Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                           Dated:12th September,2019

Community-based salt substitution program lowers BP
A community-based salt substitution program in Peru lowered blood pressure and cut new cases of hypertension. These results from a study were present at the ESC Congress 2019 together with the World Congress of Cardiology in Paris, France. The study used a salt substitutecontaining 75% sodium and 25% potassium. It was made by mixing equal parts of normal salt (100% sodium) and a commercially available low-sodium product (50% sodium, 50% potassium). Prior research by the group found that the sodium content of salt could be reduced by up to 35% without a noticeable difference in taste.

A total of 2,376 individuals were involved in the study. Half were females and the average age was 43 years. In the overall population, the salt substitute reduced systolic BP by an average of 1.23 mmHg and diastolic BP by an average of 0.72 mmHg. Blood pressure reductions were even greater in individuals with hypertension at baseline: average reductions in systolic and diastolic BP were 1.74 mmHg and 1.25 mmHg, respectively. Among the 1,865 participants (79%) without hypertension at baseline, the salt substitute significantly reduced the likelihood of developing hypertensionby 51% compared to using normal salt (hazard ratio 0.49; 95% confidence interval 0.34–0.71; p<0.001).

Senior author Dr Jaime Miranda said, “The study demonstrates that population-wide changes in sodium intake and blood pressure are feasible. The intervention was simple, highly acceptable, and low cost. Rather than pushing a healthy behaviour change, we engaged people by marketing a new product...the reality is that we, as individuals, do not regularly check our sodium or potassium intake, nor should we be doing so. Given the alarming rates of non-adherence to drug therapy of hypertension globally, we urgently require non-pharmacological measures at the population level to improve blood pressure control.”


We must live every moment of our life
As per Bhagavad Gita 2.3: The soul cannot die. It can neither be cut into pieces by any weapon, nor can it be burned by fire, nor moistened by water, nor withered by the wind.

“nainam chindanti sastrani
nainam dahati pavakah
na cainam kledayanty apo
na sosayati marutah”

As is the microcosm, so is the macrocosm is a Vedic saying. Our body is nothing but the collective consciousness of over 6 trillion cells, with each cell having a physical, subtle and a causal body. Each cell in the body is a mini human being and has a mind, intellect, ego and soul. ....read more


Mera Asia Mahan 2: The Doctor’s Emblem ‘The staff with Two Snakes’
Should doctors be using the first aid Red Cross sign? This controversy has brought about the need to understand the deeper meaning behind the doctors’ own emblem.

Doctors are required to use emblem of a staff with 2 snakes entwined.

The emblem has much deeper meaning and is the perfect reminder of well-being. Most medical associations world over use a modification of the emblem: the compulsory triad of a staff, one or two snakes and another object to represent well-being, which can be a candle, lamp (diya), wings, birds, or a kalash (urn), etc. ....read more


Thinking Differently
There are three ways to manage stress. One is to think opposite, second is to think different and the third is to think positive.

Thinking opposite was advocated by Patanjali, thinking differently by Adi Shankaracharya and thinking positive by Gautam Buddha. Out of the three approaches, the Indian Vedic philosophy focuses on thinking differently. Thinking positive and thinking opposite may not be feasible at the time of any adversity.

Thinking differently has been emphasized in mythology at multiple places. Ten heads of Ravana, five heads of Brahma, elephant head of Lord Ganesha, Fish incarnation of Lord Vishnu and third eye of Lord Shiva remind us of the principle of thinking differently. ....read more


Healthcare News Monitor

Delhi to get three new hospitals with 2,800 beds
ET Healthworld

New Delhi: In the next six months, three hospitals with 2,800 beds in total, equivalent to twice the capacity of Ram Manohar Lohia Hospital, are set to be opened in different parts of the city. This includes Indira Gandhi Hospital (IGH) in Dwarka, which will be the largest hospital in southwest Delhi with 1,241 beds. The progress report submitted by health minister Satyendar Jain to chief minister Arvind Kejriwal on Tuesday showed that 85% of the work for IGH has been completed and furniture will be provided after six months. “The target date of completion is March 21, 2020,” officials said. The two other hospitals that are likely to become functional in the next six months are a 600-bedded facility at Ambedkar Nagar in south Delhi and a 772-bedded hospital in Burari, northwest Delhi. The report stated that both are nearing completion. All three hospitals were planned nearly a decade ago. The land for IGH was bought in 1997 and, as per government records, construction started in 2014. Initially, it was supposed to be a 750-bedded hospital, but the AAP government decided to double the capacity. The construction of the hospital in Ambedkar Nagar was approved in 2013 at a cost of Rs 125.9 crore. The Delhi cabinet on October 22, 2016 decided to increase its bed strength from 200 to 600. “The hospitals were planned by the previous governments, but we are working on completing them, in many cases with improved infrastructure,” an official said. The official said a new mother and child block has been cleared by the state cabinet for Lal Bahadur Shastri Hospital in Khichripur with 460 beds. The tender process has been completed. “The proposal of four new hospitals, one each in Sarita Vihar, Madipur, Hastsal and Jwalapuri, will be brought before the expenditure finance committee (EFC) next week,” he added.

DoP bans single-use plastic products in pharma trade, law to come into force from September 11
Pharmabiz India – Peethaambaran Kunnathoor

In line with the Central government’s effort to ban disposable plastic products that account for large quantity of plastic waste, the Department of Pharmaceuticals (DoP) has decided to ban use of single-use plastics in pharmaceutical trade sector. The official ban will come into effect from the 11th of this month, sources informed. As part of the move, the secretary of the DoP, Dr P D Vaghela, called a meeting of office-bearers of pharma industry associations, medical devices associations and trade associations on last Friday in his office to find out a practical solution to stop use of plastics in industry and medical shops. Consequently, it has decided to give instructions to all concerned associations and their branches to immediately take measures to stop use of single-use plastic products such as plastic carry bags, cosmetic packagings, bottles, containers and cups. According to sources, the meeting was called as part of government’s programme on plastic waste management under the initiative, ‘Swachhata Hi Sewa Campaign’. Office-bearers of IDMA, CIPI, OPPI, AIOCD, AICDF, Jan Aushadhi and officials of DoP and NPPA attended the meeting. Association leaders who attended the meeting said officials of the Central Pollution Control Board (CPCB) and local bodies will inspect wholesale and retail premises to ensure that the business places are plastic-free.

42 days old boy undergoes liver transplant in Chennai hospital

ET Healthworld- Pushpa Narayan

CHENNAI: Aryan Sayani from Mumbai, who was just 42 days old then, might be the youngest liver transplant patient in the country, says a Chennai hospital where the boy underwent the procedure on July 23. The boy was suffering from a rare metabolic condition called urea cycle disorder. Defects in the metabolism caused by genetic mutations led to accumulation of ammonia and other precursor metabolites in the child that threatened to cause brain damage and death. In patients with urea cycle disorder, the body loses ability to covert ammonia, a by-product produced when body metabolises protein. Doctors in Mumbai advised the Sayanis’ to put Aryan on a stringent diet for at least four months after which he could be taken for a liver transplant surgery. He also received periodic dialysis to remove the ammonia. “But they told us that he could have brain damage if something went wrong. Nothing was predictable, and we did not want our child in this situation,” said the boy’s father Neerav Sayani.

Medianama- Trisha Jalan

In July 2018, the Niti Aayog invited comments on its paper on the National Health Stack (NHS). A year later, the Ministry of Health released the National Digital Health Blueprint 2019, drafted by the J. Satyanarayana Committee, which was formed to look into recommendations received on the NHS. The Ministry held an open-house in August 2019 on the Blueprint, see our report. The NHS had proposed, among other things, anonymisation of health data, federated PHR, and to digitise health and data sharing in the sector. MediaNama obtained submissions on NHS to the Niti Aayog via RTI. The following are key points industry body FICCI (Federation of Indian Chambers of Commerce & Industry) made on the NHS paper (see their submission below): Key issues in FICCI’s submission on HealthStack - Adherence to EHR Standards - Interoperability through open APls and open Standards: Strict adherence to EHR Standards will ensure true interoperability and help automate claims management including processing and adjudication thereof. Data Governance: “Mechanisms for anonymisation” should be in line with the appropriate section of the EHR Standards for India 2016.

CIOL

Artificial Intelligence is being implemented in various industries including manufacturing, healthcare etc. Presently India has 1 doctor per 1000 people and by 2023 we are looking at a shortage of up to 600,000 doctors. AI seems to be the only practical alternative. Predictive analytics has become an important aspect of the healthcare industry today due to the vast range of opportunities it presents. AI in healthcare is helping many ways to enhance the efficiency, reduce errors, make better decisions as well as it can predict the illness even before it occurs. But how? Predictive analytics is used in healthcare for the early detection of diseases. Labelled medical images - Today, there exist computer vision models on large numbers of labelled medical images (e.g. X-ray, ultrasound) with matched and clinically validated patient diagnoses. Using such systems would help doctors process more patient cases and make fewer diagnostic mistakes. There are models out there that are able to diagnose simple diagnostic problems such as a fracture on an x-ray or skin cancer better than humans can. As an example, the Google InceptionV3 network trained using 129,450 clinical images of 2,032 different skin diseases has learnt how to classify images based on pixel inputs and disease labels only. This system achieves superior performance compared to dermatologists. However, if the data you have available to teach the AI from is not enough, AI cannot perform at the level of expertise that a human would.