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Medical Voice 8th June 2019

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Dr KK Aggarwal    08 June 2019

ICMR moves to get Nipah antidote made in India with Australian help

NEW DELHI: India could soon have indigenously produced antidote to Nipah virus, a deadly disease that has hit Kerala second time in a row this year. The drug, however, is likely to be available for treatment only from next year in case of further outbreaks. Country’s top health research agency, Indian Medical Research Council, has asked an Indian vaccine and pharmaceutical manufacturer, Serum Institute of India, to manufacture the experimental monoclonal antibody for compassionate use during any future outbreaks of Nipah in India or other neighbouring countries.

The council had obtained the MAB from Australia last year during Kerala’s 2018 Nipah outbreak, but it could not be used as the vials arrived only in the first week of June — a few days after the last case of the disease was reported. The same batch of the drugs is now being used on some patients during the ongoing Nipah outbreak in the state… (Source: Express News Service, June 7, 2019)

Vitamin D does not prevent type 2 diabetes in people at high risk

(NIH): Taking a daily vitamin D supplement does not prevent type 2 diabetes in adults at high risk, according to results from a study funded by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH).

The Vitamin D and Type 2 Diabetes (D2d) study enrolled 2,423 adults and was conducted at 22 sites across the United States. A diverse group of participants were enrolled with a range of physical characteristics, including sex, age, and body mass index, as well as racial and ethnic diversity, which helps ensure that the study findings could be widely applicable to people at high risk for developing type 2 diabetes.

Subjects were randomly assigned to either take 4,000 IU of the D3 (cholecalciferol) form of vitamin D or a placebo pill daily. All study participants had their baseline vitamin D levels measured. The subjects were screened every 3 to 6 months for an average of 2.5 years to determine if diabetes had developed. Researchers then compared the number of people in each of the two study groups that had progressed to type 2 diabetes.

At the end of the study, 293 out of 1211 participants (24.2%) in the vitamin D group developed diabetes compared to 323 out of 1212 (26.7%) in the placebo group – a difference that did not reach statistical significance. The study was designed to detect a risk reduction of 25% or more.

These findings were published in the New England Journal of Medicine and presented at the 79th Scientific Sessions of the American Diabetes Association in San Francisco.

Healthcare News Monitor

Pharma News

New injectable hydrogel may improve stem cell uptake

The Hindu Business Line- Susheela Srinivas

The use of stem cells in regenerative medicine remains a challenging task because of problems associated with the survival of transplanted cells. Stem cells, when transplanted on a wound site, release chemicals called paracrine factors which stimulate other cells in the vicinity to initiate tissue regrowth. A group of Indian scientists has developed an injectable hydrogel that can help transplanted stem cells survive longer. Researchers from the Mohali-based Institute of NanoScience and Technology have devised a method to encapsulate adult stem cells called Mesenchymal Stem Cells (MSC) in an injectable hydrogel. In preliminary studies, it has been found that the hydrogel exhibits cell viability and can support long-term survival of stem cells.

Most healthy Indians resistant to Antibiotics! What this means for your health and how it will impact treatment

Financial Express- Swapna Raghu Sanand

Next time your doctor prescribes antibiotics, discuss the possibility of antibiotic resistance! Wondering why such a discussion is relevant? A brief perusal of the findings of the Annual report on Anti-microbial Resistance Surveillance Network 2017 by the Indian Council of Medical Research (ICMR), indicates a worrisome trend of increasing antibiotic resistance in healthy Indians. Way back in 1945, the alarm over antibiotic overuse was first raised by none other than Sir Alexander Fleming, who warned ‘then will begin an era of abuses.” Now, we already know this is a grim reality.

New hope for breast cancer patients

The Hans India

According to GLOBOCAN 2018, breast cancer is the most frequently diagnosed cancer and is a common cause of cancer-related death in women in India. Mortality rates are influenced by the occurrence of the disease and the availability of screening programmes and appropriate treatment. Despite lower breast cancer incidence, breast cancer mortality rates are higher in many low income countries because of later stage at diagnosis, suboptimal access to treatment, more aggressive biological subtypes, and younger age at diagnosis. Advanced breast cancer is an area where the existing drugs are not improving longevity or quality of life of patients.

Fish medicine to be administered tomorrow

The Hans India

Free fish medicine will be administered to chronic asthma patients on June 9 at Kondapalli village, said Md Masood Ali Jinna in a release on Friday. When Mrugasirakarthi enters from June 9, he would start administering the free fish medicine to chronic asthma patients from 1 am. He recalled that the tradition of administering free fish medicine was continuing for 70 years. Late Haji Hakeem Yousuf Ali cured thousands of people from the chronic disease. He said that people suffering from asthma should carry a live small fish with them and the medicine will be given along with that fish. The patients have to swallow the fish and medicine.

CDSCO needs to take on onus to approve, permit drug brand names in India: Dr BR Jagashetty

Pharmabiz- Nandita Vijay

The CDSCO needs to take on the onus to approve and permit brand names for marketing in the country. A dedicated cell should be set up to look into this with immediate effect. This would be the only way to regulate the use of brand names of medicines pan-India, said Dr. BR Jagashetty, former National Adviser (Drugs Control) to CDSCO and former Karnataka Drugs Controller. Such an effort would immediately help curb duplication of drug names and also prevent the sale of look-alike and sound alike drugs (LASA) which is major problem confronting medical professionals, pharmacists and patients in the country, he added. The reality is that when various brand or trade name drugs are being marketed in the country, it is not possible to keep track on the same. Rule 96(1) (i) of the Drugs and Cosmetics Rules, 1945 provides to print proper name of the drug in a more conspicuous manner than the trade name.

Telangana govt allocates 250 acres of land for Medical Device Park at Sultanpur

Pharmabiz- A.Raju

An exclusive Medical Devices Manufacturing Park is coming up at Sultanpur in Telangana. The state government of Telangana has already allocated 250 acres of land to set up the project. And the state government has just signed a Memorandum of Understanding (MoU) with 21 medical equipment manufacturing and allied services companies and is expecting an investment of more than Rs. 500 crore in the next 5 years. Soon after formation of Telangana, the state government of Telangana had decided to ensure that the existing industrial sector is intact and at the same time wanted to take this segment to the next level by opening new avenues wherein more advanced industrial facilities can be provided to the new entrepreneurs and investors.

IDMA paves way for Indian pharma to create roadmap in digitisation era

Pharmabiz

Indian pharma is in the process of transforming itself to be connected to devices, adopt data analytics and artificial intelligence technologies to automate its production processes in the years to come. Some of these Smart Technologies are Radio Frequency Identification (RFID), Social Media Technology, Nanotechnology and usage of Drones that will increase the speed of delivery. In its efforts to adopt QUALITY 4.0 which is an era of digitisation to facilitate innovation and connectivity between process and technology, Indian pharma is looking at a digital makeover in manufacturing, laboratories and supply chain management, said Kaushik Desai, Quality Management and Technical Committee member, IDMA.

Union Ayush ministry directs state licensing authorities to set up expert panel to facilitate licensing of ASU drugs

Pharmabiz

In order to facilitate the licensing or approval of Ayurvedic, Siddha and Unani (ASU) drugs in a streamlined manner, the union Ayush ministry has directed state licensing authorities to constitute expert committee with specific terms of reference as per Section 33-P of the Drugs & Cosmetics (D&C ) Act, 1940. The expert committee shall consist of the senior most Ayurveda, Siddha and Unani officer in the office of state licensing authority or director (Ayush), an expert of Dravyaguna, Ilmul Advia and Gunapadam, an expert of ASU Pharmacy or of Ras-shastra, Saidala and Marunthu- Alunur and an ASU Drug Inspector. The expert committee shall examine the license application and associated documents, proof of concept and testing protocols of intended patent or proprietary ASU drug as provided in Section 3 (h)(i) of the D& C Act, 1940 and Rules thereunder.

TSMC warns doctors of serious action for medical negligence in Telangana

Pharmabiz

The Telangana State Medical Council (TSMC) has expressed concern over the rising cases of medical negligence in the state during the past few years. The TSMC highlighted a case of a 6-year-old baby girl who was reportedly forced to get leg amputated because of medical negligence and lethargic attitude of a doctor at Neelima Hospital at Sanathnagar in Hyderabad. Council has warned the responsible doctor of serious action and initiated a detailed probe into the incident. The six-year-old-girl Akshara injured her leg when a heavy cup-board fell on her a month ago. During the course of treatment at Neelima Hospital, where the doctors operated on her leg discharged the girl from the hospital followed by one day hospitalization. However soon after hospitalisation the little girl complained of severe unbearable pain, after which she was again admitted to the Neelima Hospital.

State seeks new alternatives to tackle swine flu drugs

The Free Press Journal

The state government has approached the National Centre for Disease Control (NCDC) to evaluate procurement of alternative antiviral drugs as opposed to Oseltamivir, popularly known as Tamiflu, being the only drug of choice to treat swine flu. With the rise in the number of swine flu deaths, the state wants these alternate drugs to be put on trial in India and make it available here as it does not want to rely only on this particular medicine. A senior health official said the department of communicable disease have sent a letter to the NCDC suggesting them to search for an option and introduce new medicine for curing swine flu.

Healthcare News

Defunct hospitals, missing staff on agenda of new Punjab hea ..

The Times of India

Newly-appointed health and family welfare minister Balbir Singh Sidhu assumed charge of the department on Friday and vowed to improve health infrastructure, services and fill vacant posts. “My top priority will be to serve people of Punjab, with motto ‘right treatment at right time’,” he said during his meeting with officials of his department. Recently-released grading of primary health centres (PHCs) by the Union ministry of health and family welfare had Punjab faring badly, with 292 (56%) of 521 PHCs not even making it to the cutoff to be graded. Health centres are facing shortage of manpower — against sanctioned posts of 593 doctors in PHCs. only 480 have been filled. About 40 centres are without doctors, 173 without female doctors and 240 PHCs are operating with just one doctor. About 140 PHCs are without laboratory technicians and 38 without pharmacists. There is also a huge shortage of female health workers. Healthcare infrastructure in rural areas comprises three layers — sub-centre, PHC and CHC (community health centre). According to norms, a sub-centre caters to a population of 5,000 in the plains and 3,000 in the hills. A PHC can cater to 30,000 people in plain areas and 20,000 in hilly areas and a CHC is required for a population of 1.2 lakh in the plains and 80,000 in the hills. There are 521 PHCs in the rural areas of Haryana, against the required 577.

Man gets heart from Pune in city’s first transplant

The Times of India- Chaitanya Deshpande

Nagpur: A 28-year-old male patient waiting for heart transplant got a new lease of life on Friday as first ever heart transplant of Central India was performed on him successfully by doctors at New Era Hospital. The heart of a 32-year-old brain-dead male patient from Pune was successfully brought to Nagpur in a flight. City police created a green corridor from Airport to hospital in congested Lakadganj area so the heart was taken there in 7 minutes. Once retrieved, the heart needs to be transplanted within 4 hours. Doctors and police in Pune and Nagpur accomplished this task successfully. The heart came from donor Ganesh Chavan from Pune. He was admitted in KEM hospital (Pune) on May 30 with brain stroke. After treating him for six days, doctors declared him brainstem dead on June 6. Organ donation activist Jasmeet Kaur counselled his family members for organ donation. Ganesh leaves behind wife, a six-year-old son and family-members. “June 7 would have been 32nd birthday of Ganesh Chavan. On this day, he left the world but not before giving new life to four patients,” said Dr Vibhavari Dani, president of Zonal Transplant Coordination Centre (ZTCC) Nagpur.

Payal Tadvi suicide: Three roommates resume work

The Times of India

The three roommates of Dr Payal Tadvi, the BYL Nair Hospital resident doctor who had committed suicide on May 22, have resumed work, a hospital source said on Friday. They had moved out of the hostel and were staying at a guest house arranged for by the hospital authorities. “They had gone on 10-day leave following the incident. They have resumed work now,” said a senior college official, adding that they will soon be allotted new rooms. “The girls were allowed to stay with their parents to help them cope with the traumatic incident,” said the official. One roommate is a prime witness in the case. Nair’s gynaecology department continues to fight the unprecedented turn of events. Department head Dr S D Shirodkar was transferred to the civic-run Cooper Hospital. A civic official said while the decision to transfer Dr Shirodkar was taken last week itself, it was only implemented on Thursday. “She will be relieved with immediate effect. We will appoint someone to the post soon,” said the official. Dr Tadvi’s unit head, Dr Yi Ching Ling, who is accused of not resolving matters between Tadvi and her three seniors, continues to be under suspension.

Are PE investments in hospitals a good thing?

The Hindu Business Line- Jyothi Datta

When a hospital acquires another, the back room activity by private equity firms invested in these companies is often not obvious to the outside world. Private equity (PE) firms control the purse strings, defining the limits to which a hospital group could go to bid for another, besides ensuring that the hospital management runs a tight ship. And while this may be the modus operandi in industry transactions, the concern in healthcare is that hospitals require growth plans anchored in sensitive patient-centric services and not target and profit-dictated initiatives. Jayant Singh, All India Patient Rights Group, recounts a discussion on hospitals that opened with the line, “treating patients is not a viable business.” It’s almost close to two years since Singh’s seven year-old daughter, who had dengue, passed away and the family was left with a hefty bill from Fortis. “Hospitals are not a business where different departments are business units with targets, it is a service,” says Singh, who has taken legal recourse to bring transparency and accountability into hospital systems. “Even a hotel is more transparent, with the services and prices publicly stated,” says Singh.

40% of trauma-related deaths can be avoided with immediate hospital transfer: Dr. Danish Salim

ET Healthworld- Shahid Akhter

Around 1.4 million trauma-related deaths occur around the world. In India, one trauma-related death occurs in every 1.9 minutes. Most of these deaths take place on the roads. In such cases, if you are able to transfer the patient to the hospital immediately, around 40% of these deaths can be avoided. A lot of trauma victims visit the emergency department every day. They reach the hospital one or two hours after the trauma, hence we lose the platinum minutes and golden hours to save the patient. Keeping this in mind, I started a small initiative - a bike ambulance, that is currently in PRS Hospital, Trivandrum. When I put forward this idea to PRS hospital, they warmly welcomed it. We launched South Kerala’s first bike ambulance. With that, we were able to skip traffic by travelling through the narrowest areas, and were able to successfully provide good emergency care. This was my first innovation.

Hip preservation surgery performed

The Hans India

Dr Prasad Gourineni on Friday conducted hip preservation surgery on a patient from Gujarat and another child from Kerala at Amara Hospital in Tirupati. Settled in the USA, the doctor has been visiting the hospital once in every two months and rendering his services, said hospital administrator R Sridhar. The two patients were recovering fast. Orthopaedic surgeons Dr Ravikumar and Dr Ashok and anaesthetist Dr Sudhir have assisted him in the surgery. Hip preservation is a technique, where hip problems are detected at an early stage and protected with minimal interventional procedures thereby avoiding further hip damage and avoid the need for complex surgeries.

Leveraging technology will reduce the gap between doctor-patient relationship, says Sumit Puri, CIO, MAX Healthcare

eHealth- Reetika Bose

Living largely online in 21st century, a massive amount of information is created every day. “We are well aware of the fact that the customers today is changing. Going by the present scenario, there is a lot of information regarding the patients. We are working in the highly connected age of customer with powerful forces driving opportunities”, said Sumit Puri while speaking at the Healthcare Innovation Summit, New Delhi. Today in the healthcare, Sumit continued, “We have significant gaps leading to doctor-patient relationship. There are aspects where the patients have to wait for long hours to seek an appointment before they actually get to meet the doctors.”

Jammu and Kashmir: Objectionable video of doctor, patient goes viral on social media; FIR registered

IndiaTV- PTI

Police registered a case on Friday after an objectionable video of a doctor and his patient from Jammu and Kashmirs Rajouri district went viral on social media, officials said. The case was lodged after the woman in the video registered a complaint saying that the clip was forged and edited, which was aimed at outraging her modesty, Senior Superintendent of Police Yougal Manhas said. She stated in the complaint that the video was filmed long back when she visited a doctor of Rajouri District Hospital for a checkup, the officer said. A special investigation team with Deputy Superintendent of Police (Operations) Rajouri, Pranav Mahajan, as its head has been constituted to probe the matter.

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hours IST of 07 th June to 0830 hours IST of 08 th June, 2019)

Heat Wave:

Heat Wave Conditions observed in many parts with Severe Heat Wave in isolated pockets over West Madhya Pradesh and Vidarbha. Heat Wave Conditions observed in most places over West Rajasthan; some parts over East Rajasthan and isolated pockets over Marathwada, Telangana, north Gujarat and Saurashtra. Annexure 1-2)

MAXIMUM TEMPERATURES

Maximum temperatures more than 40.0°C were recorded in most parts over Punjab, Haryana, Chandigarh & Delhi, Rajasthan, Madhya Pradesh and Vidarbha; at many places over East Uttar Pradesh, Marathawada and Telangana; at a few places over Chhattisgarh and Gujarat States and at isolated places over West Uttar Pradesh, Madhya Maharashtra, Coastal Andhra Pradesh and Tamilnadu & Puducherry.

Maximum temperature departures as on 07-06-2019: Maximum temperatures were markedly above normal (5.1°C or more) at many places over Vidarbha; at a few places over West Madhya Pradesh, Chhattisgarh, Madhya Maharashtra; at isolated places over East Madhya Pradesh; appreciably above normal (3.1°C to 5.0°C) at most places over West Rajasthan; at many places over East Rajasthan, Saurashtra & Kutch, Konkan & Goa, South Interior Karnataka; at a few places over Gujarat Region, Marathwada, Telangana, Coastal & North Interior Karnataka, Rayalaseema, Kerala; at isolated places over Tamilnadu & Puducherry; above normal (1.6°C to 3.0°C) at a few places over Uttarakhand, Sub-Himalayan West Bengal & Sikkim, Assam & Meghalaya, Arunachal Pradesh and at isolated places over Bihar. They were appreciably below normal (-3.1°C to -5.0°C) at many places over Jammu & Kashmir and Odisha; at a few places over Gangetic West Bengal, Lakshadweep; below normal (-1.6°C to -3.0°C) at many places over Andaman & Nicobar Islands; at a few places over West Uttar Pradesh and near normal over rest parts of the country. Yesterday, the highest maximum temperature of 47.2°C recorded at Hoshangabad (West Madhya Pradesh).

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 08 th June to 0830 hrs IST of 09 th June 2019):-

Heat Wave conditions in many parts with severe heat wave in isolated pockets very likely over Madhya Pradesh and Vidarbha; in some parts with severe heat wave in isolated pockets very likely over Rajasthan. Heat Wave to severe heat wave conditions in isolated pockets over Uttar Pradesh and heat wave conditions in some parts over Haryana, Chandigarh & Delhi; in isolated pockets over Chhattisgarh, north Gujarat, Saurashtra & Kutch, Marathwada and Telangana.

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