5 hidden dangers in international travel

1.Vaccination:Ensure that your patients are up to date on all routine vaccines, including measles, mumps, and rubella (MMR);  varicella (chickenpox); and the seasonal flu vaccine or other specific vaccines advised for the destinations your patient will be visiting.

2.Insect bites:Encourage patients to use insect repellents (DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-3,  8-diol, or 2-undecanone); advise use of mosquito nets, especially for rooms without screens or air conditioning. Insect bites can transmit mosquito-borne diseases (Zika, dengue, yellow fever, or malaria), tick-borne diseases (Lyme disease, spotted fevers), fly-borne diseases (leishmaniasis, sleeping sickness) and flea-borne diseases (typhus, plague).

3.Food and water safety:Encourage patients to choose food that is cooked and served hot, food from sealed packages, peeled fruits and vegetables, and pasteurized dairy. Travelers should avoid drinking tap water or using ice. Bottled and canned drinks are safer choices.

4.Deep vein thrombosis (DVT):Long-distance travelers should be counseled about associated risks that increase their chances of developing DVT. People at higher risk include those who were recently hospitalized or had recent surgery,  pregnant women, and those in the postpartum period (up to 3 months after childbirth). Other risk factors include history of previous DVT; family history of DVT; obesity; increased estrogen; indwelling catheters; cancer; and certain chronic medical illnesses, such as heart or lung disease. Remind patients to move their legs frequently and to walk around every 2-3 hours while traveling. Educate them about the symptoms and what to do.

5.Road and traffic risks: Patients should always wear seat belts; avoid riding in a car in a developing country at night, if possible; avoid riding motorcycles; Know local traffic laws before driving; ride only in marked taxis that have seat belts and avoid overcrowded buses.

(Source: 5 hidden dangers in international travel - Medscape - Aug 26, 2019)

Healthcare News Monitor

AU sanctioned ICMR study on Uddanam nephropathy

ET Healthworld- Umamaheswara Rao

Visakhapatnam: The Indian Council of Medical Research (ICMR) has sanctioned a project to the human genetics department of Andhra University to conduct a study on ‘Uddanam nephropathy’ to determine if any genetic epidemiology is at work. The department had earlier done a research on genetic susceptibility in kidney disease patients in north coastal AP, including the Uddanam area. Based on their prior work and the recent proposals, the ICMR has now sanctioned the project to the human genetics department. The earlier study primarily focused on changes in three genes, including TGFB1 (transforming growth factor beta 1), APOE (apolipoprotein E) and angiotensin-converting enzyme. As part of the study, when compared with the samples of 300 kidney disease patients with the control group (relatively healthy people), the genes showed some associations. For the last two decades, the mysterious kidney epidemic has been haunting Uddanam region in Srikakulam district, killing thousands of people in about 110 villages of six mandals. CKDu/CKDnT (chronic kidney disease of unknown aetiology/non-traditional causes) are believed to be root cause behind most of these deaths. Several hypotheses comprising both environmental factors and genetic components have been put forward as the cause of the kidney diseases, including high levels of silica in water, synergetic effect of various factors such as prolonged dehydration, heat stress nephropathy and NSAID usage, gene mutations, high pesticide usage, mixing cashew nut shell powder with tea etc.

Yet another case of assault on doctor

The Hans India- T P Venu

Hyderabad: Call it a free for all, if you like. In what can be termed an apparent nonchalance, Nasreen, an attendant, twisted the hand of a female PG, Dr Pratusha, and started using abusive language in the presence of security personnel and others on Monday night at Niloufer Hospital. The medical staff said that Dr Pratusha removed a bag of the attendant Nasreen, which prompted the latter to shower expletives and turn physical. Dr Vishnu, president of Niloufer Hospital chapter of Telangana Junior Doctors Association (JUDA), said, "The security at the hospital is just on paper. This is the second time this year that a doctor has been attacked. There is so much workload. The nurses are few and there is no support."

Explainer: How Indian pharma companies are riding the biosimilars wave

moneycontrol - Viswanath Pilla

Indian pharmaceutical companies have been betting big on biosimilars for quite a while as they hope to cash in on its potentially large market. Biosimilars are replicas of biologic drugs that are used to treat different types of cancers and autoimmune diseases. Unlike small molecule generic drugs which can be chemically synthesized, biosimilars are large protein molecules, which are harder and more expensive to develop as they are made from living cells and have a far more complex chemical structure that is difficult to replicate. Also, the need to establish the drug’s safety and its effectiveness at par with its respective biologic drug means that drug makers will have to test the biosimilar drug on humans, which means spending millions of dollars on clinical trials. The estimated cost of developing biosimilars for the global markets is $75-250 million, while developing traditional non-biologic generics costs about $3-$5 million. With many biologic drugs becoming off-patent in various countries, Indian drug makers have been investing millions of dollars to get a piece of this market. A Morgan Stanley report says that as many as nine biologic drugs have either gone off patent or will do so by 2025, with combined revenues of $62 billion in 2018. But unlike generics, a category of drugs where Indian pharma companies have a clear lead, they are facing heated competition from South Korean, Chinese, US and European companies when it comes to the production of biosimilars. It was estimated that revenue from the sale of these biosimilars will grow by 24 percent annually for seven years to $13.3 billion in 2025 in the US and Europe alone.

Chinas new drug law may open door for Indian generic medicines: Report

The Economic Times - PTI

Chinas revised drug law, which removes drugs that are legal in foreign countries but not approved in China from the category of fake medicines, may allow entry of Indian generic medicines in the country, media reports said on Tuesday. Chinas top legislature, the Standing Committee of National Peoples Congress, passed the revised law on Monday to enhance management and supervision of the pharmaceutical market following numerous fake drugs and vaccine cases that had triggered a call for stronger measures to ensure drug safety. India has been demanding that China open its pharmaceutical market to Indian drugs as part of the efforts to lower the USD 57 billion trade deficit in about USD 95.5 billion total trade last year. No major Indian pharma company managed to establish itself in China in view of the rigid regulations and the costs involved. Legal foreign drugs, including generic drugs from India, will not be treated as fake medicine in China based on a revised drug administration law that will take effect on December 1, state-run Global Times reported. The latest revision removes drugs that are legal in foreign countries but not approved in China from the category of fake medicines.

Haryana pharmacy council writes to DHS to stop nurses from dispensing drugs in PHCs & CHCs

Pharmabiz India - Peethaambaran Kunnathoor

Taking serious note on the issues raised by the registered pharmacists in the state, the Haryana State Pharmacy Council (HSPC) has written to the Director of Health Services that unless the department complies with Section 42 (sub section 1) of the Pharmacy Act 1948, the council will be forced to initiate action against violators of the section. The council wanted the government to stop nurses and midwives from dispensing drugs to patients in primary health centres and community health centres. Those who are found to be defying laws will be liable for penal action including cancellation of registration as per the Act, wrote Arun Parasher, registrar of the council. He said all legal and official modes of penal actions will be initiated against such violators. According to the act, whoever contravenes the provisions of the act shall be punishable with imprisonment for a term which may extend to six months or with a fine or both. Speaking to Pharmabiz, the registrar said HSPC has also decided to serve notice to the chemists and druggists association (pharmaceutical traders) of Haryana within one month to appoint registered pharmacists to dispense drugs in their medical shops. Both the retailers and wholesalers will be served notice. If the traders do not follow the norms of Pharmacy Act, the council will turn against them too, he said.