Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                              Dated:3rd August,2019

A suspected case of monkey malaria detected
A native of Bareilly is suspected to have been diagnosed with ‘monkey malaria’ in Almora district hospital, the spotlight has again shifted to research on the deadly disease which could not be completed in a year, reports the Times of India yesterday.

The patient is suspected to have contracted the infection from a rare malaria parasite — Plasmodium knowlesi, which is usually found in monkeys. The slide report of the Bareilly native has been sent to Indian Council of Medical Research (ICMR) for final confirmation.

After the outbreak of malaria last year, experts had decided to conduct a research to rule out the presence of Plasmodium knowlesi, which is a parasite in monkeys. Based on the request of additional director (health), the principal chief conservator of forests (wildlife) had given permission to take blood samples from simians in Aonla sub-division, where malaria had spread the most. Even the scientists at Indian Veterinary Research Institute (IVRI) had said that they would conduct a research on it if they are provided blood samples. However, as the health department delayed the process of appointing a monkey catcher, the time period given by the PCCF (wildlife) to take blood samples expired earlier this year. Later, officials had said that they would seek permission again but nothing has happened so far.

A Grievances Redressal cell should be established in every hospital
The Government of NCT of Delhi has launched an exclusive website for receiving and distributing information to the public related to noise pollution as directed by National Green Tribunal (NGT). Last year, the NGT had asked for the creation of an exclusive website for receiving and dissemination information to the public for creating awareness and dealing with the issue of noise pollution vide order dated 27.9.18 in OA No. 519/2016titled Hardeep Singh & Ors vs SDMC & Ors.

The main features and flow chart of the website are as follows:

The complainant will visit the website ngms.delhi.gov.in to login and to select the concerned police station and to register the complaint. A complaint number will be generated and complainant will get an sms/email alert and contact number of the SHO concerned. Also an sms alert will be sent to the concerned SHO for immediate action. The ACP and SDM concerned shall also be intimated by sms alert for monitoring purpose......read more

Both low and high levels of hemoglobin linked to increased risk of dementia
A new study has linked both low and high hemoglobin levels to an increased risk of developing dementia in the future.

The study involved 12,305 people with an average age of 65 who did not have dementia. Overall, 745 (6%) of the study subjects were found to have anemia. The participants were followed for an average of 12 years. During that time, 1,520 people developed dementia. Of those, 1,194 had Alzheimer’s disease.

Subjects who had anemia were 41% more likely to develop Alzheimer’s disease and 34% more likely to develop any type of dementia compared to those who did not have anemia. Of the 745 people with anemia, 128 developed dementia, vs 1392 of the 11,560 people who did not have anemia. Similarly, participants with high hemoglobin levels were also more likely to develop dementia......read more

Let the mud settle down
Once, Buddha, while traveling, happened to pass a lake. Buddha told one of his disciples, I am thirsty. Do get me some water from that lake there.

The disciple noticed that some people were washing clothes in the water and, right at that moment, a bullock cart started crossing through the lake. As a result, the water became very muddy, very turbid. The disciple thought, how can I give this muddy water to Buddha to drink! So he came back and told Buddha - The water in there is very muddy. I don’t think it is fit to drink......read more

Healthcare News Monitor

Hyderabad: IMA eyes legal recourse
Deccan Chronicle

Hyderabad: The Indian Medical Association (IMA) has stated that the string of protests against the National Medical Council Bill will continue and they are going to look at all the options available to them, including legal recourse. Padma Shree Dr K.K. Aggarwal, a cardiologist says the Bill “is going to kill the alternative medical systems existing in India and will benefit only pharmaceutical companies whose sale of medicines is going to increase by 50 per cent. “The clause permitting community health workers to prescribe medicines for preventive healthcare and also simple diseases is going to benefit pharmaceutical firms the most. India’s rich heritage of Ayurveda is going to suffer in the long run which is now the most sought after form of medication in the West.” Dr Mohammed Javed Iqbal, senior member of IMA in Telangana, cautioned that “the passage of the NMC Bill means that the people have to now be aware from whom they are seeking treatment. It will now be up to the people to identify whether they are being treated by a qualified MBBS doctor, or by someone who is not medically qualified but still has the license to practice.”

NMC Bill revives turf war between docs and bureaucracy
Express Healthcare- Viveka Roychowdhury

The draft NMC Bill seems to have the broad agenda to increase the number of medical personnel. But while IMA might agree with the diagnosis, it disagrees with the prescription. The draft National Medical Commission (NMC) Bill 2019 recently passed in the Lok Sabha and Rajya Sabha has divided the doctor community in India. While the Indian Medical Association (IMA) called for a strike on July 31 and says it will intensify the protests, other factions have hailed it as a fresh start. The protesting doctors and associations hoped that there would be changes before it was passed by the Rajya Sabha. But except for two relatively minor amendments, which will go back to the Lok Sabha for the nod, the draft Bill is unchanged. Minister of Health and Family Welfare, Dr Harsh Vardhan maintained that the Bill would be “the biggest reform of the Narendra Modi government.” The draft NMC Bill seems to have a broad agenda to increase the number of medical personnel. But while IMA might agree with the diagnosis, it disagrees with the prescription.

National Medical Commission is no cure-all, many important questions remain
The Indian Express - K. Sujatha Rao

There are six reasons why governments would like to regulate medical education. One, to ensure that doctors are appropriately trained and skilled to address the prevailing disease burden; two, to ensure that medical graduates reflect a uniform standard of competence and skills; three, to ensure that only those with basic knowledge of science and aptitude for the profession get in; four, to ensure ethical practice in the interest of the patients; five, to create an environment that enables innovation and research; and six, to check the corrosive impact of the process of commercialisation on values and corrupt practices. The question is whether the National Medical Commission Bill passed by Rajya Sabha on Thursday addresses these concerns. The problem of inappropriately trained doctors of varying quality has been known since decades. The report of the Mudaliar Committee set up in 1959 had devoted substantial space to pointing out how doctors had neither the skills nor the knowledge to handle primary care and infectious diseases that were a high priority concern then as now. Likewise, standards vary greatly with competence levels dependent upon the college of instruction. In professionalising the MCI, with experts for all levels of education and practice, the NMC Bill can be a gamechanger.

CDSCO mandates ling of online application for veterinary drugs on new SUGAM portal
Business Medical Dialogues

Through a recent notification, the apex drug regulatory body Central Drugs Standard Control Organization (CDSCO) has informed to file online applications of veterinary drugs on the new SUGAM module. New Delhi: CDSCO has initiated a comprehensive e-Governance program for filing online applications through SUGAM portal with an objective to fast track approvals and bring in complete transparency in its operations. “In continuation to above, a new SUGAM module for filing online applications of Veterinary Drugs has been launched on the portal,” reads the notice. The CDSCO notice further adds that no physical application will be accepted from August 15, 2019, onwards in this regard. The drug regulatory body has directed all stakeholders to use this facility. Moreover, CDSCO shall address appropriately any suggestions to improve the services. Implementation of e-Governance at CDSCO through SUGAM portal has brought simplicity, transparency, reliability, accountability, timeliness and also simplified ease of business. It is the project of national importance that directly reflects the Governments DIGITAL INDIA initiatives and is a major influence in bringing reforms in the Indian Pharma Industry. SUGAM portal provides a single-window for all its stakeholders to access the services provided by the portal by implementing role-based access control and actions. It has consolidated the entire Drug Regulatory framework at the centre and provides a centralized dashboard for monitoring the various regulatory clearances all over the country. SUGAM enables online submission of applications requesting for permissions related to drugs, clinical trials, ethics committee, medical devices, vaccines and cosmetics. The system also builds up the database of approved drugs, manufacturers & formulations, retailers & wholesalers in India. The project also enables the complete digitization of the old CDSCO records having primarily application within the File, noting in Green sheet, and supporting documents.

Indian government begins fresh exercise to revise the NLEM
The Pharma Letter

The National List of Essential Medicines (NLEM) in India, which determines the basis of drug price regulation, is set to add new medicines for the treatment of cardiac diseases and cancer along with certain antibiotics to its list. This would result in a massive slash in prices for these drugs, reports The Pharma Letter’s India correspondent. Pharmaceutical companies have, however, been lobbying hard against price control. In a parallel move and to curtail supply shortages, the NPPA is said to be looking to hike the price of some medicines. The retail price of formulations like antibiotics metronidazole and benzylpenicillin and BCG vaccine for tuberculosis could increase. The Indian government has initiated a new process to identify essential medicines and bring some of them under price control. A newly-constituted committee of NLEM met recently and decided to shortlist drugs that would be needed in adequate numbers with no compromise on quality. Several drug majors as well as industry associations and activists participated in the meeting.

TS govt contemplating to come out with a new antibiotic policy
Pharmabiz India - A Raju

The Telangana state government is contemplating to come out with a new antibiotic policy in the state. The main objective of this new policy would be to regulate and contain the excessive and unnecessary use of antibiotics among people in the state. As part of the proposal, the Telangana government is planning to form a team of experts from both private and government health organisations representing various departments and conduct deliberations on various issues and finally come out with certain regulatory guidelines. According to Telangana Health Ministry sources, it is said that they have received complaints from health experts that some of the physicians and hospitals are prescribing strong antibiotics for even small ailments, which could be treated with simple medicines. “The state government of Telangana after witnessing various instances where in a few medical practitioners from various hospitals are increasingly prescribing heavy dose of antibiotics even for simple ailments like cold and cough. This is leading to emergence of antibiotic resistance microbes which are giving tough challenge to healthcare experts and pharma industry as well. In view of the above, the health department in Telangana has proposed to come out with an antibiotic policy and bring out new regulations to contain the excess and unnecessary use of antibiotics,” informed Etala Rajender, Health Minister of Telangana.

Let artificial intelligence do the health check
ET Tech - Priyanka Sangani

April last year, a medical device powered by artificial intelligence (AI) received approval from the US Food and Drug Administration (USFDA), marking a historic moment in healthcare globally. The IDx-DR, a software algorithm that uses AI to analyse images of the eye using a camera, achieved an 87.4% accuracy rate while detecting ‘more than mild’ diabetic retinopathy, a condition where high blood sugar levels damage the blood vessels in the retina. For IT services firms, which are already developing AI and machine language (ML) tools for other uses and industries, extending AI and ML capabilities to healthcare is a fairly non-complex process, and comes with a large upside. Rather than doing it entirely on their own though, these companies are partnering hospital chains and niche players in the field to acquire the required domain expertise. For instance, Japanese technology firm NTT DATA Services tied up with Pune’s Deenanath Mangeshkar Hospital last year to use an AI-based solution to diagnose emphysema, a chronic condition of the lungs. Over a sixmonth period, the detection rate of its proof-of-concept solution turned out to be 170% higher than traditional systems. “The use of AI to automate insights and tangentially improve the process of care delivery helps healthcare providers who are under increasing scrutiny for quality, often being asked to do more with less time and resources, and in each case, challenged by the amount of digital information that each physician must integrate to make a clinical decision,” said Mitchell Goldburgh, global solutions leader for the company’s enterprise imaging and analytics practice.