Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 6th July, 2019

WHO’s recommendations on saturated fat are out of date, expert team says

A global team of researchers has taken aim at World Health Organisation draft guidelines that recommend people reduce their saturated fat intake, saying advice should be framed around foods, not nutrients.

The WHO draft guidelines, which were released last year, recommend keeping intake of saturated fatty acids (which are found in many animal products) to less than 10 per cent of total energy intake, and using polyunsaturated fatty acids (such as those found in seeds and some fish) as a source of replacement energy if needed. But that approach glosses over recent research that shows saturated fatty acids can take many forms, and that they're not universally harmful, according to the team in an article published July 3, 2019 in the BMJ. "We think that recommendations to reduce intake of total saturated fat without considering specific fatty acids and food sources are not based on evidence and will distract from other, more effective, food-based recommendations," they wrote... (Source: https://www.abc.net.au/news/health/2019-07-04/who-saturated-fat-recommendations-out-of-date-expert-team-says/11274136)

Health Budget 2019-20: Unfulfilled expectations

The budget for the year 2019-20 was presented by the Government yesterday. We had great expectations from the budget with respect to an increase in healthcare expenditure. But once again, health did not seem to be of priority as there was no mention of health directly. Although indirectly, the government has emphasized on the Swachh Bharat Mission with an aim to make India 100% open defecation free by 2nd October, 2019. Housing for all, power for all by 2020 and tap water for all ‘Har Ghar Jal’ by 2024.

The budget allocated for national programs such as National Mental Health Programme, National Programme for prevention and control of Cancer, Diabetes, Cardiovascular Disease and Stroke, National Programme for Health Care for the Elderly and National Programme for Control of Blindness remain the same as they were last year. Though, the Tobacco Control Programme and Drug Deaddiction Programme did see an increase from 64 Cr in 2018-19 to 65Cr in 2019-20......read more

Distemper virus attack suspected in Thrissur

Health officials suspect distemper virus attack at Thekkumkara grama panchayat, near Wadakkanchery, following the death of five toddy cats (Asian Palm Civet) during the last three days, reported The Hindu on Thursday.

However, they said the people need not panic as it would not spread from animals to human beings.
The incident was reported from the uninhabited Gudallur Mana at Thekkumkara. When people found dead toddy cats two days ago, they buried them. But when they found more dead cats, they informed the health officials. District health officials reached the spot and conducted examinations. Forest and veterinary officials have also reached the place. Samples of dead cats have been sent to the Regional Disease Diagnostic Lab. Preliminary examinations indicate distemper virus attack. More tests are being conducted. According to the District Medical Officer, distemper disease is found in animals like toddy cats. But they will not spread to human beings. They will not spread to cattle or poultry birds too, according to the health officials.

Science behind regrets

In a US–based study, dying people were asked about their regrets, if any. The top five regrets were:

1. I wish I had the courage to live a life I wanted to live and not what others expected me to live.

2. I wish I had worked harder.

3. I wish I had the courage to express my feelings.

4. I wish I had stayed in touch with my friends.

5. I wish I had let myself to be happier.

Regrets are always based on suppression of emotions or non–fulfillment of desires and needs. These need-based desires can be at the level of physical body, mind, intellect, ego or the soul. Therefore, regrets can be at any of these levels......read more

Healthcare News Monitor

Expectations From Budget 2019: Making Healthcare Affordable, Accessible And Simple

BW Business World

With the new government about to roll out the first set of policies after coming into power, there are several expectations from the upcoming budget. It is not just medical care but also other social factors that play an important role in determining a person’s health status. These factors are also responsible for the gaps in health among various strata of people. The concept of “One Health” has been gradually gaining ground in the last few years. This concept includes plants, animals, the environment, and human beings. One Health recognizes that the health of the people is connected to that of the other elements of nature as well. In most nations world over, inter-sectoral coordination has been established by the concerned governments, to consult with each other, share their knowledge, and provide effective and efficient means to control the emergence of such diseases as per protocols set by the World Health Organization under their One Health programme. We look forward to a budget that will set the agenda for One Health in India as well. It is important to bring administrative and budgetary control of all schemes under various segments that deal with the health of humans, animals, environment-climate change, agriculture production, and disease control, under one roof. This will enable people working independently in these sectors on the prevention and control of diseases that have the potential to shift their host from one sector to others to understand the dynamics better. Further, such diseases can then be better researched and controlled.

India has one doctor for every 1,457 citizens: Govt

Business Standard- PTI

In India, there is one doctor for every 1,457 people as per the country's current population estimate of 1.35 billion, which is lower than the World Health Organisation norm of 1:1000, the government has informed Parliament. A little over 11.57 lakh allopathic doctors are registered with the state medical councils and the Medical Council of India as on January 31, and assuming 80 per cent availability, it is estimated that around 9.26 lakh doctors may be actually available for active service, Minister of State for Health Ashwini Choubey said in reply to a question in Rajya Sabha on July 2. Besides, there are 7.88 lakh Ayurveda, Unani and Homeopathy (AUH) doctors in the country, he added. "Assuming 80 pc availability, it is estimated that around 6.30 lakh Ayurveda, Unani and Homeopathy (AUH) doctors may be actually available for service and considered together with allopathic doctors, it gives a doctor population ratio of 1:868," he said. As per Indian Nursing Council (INC) records, there are around 30.4 lakh nursing personnel registered in the country as on December 31, 2018, Choubey said in his reply. Assuming 60 per cent availability in the case of registered nurses and registered midwives and 80 per cent availability in the case of auxiliary nurse midwives or lady health visitors, it is estimated that around 20 lakh nursing personnel are available for active services, which gives a nurse-population ratio of about 1:675 against WHO norms 3:1000 (population taken as 135 crores), he said. He was replying to a question on shortage of doctors and nurses in the country. Further, there are 8,500 nursing institutes in the country from where 3.2 lakh nursing personnel annually pass out.

Hospital facilities to shrink as population rises: Economic Survey

Mint-Neetu Chandra Sharma

Rising population over the next two decades will sharply reduce the per capita availability of hospital beds in India across all major states, if country’s hospital facilities remain at current levels, according to the Economic Survey 2018-19 released on Thursday. Noting that access to healthcare was still a major challenge in India, the Survey report said the country already fared poorly relative to other emerging and developed economies in terms of per capita availability of hospital beds. However, the Economic Survey also noted that India was likely to witness a sharp slowdown in population growth in the next two decades. Although the country as a whole will enjoy the “demographic dividend" phase, some states will start transitioning to an ageing society by 2030, it said. Population in the 0-19 age bracket has already peaked due to sharp decline in total fertility rates (TFR) across the country. Southern states, Himachal Pradesh, Punjab, West Bengal and Maharashtra now have fertility rates well below the replacement rate. TFR in Bihar, Uttar Pradesh, Jharkhand, Chhattisgarh, Rajasthan and Madhya Pradesh are above the replacement rate, but are also experiencing significant declines. As a result, the national TFR is expected to be below the replacement level by 2021, the Survey noted. Yet the hospital facilities continue to be scarce. “If India’s hospital facilities remain at current levels, rising population over the next two decades even with slowing population growth rates will sharply reduce the per capita availability of hospital beds in India across all major states," the Survey report highlighted. The Survey noted that all major states are projected to witness a decline in the share of young population and an increase in the share of elderly population over the next two decades. States ahead in the demographic transition, such as Himachal Pradesh, West Bengal, Maharashtra, Punjab and most of the southern states, would have less than one-fourth of the population under the age of 20 but about one fifth or more population over the age of 59 by 2041.

Those who assault doctors should be blacklisted from medical facilities: Hema Malini

The Asian Age-ANI

Expressing concern over attacks on doctors across the country, Bharatiya Janata Party (BJP) MP from Mathura, Hema Malini on Thursday demanded Modi government to bring a strict law in place to protect medical community and debarring those who assault doctors from facilities, including hospitals. "My concern is about the vicious attacks on doctors in various hospitals across the country. On 17 June, around eight lakh doctors walked out on all India strike. For saving the life of a patient the doctor goes through a very stressful condition," she said in Lok Sabha. Calling doctors "superhero" and "national asset", the BJP leader said, "They are our superhero and national asset. We trust God and place equal trust in doctors. There should be a very strict law to protect the medical community. The government should make rules to blacklist those who assault doctors; they should be debarred from facilities, including hospitals." Last month, a nationwide doctor's strike took place after a junior doctor at NRS hospital was assaulted by the family of a patient in West Bengal's Kolkata. However, the protest later came to an end on June 18.

Apple Watch Series 4's ECG feature helps doctor save a life in a restaurant

moneycontrol-Pranav Hegde

The Apple Watch comes with a number of health and fitness monitoring features like a heart-rate sensor, activity tracker, etc. One of the newly introduced features launched in Apple Watch Series 4 includes the ElectroCardioGram (ECG) that detects any irregularities in the heart rhythm. This feature came in useful for a man who was suffering from atrial fibrillation. Atrial fibrillation or A-fib is a condition wherein the heart beats rapidly at an irregular rate. This condition is hard to detect as people do not experience any symptoms. A-fib, if not diagnosed, can develop clots, eventually leading to a stroke or even heart failures. Having the ECG feature in Apple Watch can certainly help one detect diseases like A-fib. In one such instance, a physician used his Apple Watch Series 4 to detect A-Fib in the person inside a restaurant. Tommy Korn MD, an ophthalmologist from San Diego, California, tweeted, “As a physician, it’s much faster to put my #applewatch4 on someone else’s wrist to detect disease (A. fib) than finding an ECG machine at a public restaurant! (Indeed, a true #mhealth guardian)”. The tweet also included a short video wherein the doctor was seen performing ECG on the restaurant-goer. Korn replied to one of the comments and informed that the person detected with A-fib was okay and sent to the hospital. Apple Watch Series 4 is available in India at a starting price of Rs 40,900. The ECG feature is currently available in the US, Europe, and Hong Kong. It is yet to make its way in the Indian market.

E-pharmacies claim in HC they are like Swiggy, only deliver drugs

The Times of India-PTI

New Delhi, Jul 4 () E-pharmacies on Thursday told the Delhi High Court that they do not require a license for online sale of drugs and prescription medicines as they do not sell them, instead they are only delivering the medications akin to food-delivery app Swiggy. The e-pharmacies told a bench of Chief Justice D N Patel and Justice C Hari Shankar that just like Swiggy does not require a restaurant license to deliver food, they do not require any license to deliver medicines to customers who purchase drugs online. The submission came during hearing of a plea seeking contempt action against the e-pharmacies for continuing to sell drugs online despite a high court order staying such activity. The petition also seeks contempt action against the central government for allegedly not taking any action against the defaulting e-pharmacies. The central government, in its defense, told the court that framing of rules to regulate e-pharmacies was under consideration and consultations were being held with all the stakeholders. Several of the e-pharmacy companies and the Centre also sought time to file their response to the contempt plea. Subsequently, the bench granted them time till September 24, the next date of hearing. The contempt plea was filed by Zaheer Ahmed who had earlier moved a PIL seeking a ban on "illegal" sale of drugs online. The high court had earlier stayed the sale of drugs and prescription medicines by online pharmacies while hearing Ahmed's PIL. In his earlier petition, he has said that the online illegal sale of medicines would lead to a drug epidemic, drug abuse and misutilisation of habit forming and addictive drugs. The PIL has said that since there was no mechanism to control the sale of medicines online, this puts health and lives of people at a high risk and affects their right to a safe and healthy life under Article 21 of the Constitution. "Online pharmacies are operating without a drug licence and cannot be regulated in the present regime. Unregulated and unlicensed sale of medicines will increase risk of spurious, misbranded and sub-standard drugs being sold," the plea has said. HMP SKV RCJ.

E-pharma wants a budget with reforms that keeps up with innovation

YourStory- Pradeep Dadha

On July 5, the online pharma industry will be eagerly awaiting Finance Minister Nirmala Sitharaman’s presentation of the Union Budget 2019-2020 - one of the most important markers of the economic growth of the country. According to an EY Report ‘E-pharma: Delivering Healthier Outcomes,’ Indian e-pharma players are expected to reach a combined market size of $2.7 billion by 2023. Evidently, this decade mark the formative years for the Indian epharmacy sector. The retail pharmaceutical sector was valued at $25 billion in FY17, and is projected to grow at a CAGR of 15 percent to reach $59 billion by 2023. This is an opportunity for regulators to bring clarity and stability to the nascent e-pharma industry, and allow it to flourish. Expectations are also high as startups hope for revised tax reforms and policies to further strengthen Digital India. With around 460 million active internet users in the country, and fast adoption of digital products and services, optimists believe that Narendra Modi’s second term as Prime Minister will further improve the ease of doing business. India, currently ranked 77th in the Ease of Doing Business ranking is now aiming higher, eyeing the top-50 list. The Prime Minister has already made tremendous strides towards smoothening bureaucratic hurdles, and we are hopeful that this budget offers scope to innovate with complete support.

Humiliated over insult, paediatrician plans to quit

The Times of India

Humiliated by Dakshina Kannada zilla panchayat president Meenakshi Shanthigodu’s harsh words, the pediatrician at the receiving end of it, who worked at the Puttur Government Hospital, has plans to put in her papers. Dr Archana Karikala was allegedly insulted by the ZP chief in front of patients, while on duty, and following this, she went on leave. A video of the ZP chief yelling at the doctor had gone viral. Indian Medical Association (IMA), Dakshina Kannada chapter, and Karnataka Government Medical Officers Association (KGMOA), have sought an apology from the ZP president, and doctors’ forums are now waiting for the police’s response to the complaint filed by the paediatrician. “Citing the reason of enquiring about a patient’s health, the ZP chief has threatened and abused a sincerely working Dr Archana Karikala. This irresponsible behavior of the ZP president has caused immense pain to doctors and the public,” said Dr Sachidanand Rai, president, IMA, Mangaluru chapter.