Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 11th June, 2019

Change the way you live and eat to prevent stroke: HCFI

A recent study has found that people at high genetic risk of stroke can still reduce their chance of getting it by sticking to a healthy lifestyle. This includes quitting smoking and maintaining an ideal weight. The need of the hour is to raise awareness on the importance of adopting a balanced lifestyle right from a young age and for elders in the family to set precedence for kids on these lines.

This proves the age old Vedic expression that you can change your destiny and sanchit karmas by following a proper lifestyle.

The acronym FAST can be used to recognize the warning signs of stroke.

Face — Ask the person to smile. Does one side of the face droop?

Arms — Ask the person to raise both arms. Does one arm drift downward?

Speech — Ask the person to repeat a simple sentence. Are the words slurred? Does he or she fail to repeat the sentence correctly? and

Time — If the answer to any of these questions is yes, time is important.

Neurological disorders are the most complex among all health problems. People should therefore exercise regularly, maintain a healthy weight, keep their sugar, blood pressure and cholesterol under control, and most importantly quit smoking and alcohol consumption.

Stroke is an emergency and getting timely help and treatment is extremely important. Hence, it is very important to act fast to identify these patients. Early treatment improves the chances of recovery.

Some tips from HCFI

  • Lower your blood pressure levels as a high BP is one of the leading causes for a stroke.
  • Losing weight can help prevent other associated complications.
  • Indulge in about 30 minutes of physical activity every day.
  • Quit smoking and drink in moderation if you must.
  • Keep your blood sugar levels under control.
  • Reduce stress through activities such as meditation and yoga.

Untreated white-coat hypertension and cardiovascular and mortality risk

(ACP Internist excerpts): Untreated white-coat hypertension, but not treated white-coat effect, was associated with an increased risk for cardiovascular events and all-cause mortality, according to a systematic review and meta-analysis published in June 11 by Annals of Internal Medicine.

Twenty-seven observational studies with at least three years of follow-up were included. They evaluated 25,786 participants with untreated white-coat hypertension or treated white coat effect and 38,487 participants with normal blood pressure followed for a mean of 3 to 19 years.

Compared with normotension, untreated white-coat hypertension was associated with an increased risk for cardiovascular events, all-cause mortality, and cardiovascular mortality. The risk of white-coat hypertension was attenuated in studies that included stroke in the definition of cardiovascular events. No significant association was found between treated white-coat effect and cardiovascular events, all-cause mortality or cardiovascular mortality.

The elevated risk associated with white-coat hypertension was particularly evident in studies that used ambulatory blood pressure monitoring (not home self-monitoring) and studies with at least five years of follow-up time. These findings suggest that individuals with isolated office hypertension who are not receiving antihypertensive treatment should be closely monitored, while individuals who are receiving antihypertensive treatment could be harmed by overly aggressive management. They added that out-of-office blood pressure monitoring is critical in the diagnosis and management of hypertension.

White coat effect is not associated with increased risk, and out-of-office monitoring seems warranted to prevent intensification of antihypertensive treatment. For adults not taking antihypertensive medication, the risk for cardiovascular disease events and all-cause mortality is only moderately increased, and this risk is substantially lower than that associated with sustained hypertension.

Therefore, out-of-office BP monitoring is useful for distinguishing between white coat hypertension and sustained hypertension among persons with high office BP.

Healthcare News Monitor

Pharma News

Central Drug Lab says no formaldehyde in J&J's baby shampoo

The Times of India- PTI

NEW DELHI: Johnson & Johnson's famous baby shampoo does not contain chemical formaldehyde, re-tests done by noted central drugs laboratory has said. The Central Drugs Laboratory in Kolkata conducted tests on two different lots of the J&J baby shampoo after the company contested a finding of the Rajasthan Drugs Control Organisation (RDCO) that claimed to have found formaldehyde in the shampoo. The RDCO on its website posted results of the tests done by Central Drugs Laboratory which stated that "the sample does not contain formaldehyde" in case of both the lots. When contacted a Johnson & Johnson spokesperson told PTI: "We are pleased with the conclusion of the Rajasthan FDA, which confirms that Johnson's Baby Shampoo does not contain formaldehyde". The outcome reaffirms the company's own testing and the longstanding assurance it gave that its baby shampoo does not contain formaldehyde or any formaldehyde-releasing ingredients, the company said. "Importantly, this is the result of the appellate laboratory, following a magistrate court order for re-testing, and overrules an earlier test result that was erroneous," the spokesperson said.

Drug found to delay Type-1 diabetes by 2 years

Business Standard- IANS

In a first, researchers have found that a treatment affecting the immune system effectively slowed the progression to clinical Type-1 diabetes in high risk individuals by two years or more.
"The results have important implications for people, particularly youth, who have relatives with the disease, as these individuals may be at high risk and benefit from early screening and treatment," said Lisa Spain, Project Scientist from US National Institutes of Health's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The study, involving treatment with an anti-CD3 monoclonal antibody (teplizumab), was conducted by Type 1 Diabetes TrialNet, an international collaboration aimed at discovering ways to delay or prevent Type-1 diabetes.

New plaque psoriasis drug study yields positive results: Dr Reddy's

Business Standard-PTI

Dr Reddy's Laboratories Ltd Monday said it has obtained positive results in the phase-IIb study of its oral molecule PPC-06 (formerly referred to as XP23829) in patients with moderate to severe plaque psoriasis. According to a press release from the city-based drug-maker, the detailed safety and efficacy data from the study would be presented in future dermatology conferences. Senior vice-president and head, proprietary products business of the company, Anil Namboodiripad said PPC-06 is an oral molecule with a novel mechanism of action that has the potential to address unmet medical needs of psoriasis patients. "The top-line data we are reporting today support our belief that PPC-06 may become the first approved oral prodrug of mono methyl fumarate (MMF) for treatment of moderate to severe plaque psoriasis in the US," the official said. Further clinical development requirements would be discussed with the USFDA to support the approval of this product, he added.

Roche's combo lymphoma treatment wins U.S. FDA approval

ET Healthworld- Reuters

The U.S. Food and Drug Administration on Monday granted earlier-than-expected approval to Roche Holding AG's antibody-drug conjugate Polivy for treatment of patients with advanced lymphoma. Polivy was approved in combination with Roche's older drug Rituxan and a chemotherapy agent for adult patients with advanced diffuse large B-cell lymphoma (DLBCL) whose cancer has worsened despite at least two previous lines of therapy. Antibody-drug conjugates are designed to deliver a toxic chemotherapy directly to tumors. Roche said the average U.S. list price for a four-month course of Polivy would be $90,000. Rituxan is priced at $39,500 for four months.

Gujarat: Teachers bag patent for anti-cancer innovation

The Indian Express

Three teachers from the Faculty of Pharmacy of The Maharaja Sayajirao University of Baroda have been granted a patent for the invention of a steroidal chemical entity, a 4-Androsten compound, which has proved effective as an anti-cancer derivative to be used in breast cancer as per preliminary experiments. Professor MR Yadav, Dr Prafulla Sabale and Dr Prashant Murumkar applied for the patent in 2010. According to tests conducted in Germany, the new chemical entity has proved effective in inhibiting the aromatis enzyme from forming the female hormones which aid in the growth of cancerous cells, and in inhibiting their growth through an in-vitro cancerous cell line testing. These inhibitors are further categorised as steroidal and non-steroidal drugs and currently, there are more non-steroidal drugs in the market.

Cipla gets EIR from USFDA for Kurkumbh facility

Zee Business

Pharma major Cipla Monday said it has received establishment inspection report (EIR) from the US health regulator after inspection of Kurkumbh facility in Maharashtra. The Kurkumbh manufacturing facility was inspected by the United States Food and Drug Administration (USFDA) from March 11 to March 20, 2019, Cipla said in a BSE filing. The company has received the EIR indicating closure of the inspection, it added.

Pharmabiz- Peethaambaran Kunnathoor

The number of wholesale licenses (Form 20B and 21B) granted for supplying pharmaceutical products across Bihar is four to five times more than the number of retail licences (Form 20 and 21) issued for local sales, even as the number of medical shops is steadily increasing every year, according to a statistical data of new licenses granted from July 2018 to June 2019. Similarly, the number of Restricted Licenses (RL) granted in Form 20A and 21A is also bigger in most of the districts than the ordinary retail licenses. Restricted license is issued only to sell OTC products and it does not want the supervision of a qualified person (pharmacist). But the license allows in places where the population is not more than five thousand and it targets only rural areas, as per D&C Act. The figures in the data elucidate one fact that majority of the medical shops in Bihar are run on wholesale licenses rather than getting licenses in Form 20 and 21 (retail licence).

SKC&DC raises alarm over huge sales of drugs on internet when DCC panel meets to discuss on e:pharmacy

Pharmabiz- Nandita Vijay

Suvarna Karnataka Chemists and Distributions Association (SKC&DA) has raised an alarm over huge increase in sales of drugs taking place on internet, This was particularly after the draft notification dated August 28, 2018 inviting suggestions and comments. This is despite repeated representations made by the Association to the CDSCO to examine the issue of regulating the e:pharmacy business, said V Harikrishnan at the panel of Drugs Consultative Committee meeting. “We have raised concerns in the past on the fairness and neutrality of the discussions to permit the drugs sales without a regulation. Moreover the draft regulation would overturn the livelihood of 7.5 lakh chemists including pharmacy professionals. Unfortunately the concerned authorities have not made any clarifications in this regard till date even after the receipt of our appeal,” stated Harikrishnan in his communication to the government.

Healthcare News

2 US Nagar-based hospitals under Atal Ayushman scanner

The Times of India

Dehradun: In a case of gross violation of norms, a doctor employed with one of the government hospital in US Nagar is accused of referring patients to a private hospital for treatment under Atal Ayushman Scheme. It was found that the accused government doctor was also working with private hospital on full time basis. In another case, a private hospital’s owner has been charged of forgery by giving wrong information to the health department to get his hospital empaneled with the Atal Ayushman Scheme. Both the hospitals were issued notices for irregularities under Atal Ayushman scheme on Monday. The hospitals have to revert with their explanations on the alleged irregularities within 15 days after

Kin protest after patient death at NRS

The Times of India

Trouble broke out at NRS Medical College and Hospital on Monday night after the death of a patient. The patient’s family alleged medical negligence and staged protest both inside the hospital and outside, following which a large police contingent was deployed. Mohamad Sayeed, a critically ill patient from Tangra, was brought to the hospital’s emergency on Sunday. Even though he was admitted immediately, his relatives claimed no proper medical care was given. Sayeed died on Monday night. Soon after his death, people from his locality reached the hospital to stage a protest. No complaint, however, was filed till reports last came in.

Jaipur's Sawai Man Singh Hospital patients to get medicines on bed

The Times of India

City’s Sawai Man Singh Hospital, competing with private and corporate hospitals, has started providing medicines to patients on their beds. The hospital began the facility at the day care ward for cancer patients on Monday. Attendants of the patients will not have to arrange medicines, which now be provided by the nurses and other healthcare staff posted at the day care ward. It is a move taken to benefit patients especially those who do not have attendants and they come for treatment alone. “The facility has been initiated to benefit all the patients but it will help those patients immensely who come for treatment without any attendant. Most of the patients are underprivileged and those also who are disowned by their families,” Dr DS Meena, medical superintendent, SMS Hospital told TOI. The hospital administration officials have seen that increasing number of patients coming to hospital without any attendants, which is a major cause of concern. With the help of dedicated staff and who is willing to serve the patients with more care, the hospital administration took step to make the medicines available at the beds.

All govt hospitals will have e-hospital management system

Business Standard- PTI

Odisha Health and Family Welfare minister Naba Kishore Das Monday said all government- run hospitals in the state will have e-hospital management system which will help both patients and officials. He said all the 384 CHCs (community health centres), 1318 PHCs (primary health centres), seven medical colleges and 32 district headquarters hospitals will have the Odisha e- Hospital Management Information System (OeHMIS) facility within two years. The OeHMIS facility which will help both the patients and the officials, Das said after reviewing the progress in implementation of the Rs 1,416 lakh OeHMIS programme.

Guj infant branded with hot iron to 'cure' cardiac problem

Business Standard- PTI

A 7-month-old girl who was branded with a hot iron as part of a traditional cure steeped in superstition in Gujarat's Banaskantha district was Monday discharged after being treated for a burn injury that turned septic, a doctor said. The infant had a cardiac problem and her parents took her to a quack in Lakhani area around a week ago who dispensed the hot iron "cure", following which the wound festered and her condition deteriorated, he said. "She was brought here and was discharged today after getting proper medical care," said Dr Sunil Acharya of a private hospital in Deesa. This is the second such case in the district this month, an official said. On June 2, a baby boy was similarly branded in Vaseda village in Vav taluka and succumbed to infection, he said.

Power cut interrupts surgeries at Andhra's Kurnool Government General Hospital

The News Indian Express

Medical facilities, including critical care and surgeries, went for a toss and hundreds of patients at the Kurnool Government General Hospital (KGGH) had to face a harrowing time for nearly five hours with a major power outage on Monday morning. At least ten surgeries had to be postponed as power supply to the hospital was cut off due to transformer failure. Only two generators were functioning and they are not enough to supply power to the entire building and wards. The power supply was disrupted around 8 am plunging the entire building into darkness. It was restored only after five hours. On an average in a day, around 2,000 outpatients and 1,100 inpatients are treated at the hospital.

Medical negligence in Coimbatore: Cotton found inside woman’s body

The New Indian Express

Doctors of a private hospital near Puliyakulam have been accused of medical negligence with one claiming that they left a cotton swab inside his wife’s abdomen during a surgery. Alleging that it happened when his wife had visited the hospital for a hysterectomy, it came to light when she sought treatment for stomach pain in March, he said. Submitting a petition to the Collector on Monday, A Ganesan (37) said his wife had her uterus removed in November 2018 at a private hospital in Puliyakulam and spent as much as Rs 1 lakh. It was a few months later that she experienced acute pain in her abdomen and went to ESI hospital for treatment. After a scan, the doctors there told her of the presence of a foreign object in her abdomen.

Payal Tadvi suicide case: Report confirms ragging, no evidence of casteism

The Indian Express- Tabassum Barnagarwala

THE state-appointed committee formed to look into the suicide of Dr Payal Tadvi, a second-year gynaecology student in TN Topiwala National Medical College, has submitted a report whose findings are that while Tadvi was subjected to ragging by three seniors, no evidence has been found in the course of inquiry to suggest that she was subjected to caste-based discrimination. The report lays stress on immense workload and long working hours that put pressure on Tadvi. The 16-page report is with the medical education department and is set to be submitted to Medical Education Minister Girish Mahajan in a few days. The four-member committee recorded the statements of 32 people, including doctors, hostel inmates, family members of Tadvi and parents of the three accused doctors — Dr Bhakti Mehare, Dr Ankita Khandelwal and Dr Hema Ahuja, presently in judicial custody.

Coimbatore: Woman patient seeks justice for medical negligence caused by doctor

Deccan Chronicle- Lakshmi L Lund

A lab technician who was employed at a private hospital who suffered hernia and uterus-related issues was advised uterus removal procedure by a doctor who owns and runs the Genesis Royal Infirmary Hospital located in Pulikulam here. The 40-year old patient Bhuvaneshwari, a resident of Papanaickenpalayam underwent the procedure in November last year. The patient who is mother of a three-and-a-half-year-old boy alleges that due to medical negligence, a gauze piece was left un-removed when the procedure was performed. “After the uterus was removed, I suffered abnormal abdominal pain for several months which the doctor prescribed antibiotics. It was in March this year, I visited the ESI Hospital here and a biopsy brought to light that the piece of gauze still remained inside my body. A procedure was performed and the same was removed. Yet, the discomfort continued and answering natures call became increasingly difficult,” she said.

RTI?study: Patients forced to get dialysis from private hospitals

The Free Press Journal

A Mahim resident, Jitendra Tandel has started a Non Governmental Organisation (NGO) 'Rugnakalyan Seva' to help patients get treatment at reduced prices, especially dialysis patients who are often forced to opt for expensive dialysis from private nursing homes or hospitals. Tandel, a secretary of Rugnakalyan Seva, is a nephrology patient on dialysis since 14 years. He filed a Right to Information (RTI) in the first week of May asking for the number of dialysis units functioning at the King Edward Memorial (KEM) Hospital. He asked for information from April 1, 2018 to April 30, 2019. In fact, in March 2018, the roof made of Plaster of Paris collapsed and the work is still ongoing. The work was stopped for some time, stating it is an heritage building and no changes can be made, worse still, the electric supply too gets disconnected.

Odisha To Have ‘New Health Policy’, E-Hospital Management, Doctor Surplus State In 2 Yrs

Ommcom News-Debashish Maharana

Presiding over his first ever review meeting, new Health Minister Naba Kishore Das today informed that Odisha is going to have a new Health Policy Vision 2025 in which all the government-run hospitals will have e-hospital management and also reiterated that our State will be doctor surplus in the next two years. He also asserted that every activity by the department will be done in a time-bound manner. Soon after the maiden review meeting, the Health Minister informed media, “There wasn’t a health policy in Odisha. We are going to have a new health policy and it’s Vision 2025. We would now stick to see what should be done by us in 100 days. It will be reviewed by me everyday.”He added, “The first one is Odisha e-hospital management. The information system will be strengthened. We have laid down a guideline. We have 384 CHCs, 1318 PHCs, seven medical colleges in 32 health districts. All will have e-hospital management in which the people will reap the benefits. Data will be stored like AIIMS and big hospitals in other states. It will help in making better our healthcare services.”

Cardiac arrest during elective stenting

As per a new registry, 2 patients will die per year in centres doing 1500 stentings per year and 4 will have cardiac arrest on the table due to the procedure. The number may be much higher for low volume centres.
(Medscape Excerpts): A European registry has shown high rates of unexpected cardiac arrest and death in patients undergoing elective percutaneous coronary intervention. The analysis of over 113,000 elective cases performed at 11 high-volume PCI centers (> 1500 cases per year) shows that 330 patients arrested during PCI, or one per 344 procedures; of which 162 patients died on the table or during the first 24 hours corresponding to one death per 702 procedures....read more

Nipah Update: No new Nipah cases in Kerala

This page will be daily updated till the Nipah scare is over. Inputs invited in this white paper.
Union Minister of Health and Family, Dr Harsh Vardhan has said that there have been no new cases of Nipah virus disease and the clinical condition of Nipah positive patient is improving further.
According to a Health Ministry press release, as on Sunday, there are 8 patients in the isolation ward and 7 of them were tested negative for the Nipah virus. The sample from the 8th patient is being tested in the point of Care (POC) lab. Four other patients from the isolation were discharged on Saturday as their clinical condition improved....read more

The very purpose of life is to face sufferings