discard them.

6.If you’re having a large gathering, stick with smaller serving dishes, but have your backup in the fridge to pull out half way through, so that you can keep things at a good, healthy temperature

7.If you are serving things such as salads with dressings, put the dressing on the side, and let people decide how much they want to use. This will help keep moisture out of the dishes, because moisture is where bacteria likes to grow.

8.When the party is over, be mindful not only of what you can save, but how you pack it up.

9.If you’re storing foods, use shallow containers, and bring the food to room temperature before you put them in the refrigerator

10.Once the food is in the refrigerator, you have a window of about 2-3 days to eat leftovers.

11.If you’re not sure if something is still good to eat – use your senses. Inspect it for visible mold and smell it to see if it smells right; if in doubt, throw it out.

Eating cherries can reduce gout attacks and improve pain.

Healthcare News Monitor

Busting myths about smoking

The Pioneer

India has a major problem with tobacco. It is the second largest consumer of tobacco with over one in 10 of the world’s smokers and incurs a staggering economic burden of approximately $26 billion per annum. As per a report by the Ministry of Health & Family Welfare, the total economic costs attributable to tobacco usage related diseases in India, in the year 2011 for people aged between 35-69, was Rs 1,04,500 crore (around $22.4 billion). The tobacco epidemic has indeed reached alarming levels. As per latest estimates, there are nearly 106 million people in India who smoke tobacco and 32 million who smoke as well as chew it. There are a total of 270 million people who use it. India is home to roughly 11.2 per cent of the smokers in the world and 1.35 million people in the country die every year due to tobacco-related illnesses.

Drug Formulations: Banking on Brands

India Legal

The central government has ordered state drug controllers not to allow pharma companies to market drug formulations in which the composition has been tweaked while retaining the old brand name. With this in place, certain companies will not be allowed to retain the brand name in medicines that have undergone a change in raw material or active pharmaceutical ingredient. Hopefully, this will not apply with retrospective effect as a new law ought to be prospective, not retrospective. Article 20 (1) protects individuals against ex post facto legislation and says that no person can be convicted for an offence that was committed before the enactment of the law. This immunity is only limited to criminal proceedings. However, it does not prohibit a civil liability retrospectively, i.e. with effect from a past date. So, a tax can be imposed retrospectively.

Office cafetarias must offer health benefits on platter: Docs

The Free Press Journal- Swapnil Mishra

Eating junk food at work can lead to several health issues and scarily, this eating pattern spills over to eating habits outside as well, say experts. Doctors from the King Edward Memorial Hospital said such dietary habits can increase the risk of diabetes and heart ailments in people as compared to those who make healthy food choices. Unhealthy food choices can also lead to obesity over time. “There is a need to raise awareness that lifestyle-related ailments can increase absenteeism, lower productivity, and result in higher healthcare expenses for employers,” they said. Offering more healthful meal options at work holds out the promise of improving wellness among employees. Employers should consider offering appealing and healthy options in cafeterias, vending machines, and at meetings and social events. Dr KK Aggarwal, president, Heart Care Foundation of India (HCFI), said Indians have a tendency to accumulate fat around the abdomen, which can lead to insulin resistance. One of the primary reasons for this is the lifestyle people lead today. “On-the-go and fast-paced lives mean people skip their breakfast and end up eating unhealthy, quick-fix meals through the remainder of the day. At work they should substitute junk food (refined carbs with trans fats) with fast food (fruits, milk, curd, salad, dry fruits, sattu, lemon water, sugarcane juice and honey),” said Dr Aggarwal. There should be greater emphasis on providing people with healthier options (stocking more fruits and vegetables in dorms, cafeterias and workplaces, substituting fruit for dessert, and offering free fruit).

Pharma News

Weekly pharmacy visits improve adherence to heart failure medications in elderly patients

Business Standard- ANI

Elderly patients with heart failure often miss their medicines or take a lower dose than the prescribed one which can worsen their condition. However, weekly pharmacy visits can improve adherence to medications and quality of life, a study has shown. The study was presented at Heart Failure 2019. "Patients would need to see the pharmacist every week lifelong for the benefits to continue: The key point is that pharmacy visits need to be used as an opportunity to provide structured care," said co-principal investigator Martin Schulz, Freie Universitaet, Germany. "Adhering to a complex medication regimen is a huge challenge for elderly patients with heart failure," pointed Schulz.

Pharma wrap: Modi govt to focus on reducing out of pocket health expenditure

Moneycontrol- Viswanath Pilla

Last week, Prime Minister Narendra Modi-led National Democratic Alliance (NDA) was re-elected with a thumping majority. Modi government’s first tenure had brought healthcare to the top of the agenda. The launch of Ayushman Bharat, including more vaccines as part of the National Immunisation Programme (NIP), Rs 6,000 aid for pregnant women, promotion of AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) and price controls and margin caps on drugs and devices like stents and knee plants, have all got the government a lot of goodwill. Ayushman Bharat, which was launched seven months before the general election, did reap rich political dividends for PM Modi. The scheme provides annual health cover of Rs 5 lakh to over 10 crore poor families. NDA swept the states of Bihar, Madhya Pradesh and Uttar Pradesh where such a scheme is being implemented for the first time.

Granules Pharma gets USFDA nod for ADHD capsules

India Infoline News Service

Granules Pharma, in its press note to the exchanges on Monday, informed that the USFDA has given nod for Methylphenidate Hydrochloride Extended-Release capsules for 10 mg, 20 mg, 30 mg, 40 mg and 60 mg, bioequivalent to the reference listed drug product (RLD), Ritalin LA Extended-Release Capsules, 10 mg, 20 mg, 30 mg, 40 mg, and 60 mg, of Novartis Pharmaceuticals Corporation (Novartis). The Abbreviated New Drug Application (ANDA) for the drug has been filed by Granules Pharmaceuticals, Inc., a wholly owned foreign subsidiary of Granules India Limited. Methylphenidate Hydrochloride Extended-Release Capsules are used for the treatment of Attention Deficit Hyperactivity Disorder (ADHD), the company said in a press note to the exchanges on Monday.

Maharashtra govt amends IPC Rules to make illegal trading of medicines a non-bailable offence

Pharmabiz- Shardul Nautiyal

The Maharashtra government has amended section 274 to 276 of Indian Penal Code (IPC) to make the illegal trading of medicines a non-bailable offence. In the amendment, there is a provision for life imprisonment for those who are involved in trading of adulterated and spurious drugs. Until now, drug dealers used to get bail under provisions of IPC and continued with the nefarious activity of selling spurious drugs to gullible customers. The state FDA had to rely on police investigations without actually itself investigating the matter as per the D&C Act. This is a significant development as the state has passed the Bill in the legislative assembly for the amendment of IPC Rules pertaining to spurious drugs. Maharashtra FDA had some time back proposed to the Maharashtra government to amend IPC rules in line with that stipulated in D&C Act, 1940 to make it more stringent for offenders. The amendments have been made to penalise unscrupulous drug dealers who generally used to go scot-free after illegal trading in spurious drugs due to weak provisions under the current IPC rules.

Karnataka DC dept links 12 Sakala services to Seva Sindhu portal to ensure time-bound access to pharma service certificates

Pharmabiz- Nandita Vijay

The Karnataka drugs control department is now aggressively working to ensure that 12 of the 15 Sakala services related to pharmaceutical certifications will now be able to take the online route. It will be made available on the Seva Sindhu portal coming under the ambit of the Directorate of Electronic Delivery of Citizens Services, under the aegis of the Department of Personnel and Administrative Reforms e: governance arm. This will be effective from June 1, 2019. While Sakala guarantees services to the citizens with a stipulated time limit, the Seva Sindhu is also an initiative of the government to deliver services in a secure and easily accessible manner to the citizens. The 12 services identified for the Seva Sindhu portal are WHO certificate, Market standing certificate, GMP certificate as per Schedule M, No conviction certificate, Production capacity certificate, Validity license certificate, Issue of manufacturing and marketing certificate, Quality and capacity certificate, Performance certificate, Installation and registration/products certificate, Certificate of Pharmaceutical Products (COPP) and Good Laboratory Practices certificate.

Demand for pharmacy courses on the rise in India, Telangana to witness 30% increase in demand: AICTE report

Pharmabiz- A Raju

The demand for pharmacy courses like Bachelor of Pharmacy (B.Pharm) and Diploma in Pharmacy (D.Pharm) is growing in India during the last two years, according to a recent report by the All India Council for Technical Education (AICTE). Particularly in Telangana state, the demand for pharmacy courses has witnessed an increasing trend during the last two years. There are more than 120 pharmacy colleges in the state having nearly 10,000 seats. During the last academic year 2018-19, more than 9,000 seats were filled. And this academic year again, the demand has seen a considerable rise and the AICTE has predicted more than 30 per cent increase in the demand for admission of various pharmacy courses by the students in Telangana. And all this is happening for the first time during the last five years.

GSPC suspends registrations of 5 pharmacists in Gujarat for renting out certificates to retail pharmacies

Pharmabiz- Shardul Nautiyal

As a major deterrent to pharmacists, the Gujarat State Pharmacy Council (GSPC) has suspended registrations of five pharmacists for renting out certificates to retail pharmacies after being employed elsewhere in violation of Pharmacy Act, 1948. GSPC has around 70,000 registered pharmacists and there are 25, 000 retail licensees in the state of Gujarat. GSPC officials have been witnessing an increasing trend of pharmacists renting out certificates to retail drug stores to earn extra income which is detrimental to patient safety, as per GSPC officials. Pharmacy Act empowers state council to take action ranging from issuing warning letters to temporarily and permanently canceling registrations of pharmacists for professional misconduct. The state council executive committee has quasi judicial powers to take action against the offending pharmacists as per section 36 of the Pharmacy Act, 1948.

Hologics Aptima Combo 2 Assay & Cepheids Xpert CT/NG get US FDA marketing approval for extragenital testing for chlamydia and gonorrhea

Pharmabiz

The US Food and Drug Administration (FDA) cleared for marketing two tests that can detect the presence of the bacteria Chlamydia trachomatis and Neisseria gonorrhoeae, which cause the sexually-transmitted infections, respectively, chlamydia and gonorrhea, through diagnostic testing of extragenital specimens. The Aptima Combo 2 Assay and the Xpert CT/NG are the first devices cleared for extragenital diagnostic testing of these infections via the throat and rectum. These tests were previously only cleared for testing urine, vaginal and endocervical samples. The agency granted clearance of Aptima Combo 2 Assay to Hologic, Inc. and Xpert CT/NG to Cepheid.

Healthcare News

MCI recognises 17 non-teaching hospitals for internship in state

The Times of India

In a move to benefit patients, the Medical Council of India (MCI) has recognised 17 non-teaching hospitals for compulsory rotatory internship in the state. The MCI recognition of 17 non-teaching hospitals will help the students to move out from medical colleges and gain experience in district hospitals. These MBBS students will take care of patients in district hospitals at a time when healthcare facility is reeling under shortage of doctors. Department of medical education has issued a circular to all government-run medical colleges, informing them about recognition of non-teaching hospitals authorised by MCI for compulsory rotatory internship for MBBS and BDS students, completing their degrees from state medical colleges.

Stress factor spikes patient count at mental health hosp

The Times of India-Amrita Didyala

There has been a huge jump in the number of patients at the Institute of Mental Health, Erragadda. From 200 a day three to four years ago, the daily average has shot up to 500 now. Confirming the rise in figures, Dr M Umashankar, superintendent, Institute of Mental Health, said in addition to the 500 outpatients, the city’s largest tertiary centre for mental health gets an average of 50 to 60 admissions per day of in-patients. Psychiatrists say increasing stress levels are a major factor for the rise in the number of out-patients. Patients availing the OP facility largely come with problems of anxiety, depression and obsessive-compulsive disorders. Besides this, there are also patients struggling with drug abuse, many of whom have been consuming marijuana (ganja). In-patients, on the other hand, are people who suffer from serious psychotic disorders and need intervention.

GMCH resident alleges assault attempt by patient’s relatives

The Times of India

Nagpur: A resident doctor on duty in ward no. 8 of the Government Medical College and Hospital (GMCH complained of an attempted assault by relatives of a female patient on Sunday morning. According to Maharashtra Association of Resident Doctors (MARD), Dr Aditya Solanke, a third-year student of (Master of surgery) MS, sustained some minor injuries in the scuffle. “Ward no. 8 is reserved for female and paediatric patients and no male relative can enter or stay with the patient in this ward. However, a male relative of one of the patients insisted on staying in the ward. When resident doctors asked him to wait outside the ward, the patient and other relatives created a scene,” said Shubham Ingle, student secretary. He also alleged that many other male relatives of the patient gathered outside the ward and issued threats to the residents.

Nair Hospital did nothing on our letter against ragging: Doctor Payal Tadvis kin

Daily News & Analysis- Varun Singh

The family of a resident doctor who committed suicide at BYL Nair Hospital last week has accused the hospital authorities of sitting on their complaint raising her alleged harassment over caste by three fellow female doctors. "For us, everything including our life has come to a halt now," said Ritesh Tadvi, brother of Dr Payal Tadvi, who hanged herself in her hostel room on May 22. Ritesh said the fact that they hail from a tribal community in Jalgaon district was the reason for her ragging. Payals brother said they had written a letter to Nair authorities on May 10 about the young doctors ordeal, but the hospital never took any action. However, hospital dean Dr RN Bharmal said they never received any complaint.

Gullible patients falling prey to touts in VIMSAR

The New Indian Express

Patients are falling prey to exploitation by touts in Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR) at Burla. Though the hospital officials deny the presence of these agents, desperate patients are allegedly being exploited by them to provide quick services. These agents infiltrate into the hospital campus and look out for patients who are illiterate, unaware or helpless. They then approach the patients or their attendants and offer them quick services, including buying medicines, arranging blood and getting post-mortem done in odd hours, in return of commission.

Manipal Hospitals to buy Medanta in Rs 5,800 crore deal

The Economic Times- Raghu Balakrishnan

The promoters of leading hospital chain Medanta have agreed to sell the business to Manipal Hospitals for Rs 5,800 crore, said two people aware of the development, ending negotiations that have lasted two years. Besides the promoters, existing investors Carlyle and Singapore-based Temasek also agreed on the price and will exit the hospital chain, they said. Medanta’s promoters — renowned cardiac surgeon Naresh Trehan, his family members and cofounder Sunil Sachdeva, who jointly own 55% of the company — will sell their entire stake to Manipal. Medanta, founded in 2009, operates super speciality hospitals and clinics in cities such as Gurgaon, Lucknow, Indore, Ranchi and Sri Ganganagar.

Osmania General Hospital comes to rescue of farm labour twice

The Hans India

Osmania General Hospital (OGH) with help of Helping Hand Foundation (HHF) came forward to rescue a farm labour G Lalita (30) who is hailing from an economically backward section and a resident of remote village in Chevella in Vikarabad. In 2015, her husband who is also a farm labour had to sell a small piece of land to repay the debts on account of failed crop that year, depressed with the financial condition of the family, Lalita had consumed Organo phosphorus pesticide aer which she collapsed and was shied to OGH in a critical situation.

200 bedded Gandhi Nagar Maternity Hospital yet to see light of day

State Times

The construction work on 200 bedded Maternity Hospital in Gandhi Nagar was started during the term of National Conference-Congress alliance government in 2012-13 but more than seven years have passed and the experts are still finding fault with the infrastructure facilities being created to ensure better patient care. It is no more a political secret that a well-known public representative had lobbied hard for the maternity hospital in his assembly constituency by even throwing all norms to wind. On Saturday, when a high level team led by Principal Government Medical College Hospital, Dr Sunanda Raina conducted thorough inspection of the under-construction building, the same was not satisfied with the facilities created so far and suggested some modifications to cater to the basic needs of the patients.

Hyderabad: Yashoda Hospitals launches ‘game-changing’ device

Telangana Today

A diagnostic tool capable of detecting extremely small nodules in lungs was launched by the pulmonology department of Yashoda Hospitals, Somajiguda, on Sunday. The diagnostic machine, Virtual Bronchoscopic Navigation System (VBNS), dubbed ‘The Lung Point’, enables pulmonologists to identify lung cancer at a very early stage and improves survival chances of patient. This is for the first time that such a high-end diagnostic tool has been launched in the two-Telugu speaking States, the hospital doctors said. The sophisticated system will enable doctors to visualise live images of lungs along with a navigational tool that helps them visit the exact spot of the lung. The doctors said the VBNS is literally like a GPS that will allow doctors to minutely see lungs and its peripheries.

Research at SKIMS takes hit as doctors continue private practice

Rising Kashmir- Mansoor Peer

Despite drawing non-practicing allowances, doctors at SK Institute of Medical Sciences, Soura continue to go for private practices’ taking a toll on research activities. Moreover the officials accuse SKIMS of being hand in glove with the erring doctors.As per the doctors, at SKIMS heads of many departments, faculty members, doctors flout norms and indulge in private practice which is an offence. “Many doctors, faculty members violate restrictions on private practice while serving at the institute. They are not supposed to do so. It has affected the patient care and research. The institute lags behind in research,” said a doctor at SKIMS. He said the authorities at the helm have failed to take action against the offenders. He accused the institute authorities of being “hand in glove” with the erring doctors.

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 26 May to 0830 hrs IST of 27 May, 2019)

Heat Wave:

Yesterday, Heat Wave Conditions were observed in some parts of Vidarbha, Telangana and Rayalaseema and in isolated pockets over Marathwada and Tamilnadu & Puducherry. (Annexure 1 & 2).

MAXIMUM TEMPERATURES

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

Maximum temperature departures as on 26-05-2019: Maximum temperatures were appreciably above normal (3.1°C to 5.0°C) at most places over Rayalaseema; at many places over Vidarbha, Marathwada, Telangana and North Interior Karnataka; at a few places over Coastal Andhra Pradesh and Nagaland, Manipur, Mizoram & Tripura; at isolated places over Bihar, West Madhya Pradesh, Madhya Maharashtra and Tamilnadu & Puducherry; above normal (1.6°C to 3.0°C) at many places over Jharkhand, Chhattisgarh and Kerala; at a few places over East Uttar Pradesh, Gangetic West Bengal, West Rajasthan, Odisha, Gujarat State, Konkan & Goa, Coastal Karnataka and Andaman & Nicobar Islands; at isolated places East Rajasthan and South Interior Karnataka. They were below normal (-1.6°C to -3.0°C) at many places over Jammu & Kashmir; at a few places over Haryana, Chandigarh & Delhi and Sub-Himalayan West Bengal & Sikkim and at isolated places over Punjab and near normal over rest of the country.

Yesterday, The highest maximum temperature of 46.5°C was recorded at Nagpur Sonegaon and Wardha (Vidarbha).

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 27 May to 0830 hrs IST of 28 May 2019):-

Heat Wave Conditions in some parts with severe heat waves in isolated pockets very likely over Vidarbha and in isolated pockets very likely over East Uttar Pradesh, Jharkhand, Telangana, south Madhya Maharashtra, south Marathwada, Chhattisgarh and Odisha.

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