Editor in Chief Dr KK Aggarwal, Padma Shri Awardee


Dated: 5th June, 2019

Nipah is back in Kerala

Nipah virus, the National Institute of Virology, which tested the Kerala man's blood samples, confirmed the presence of the virus

A 23-year-old college student, admitted in a private hospital in Kerala's Ernakulam, has tested positive for Nipah virus, which killed 17 people in the state last year.

Four more people, including two nurses, are down with fever and two of them had come in contact with the 23-year-old man. 311 people, among them 22 students, are under surveillance.

The centre will send monoclonal antibody (medicines) to Kerala that have come from Australia.

Wildlife department has been told to catch bats to test presence of the virus. The medicine, sourced from Australia is available only with the National Institute of Virology. It was used as a preventive medicine for people who were exposed to the Hendra virus in Australia, which mainly infects large fruit bats (flying foxes) and can be passed on to livestock and people.

Nipah virus is transmitted from animals to humans and then spreads through people to people contact. It is associated with fatal encephalitis and respiratory illness. In initial stages, it causes fever, headache, muscle pain, dizziness and nausea.

According to the WHO 18 Nipah cases were reported in Kerala last year; 17 of them died. The first death was reported on May 19, 2018. Since then, more than 2,600 contacts were identified and followed up with during the outbreak.

The last known outbreak in the subcontinent before Kerala last year was in 2004 in Bangladesh. The virus was first identified in 1999 during an outbreak affecting farmers and others in close contact with pigs in Malaysia and Singapore. More than 100 people died in that outbreak that year, and about a million pigs were killed to try to halt its spread. [ source NDTV]

Lessons

1.The index first case has been identified

2.With that the infection one should be able to constrain

3.But the question is why dii it come back. That means the virus still remined in Kerala post last year infection ion some bats.


Weekly pharmacy visits enhance drug adherence in heart failure patients

Elderly patients with heart failure who see a pharmacist once a week are more likely to take their tablets and be active in daily life, according to late breaking results from the PHARM-CHF randomised controlled trial presented at Heart Failure 2019, a scientific congress of the European Society of Cardiology (ESC).

In the study, 237 ambulatory chronic heart failure patients aged 60 years and older were randomly allocated to usual care or a pharmacy intervention and followed-up for a median of two years.

Patients brought their drugs to a pharmacist who made a medication plan, checked for drug interactions and double medications, and contacted the physician about any risks. Patients then visited the pharmacy every 8–10 days to discuss adherence and symptoms, and have blood pressure and pulse rate measurements. Drugs were provided in a pillbox with compartments for morning, noon, evening, and night on each day. The pharmacist updated the medication plan if needed and contacted the doctor with new drug-related problems or significant changes in vital signs.

  • The proportion of adherent patients increased from 44% to 86% in the pharmacy group and from 42% to 68% in the usual care group, a significant 18%-points difference between groups.
  • The proportion of adherent patients increased from 44% to 86% in the pharmacy group and from 42% to 68% in the usual care group, a significant 18%-points difference between groups.
  • Six patients would need to receive the intervention to achieve at least 80% adherence in one patient.


Healthcare News Monitor

Pharma News

Four Cs to determine the course for Indian pharma

The Economic Times- Kiran Kabtta Somvanshi

ET Intelligence Group: Recovering from regulatory turbulence in the most profitable global market, top Indian pharma companies have zeroed in on cost rationalisation, better compliance standards and a more nimble response to competition while hoping the Chinese market could provide the salve going ahead. A review of the FY19 performance of leading Indian pharma companies point to four dominant themes that hold the future for the industry. Cost: Rationalisation of cost during difficult times seems to be the most important mantra for Indian pharma companies that compete on low-cost generics. Spending high on R&D related to generic drugs has not been paying off — prompting companies to go back to their planning boards to make R&D more productive. Besides, legal costs as well as expenditure on drug marketing have surged in recent years. As Sun Pharma NSE -1.36 % founder Dilip Shanghvi said in the fourth-quarter earnings call, strengthening core operations and managing overall cost structure is necessary to ensure competitiveness in the market.

Dhanuka Laboratories leads race for Orchid Pharma

The Economic Times- Joel Rebello

Mumbai: Gurgaon-based Dhanuka Laboratories has been shortlisted as the highest qualified bidder to take over distressed company Orchid Pharma NSE 4.12 %. The company has bid less than 1,000 crore for Orchid that owes lenders 3,200 crore, which means lenders will vote for what will effectively mean a close to 70% haircut. Besides Dhanuka, two other companies - Accord Life Spec and Covalent Laboratories - had bid for Chennai-based Orchid Pharma in a second round of bidding, which was ordered by the Chennai bench of the National Company Law Tribunal (NCLT) in February. A second round of bids was necessitated after the previous winner, Ingen Capital, could not fulfil its financial obligation, including 334 crore in upfront cash. The Chennai bench of the NCLT annulled Ingen Capital's resolution plan in February and allowed 105 days to the resolution professional and the committee of creditors (CoC) to seek fresh expressions of interest.

Government plans to roll out e-pharmacy project in 100 days

Mint- Teena Thacker

Formal recognition and regulation of online pharmacies is a step closer to reality, with health ministry officials set to meet industry stakeholders on 10 June to finalize the rules. The new government is planning to roll out the e-pharmacy project in its first 100 days, having released the draft rules for it last year. India’s online pharmacies that currently operate in a regulatory grey area, thanks to conflicting court orders, hope the new rules will bring much-needed clarity to the sector. According to the proposed e-pharmacy rules which were opened for public comments in September, only government-registered e-portals can sell medicines, and they must retain prescriptions and verify details of patients and doctors.

Aurobindo Pharma gets 10 observations from USFDA for its Unit 3 at Hyderabad

Moneycontrol- PTI

Drug firm Aurobindo Pharma June 4 said it has received 10 observations from the US health regulator for its Unit 3 in Hyderabad. The United States Food and Drug Administration (USFDA) conducted an inspection at company's Unit III, a formulation manufacturing facility located at Bachupally, Hyderabad, from May 13 to May 24, 2019, Aurobindo Pharma said in a filing to the BSE. "The company has received a 'Form 483' with 10 observations," it added. None of the observations are repetitive and are more procedural in nature, Aurobindo Pharma said. The drug firm, however, did not provide any details about the observations made by the regulator.

GlaxoSmithKline's Nucala receives positive CHMP opinion for new self-administration options

Pharmabiz

GlaxoSmithKline announced that the European Medicines Agency’s (EMA) Committee for Medicinal Products for Human Use (CHMP) has issued a positive opinion recommending two new methods for administering Nucala (mepolizumab) to patients with severe eosinophilic asthma: a pre- filled pen and a pre- filled safety syringe, to be taken once every four weeks. If approved, the two new Nucala options will offer healthcare professionals the choice of prescribing at-home administration for appropriate patients. The original lyophilised powder version remains available for administration in clinic by a healthcare professional. A CHMP positive opinion is one of the final steps before marketing authorisation is granted by the European Commission.

KSRPA objects to erratic MRPs on labels inflating drug prices, urges govt to tweak DPCO to correct same

Pharmabiz- Nandita Vijay

Karnataka State Registered Pharmacists Association (KSRPA) has pointed out that DPCO which is expected to control soaring prices of essential drugs has dismally failed to contain the difficulties of poor patients. This is particularly true in the case of the non-scheduled generic drugs. Quoting para 9 of the DPCO, the Association said that it controls the maximum retail price (MRP) of the scheduled generic drugs, by way of ceiling price. But other generic drugs do not fall under price control. While encouraging the industry, the legislative note is to strike a balance between supply of such drugs and the cost of healthcare. Unfortunately, pharma companies have made it a habit to display an inflated MRP on the labels of the generic drugs which is blown up several times more than the real costs, said Ashokswamy Heroor, president, Karnataka State Registered Pharmacists Association in his communication to the Union government.

CTMR urges Union Ayush ministry to open Jan Aushadhi model Siddha shops all over India

Pharmabiz- Peethaambaran Kunnathoor

Congratulating Sripad Yesso Naik on his assuming office as the Minister of Ayush for the second term, the Chennai based Centre for Traditional Medicines and Research (CTMR) appealed to the minister to establish ‘Jan Aushadhi’ model Siddha medical stores in all major cities and Ayush hospitals in the country to make quality traditional medicines at affordable prices. On the way to Delhi to submit a memorandum to the minister, the CTMR secretary, Dr. T Thirunarayanan, has responded to queries from Pharmabiz that the Siddha community in Tamil Nadu now needs the ministry’s special attention and focus on Siddha stream to promote the method of treatment and Siddha drugs in national level. Jan Aushadhi model shops for Siddha will help promote the system and the drug industry in places where the system is currently alienated or made inaccessible to people, especially to the Tamil diaspora who are mostly the followers of the Siddha system.

Pollution driven illness like TB, cancer a challenge to doctors on World Environment day

Pharmabiz

Doctors are increasingly concerned on the challenge to treat pollution driven illnesses. From tuberculosis to cancer and skin disorders are manifesting with a vengeance. This is happening especially when the nation is observing the World Environment day on June 5. According to the World Health Organization, around 3 billion people around the world cook and heat their home with solid fuels (wood and coal) or cook over open flames. This type of cooking paired with poor ventilation leads to high levels of indoor air pollution which can contribute to lung cancer. Not just outdoor pollution causes cancer. Women and children are more likely to be affected by this indoor pollution due to their proximity to the cooking fire, and time spent in the household. Also, outside pollution from vehicle exhaust, power plants, wood stoves, and other sources contain tiny particles that can also contribute to lung cancer.

Healthcare News

Patient refuses to file plaint against doc who thrashed him

The Times of India

Relatives of the patient who was beaten up by a doctor in Sawai Man Singh (SMS) Hospital have refused to register complaint against the doctor, urging doctors to allow them to go home to celebrate Eid on Wednesday. A video of the doctor beating the patient had gone viral on Monday. The patient’s relatives have given in writing, addressing the station house officer, Moti Doongri police station, that they did not want to register any complaint. TOI has the possession of the factual report prepared by SMS Hospital and the letter written by the patient’s attendant, which is part of the factual report. Twenty-six-year-old Mubarak, was admitted to the hospital with acute gastroenteritis on June 1. He is still undergoing treatment at 1C ward of SMS Hospital. Talking to TOI, Mubarak’s brother-in-law Shahid, said, “We are fruit vendors and sell fruits in streets. We want to celebrate Eid, so we have asked the doctors to allow us to go. Mubarak is fine now. I thank all the doctors for the treatment.” Mubarak’s video is also circulating in which he is apologising with the doctors.

Ayurveda, homeopathy doctors told to refer suspected cases

The Times of India

Ayurveda and homeopathy doctors who come across patients with fever or other-such symptoms need to refer them immediately to an allopathic doctor. Labour department has been asked to increase surveillance in areas where migrant labourers stay, stated a release issued by the state government. Meanwhile, doctors and staff at Ezhikkara block primary health centre within which Vadakkekara panchayat falls, have been given adequate training. The first confirmed case of Nipah came from here this year. With 311 persons under surveillance now, health department has prepared an action plan for 21 days for them. All the government employees in the district will be given special training on Wednesday to identify patients with fever.

Hospital with 800 beds to open in Delhi's Burari

The Times of India-Pankhuri Yadav

The Public Works Department is all set to open an 800-bed multi-specialty hospital at Burari in north Delhi by the end of July. Originally proposed as a 200-bed facility by the then Congress government, the Aam Aadmi Party government increased the number of beds in 2015 to benefit people from north and northwest Delhi and Noida. The new medical centre will boost the availability of specialised healthcare beyond the state government’s two other super speciality hospitals, Rajiv Gandhi Super Speciality Hospital in Dilshad Garden and Janakpuri Super Speciality Hospital. A fourth super specialty medical centre is coming up in Dwarka. This proposal for an enhanced hospital project was incorporated in the Delhi budget of 2015-16. Officials said that the hospital at Burari will offer diversified and specialised treatment to Delhiites. According to a senior health official, the residents of north and northwest Delhi did not have a super speciality hospital in the region and they were forced to travel to Safdarjung Hospital or AIIMS for necessary treatment. With this hospital now preparing to receive patients, people from the area as well as those from other parts of the city could avail of good treatment.

Navsari to get modern hospital by next year

The Times of India

A multispecialty hospital will start functioning in Navsari district by next year. The hospital is being set up by Nirali Memorial Medical Trust, which was established by AM Naik, group chairman of Larsen & Toubro Ltd. It will be managed by Apollo Hospitals. An agreement in this regard was also signed by Naik and Apollo Hospitals chairman Dr Prathap C Reddy. Naik said, “The hospital will provide best medical care facilities to rural and underprivileged people.”

Gurugram: Two ex-staffers of government hospital rehired, panel wants probe

The Times of India-Seema Sharma

The Haryana State Human Rights Commission has directed the chief secretary to hold an inquiry against the deputy commissioner (DC) of Gurugram for reinstating two employees of a civil hospital who had not allowed a heavily pregnant woman to enter the healthcare facility because of which she delivered the child outside. Principal Secretary had tasked senior doctors to conduct the enquiry in which these employees were indicted and services of two of them were terminated. Deep Bhatia, a member of the commission, told TOI that they had asked the chief secretary to launch a probe to understand the circumstances under which the DC passed orders for taking back the erring employees. “The chief secretary should take appropriate preventive measures, so that such type of violations of human rights in medicalcare facilities do not reoccur,” Bhatia said.

U'khand hospital discharges rape survivor without proper treatment, makes her share vehicle with accused

Business Standard- ANI

The parents of a nine-year-old rape survivor here have alleged that their daughter was discharged from a hospital without proper treatment and then made to travel with the accused in a police vehicle to record her statement before the magistrate. The girl, who hailed from Tehri district, was allegedly raped in Nainbagh area on May 30. The Circle Officer (CO) of the area Uttam Singh has been suspended on charges of negligence of duty. The victim was admitted to Doon Medical College and Hospital. Her parents alleged that she was discharged from the hospital even before she could recover fully. According to parents, their daughter could not give her statement properly as her condition worsened after she travelled four hours with the accused.

Under construction hospital at Bemina will be children's hospice: J-K govt

Business Standard- PTI

Jammu and Kashmir government Tuesday issued orders for converting 500-bed maternity-cum children's hospital coming up at Bemina here into an exclusive pediatric hospital. The State health department issued orders for converting the maternity-cum-children's hospital into a pediatric hospital here following the decision taken by State Administrative Council (SAC) last week. The SAC in its last meeting on 29th May had approved conversion of the under construction health institution -- with 200-bedded maternity hospital and 300-bedded pediatrics hospital at Bemina, Srinagar -- into a full-fledged 500-bedded Children's Hospital, an official spokesman said. He said provision of quality childcare health facilities at Srinagar which witnesses rush from other districts has been a long standing demand of general public in particular those who are not able to afford the same in private centres.

Mysuru: Hospitals yet to be paid for treating poisoned victims

The New Indian Express- K Shiva Kumar

They bravely worked day and night to save devotees who were battling for life after having consumed poisoned prasadam at the Kichuguthu Maramma Temple in Sulvadi. Now, they are running from pillar to post to get their bills cleared. The case had shot into the limelight as 15 lives were lost in the tragedy. It was even discussed in Parliament and the Prime Minister’s Office had announced compensation for the kin. However, for the doctors and hospitals, the chances of recovering payments are slim. As the government hospitals in Hanur, Kollegal and Chamarajanagar, which were closest to the temple, did not have the best health care facilities, 104 patients, including 30 in critical condition, were rushed to KR Hospital in Mysuru. While a majority were discharged within 15 days, a few remained under care for a month after which they were given psychiatric counselling as well.

Maharashtra: Tribunal directs doctor and company to pay Rs 15 lakh to private firm for data theft

The Indian Express- Mohamed Thaver

The Telecom Disputes Settlement and Appellate Tribunal on Friday directed a doctor and a company he co-founded to pay Rs 15 lakh as compensation to a private company, Preventine Life Care Private Limited, over data theft. Navi Mumbai-based Preventine had approached earlier the state IT secretary, who had in 2014 ordered the doctor to pay Rs 30 lakh as compensation in the matter. The doctor then appealed the order at the Telecom Disputes Settlement and Appellate Tribunal in Delhi. Preventine, which provides diagnostic services related to genetic disorders for newborn babies, had in January 2013 filed a civil and criminal suit against Dr Rishi Dixit. Dixit was employed with them as a senior manager between 2010 and 2012. The complaint also named a company, Navigene Genetic Science Private Limited, as well as a senior research associate who worked with Preventine.

Kolkata: Doctor confined for an hour after minor dies

The Indian Express

A six-year-old boy died in Garden Reach area on Tuesday, following which his relatives attacked the doctor and kept him confined for an hour, accusing him of medical negligence. The doctor, however, has denied all the charges. A police complaint has been lodged against the doctor, Amitabh Mondal, and the relatives have demanded his arrest. The body of six-year-old Subham Tiwary, who was a class 1 student, has been sent for autopsy to SSKM hospital. A police official said, “Dr. Amitava Mondal, MBBS (Ortho), was manhandled and kept confined inside a house at Fatehpur village in Garden Reach police station area over an allegation of carrying out improper treatment of Subham. He was under doctor Mondol’s treatment till today morning. After his condition deteriorated, the patient was shifted to Ramkrishna Mission Seva Pratisthan. After the doctor was confined, local police had to rescue him. The situation was then brought under control.”

Chhattisgarh: Man accuses hospital of removing mother's kidney without consent

Times Now

A man has accused a private hospital in Chhattisgarh's Raigarh district of removing his mother's kidney without consent, police said Tuesday. An official said district collector Yashwant Kumar had ordered a probe into the allegations made by Aishwarya Patel against Vananchal Care Hospital. Patel's mother Sumitra (62), a native of Markam Godi village in neighbouring Janjgir-Champa district, was admitted in the hospital, located in Kharsia area here, on May 26 for a surgery to remove stones in her left kidney, he said quoting the complaint. "Patel has named three doctors in his complaint which was filed at Kharsia police station on Monday," the official said. The doctors have refuted the allegations and told reporters that the woman's kidney was removed as it had developed an infection, adding that consent of the relatives was obtained.

Nipah scare: How a Malaysian doctor discovered the deadly virus

Times Now

The Nipah is an RNA virus, which was first discovered as a zoonotic (spread from animals to humans) pathogen after a 1999 outbreak involving severe respiratory illness in pigs and encephalitic disease in humans. The nomenclature of Nipah virus, or NiV, originated from Sungai Nipah, a village in the Malaysian Peninsula where pig farmers became ill with encephalitis. In 1999, pig farmers in Malaysia's Sungai Nipah were diagnosed with a curious disease which started off with mild flu like symptoms -- fever, headache etc. Initially, the virus was prevented with a Japanese encephalitis antidote, but the remedy was not entirely successful. The rapid spread of the disease and the rise in fatality levels – around 40 per cent of those infected at the time -- soon created alarm among the farmers and the general public.

Anti-Tobacco workshop held District Central Hospital

The Hans India

Consumption of tobacco and related products would lead to cancer and annihilating lungs, sometimes it leads to death, warned ADMHO Dr Ratnakumari on Tuesday. She addressed a district level workshop on Anti Tobacco at the District Central Hospital. Speaking on the occasion, she has appealed to the officers to conduct awareness programmes to create awareness on the ill effects of the consumption of tobacco. By consuming tobacco, cigarette, gutkha, beedi every year about one million people have been losing their lives, she lamented.

Narayana Hospital observes infection control month

State Times

The Ever-growing menace of Hospital acquired infection is gradually acquiring gigantic proportion. Recognizing this, the SMVD Narayana Superspeciality Hospital, Kakryal celebrated the month of May as Hospital Infection control Month. This was primarily aimed at reinforcing and increasing awareness towards prevention of Hospital acquired Infection, not only among the hospital staff but also patient relatives and other people. The specific areas covered included, the paramount importance of Hand Hygiene at all times, preventions of Surgical Site Infection, Prevention of Catheter related Blood stream and Urinary tract infection, increasing antibiotics resistance etc.

Doctor carries leprosy patient in arms

Orrisa Post- PNN

A video showing a doctor helping an elderly leprosy patient cross a busy road by carrying him in his arms is going viral here and at the same time deluge of wishes are reaching the doctor. Dr Shankar Ramchandani, a senior resident doctor of Burla based VIMSAR was driving somewhere Monday morning when he saw an elderly leper trying to cross the busy road to reach the leper colony, across the road. After watching him struggle wading through the bumper to bumper traffic, Ramchandani parked his car by the roadside and walked down to the person. Addressing the man as ‘mausa’ (uncle), he enquired him about his destination. Though a little perplexed to hear ‘mausa’ from someone looking like a ‘babu’ (officer), he told him of his struggle to cross the street.


Current Temperature Status and Warning for next five days

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 03 June, 2019 to 0830 hrs IST 04 June, 2019)

Heat Wave:

Yesterday, Severe Heat Wave conditions observed in many parts over West Rajasthan and at isolated pockets over Madhya Pradesh & East Rajasthan. Heat wave conditions observed at many places over Vidarbha and East Rajasthan; over some parts of Madhya Pradesh and at isolated pockets over West Rajasthan. (Annexure 1 & 2).

MAXIMUM TEMPERATURES

Maximum temperature departures as on 03-06-2019: Maximum temperatures were markedly above normal (5.1°C or more) at most places over West Rajasthan; at many places over East Rajasthan; at a few places over West Madhya Pradesh; at isolated places over East Madhya Pradesh; appreciably above normal (3.1°C to 5.0°C) at many places over Marathwada and Vidarbha; at isolated places over Telangana and South Interior Karnataka; above normal (1.6°C to 3.0°C) at many places over Himachal Pradesh and Madhya Maharashtra; at a few places over Arunachal Pradesh, Assam & Meghalaya, Jammu & Kashmir, Haryana, Chandigarh & Delhi, Gujarat Region, Konkan & Goa Kerala and Tamilnadu, Puducherry & Karaikal.. Yesterday, the highest maximum temperature of 50.3°C was recorded at Churu (West Rajasthan).

Temperatures Recorded at 1430 Hours IST of Today, the 04 th June, 2019

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 04th June to 0830 hrs IST of 05th June 2019):-

  • Churu (West Rajasthan) recorded the maximum temperature of 47.6°C (Annexure 3).
  • Temperatures recorded at 1430 hours IST of today have risen by 3-6°C in most parts over Chattisgarh, in isolated pockets over Bihar, Coastal Andhra Pradesh and Uttrakhand; risen by 1- 3°C in many parts East Uttar pradesh, Jharkhand, Odisha and in isolated pockets over Karnataka, Rayalaseema, Kerala and Tamilnadu & Puducherry.(Annexure 4).


Nipah virus emerges again: College student in Kochi infected with Nipah

Kochi, Jun 4 (PTI): Kerala Health Minister K K Shailaja confirmed Tuesday that a 23-year-old college student admitted to a hospital here has been infected with the Nipah virus. The results of blood samples of the student, which were tested at the National Institute of Virology (NIV) in Pune, have confirmed Nipah, she said. The result came this morning, she said. The student has been admitted to a private hospital here. Earlier, blood samples examined at two virology institutes--Manipal Institute of Virology and Kerala Institute of Virology and Infectious Diseases--had indicated Nipah.
The Nipah virus infection is an emerging zoonotic disease and has made its appearance once again in Kerala.....read more


Let's pledge to control air pollution on this World Environment Day

Today is World Environment Day and the theme for this year is “Air pollution”, a pressing environmental issue today.
Nine out of 10 people now breathe polluted air, which kills 7 million people every year, according to the WHO. And it's just not outdoor air pollution; household (indoor) air pollution also causes 4 million deaths annually. Air pollution has rightly been listed as one amongst the top 10 health concerns of 2019 by the World Health Organization (WHO).
Latest data show that India has seven of the world's worst 10 polluted cities and 22 of the worst 30 polluted cities....read more


Do unto yourselves what you do to God