Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                               Dated:15 November,2019

Prevalence of antibiotic resistance in the US much higher than estimated

Antibiotic resistance is a greater threat in the United States than previously estimated and is not going away, according to the US Centers for Disease Control and Prevention (CDC).

Each year, antibiotic-resistant bacteria and fungi cause more than 2.8 million infections and 35,000 deaths in the United States. On average, someone in the United States develops an antibiotic-resistant infection every 11 seconds, and every 15 minutes, someone dies from such an infection, according to the CDC. Antibiotic resistance remains a “significant enemy [that] threatens both our nation's health and our global security, and we all play an important role in stopping it,” CDC Director Robert R. Redfield, MD, said.

The updated report establishes a new national baseline of infections and deaths from antibiotic-resistant germs. The report lists 18 antibiotic-resistant threats, which are classified on the basis of level of concern to human health ? urgent, serious, or concerning. There are two new "urgent" threats on the list ? drug-resistant Candida auris and carbapenem-resistant Acinetobacter … (Medscape excerpts).

Girl suspected to be suffering from dengue dies in Delhi
Rise in hematocrit along with rapid fall in platelets is the danger sign in dengue

A16-year-old girl suspected to be suffering from dengue died at a Delhi hospital. She was running fever for the last 8-10 days. She was a resident of a housing complex; more than 1500 families are residing in various towers of the housing complex. The National Buildings Construction Corporation (NBCC) is responsible for cleaning, sweeping, collecting garbage and carrying out anti-malarial and anti-larval activities at the complex.

Less than 1100 cases of dengue and no deaths due to the mosquito-borne disease have been reported so far this year in the city. Cases of malaria and Chikungunya have also decreased in Delhi. Of the total dengue cases, there were 787 in October, while in the same month 249 malaria cases were also recorded. 143 cases of Chikungunya have also been reported this year. ....read more

Adverse childhood experiences associated with leading causes of death
(Excerpts from CDC): A first-ever CDC analysis provides comprehensive estimates of the potential to improve health by preventing adverse childhood experiences (ACEs).

At least five of the top 10 leading causes of death are associated with ACEs. Preventing ACEs could potentially reduce chronic diseases, risky health behaviors, and socioeconomic challenges for adults.

ACEs can include experiencing abuse, witnessing violence or substance misuse in the home, and having a parent in jail. Exposure to ACEs can result in extreme or repetitive toxic stress responses that can cause both immediate and long-term physical and emotional harms. ....read more

The spiritual prescription "I am sorry"

Two hardest words for a doctor to say: "I’m sorry." Most defence lawyers counsel doctors to not apologize to patients. Their view is that if you say you’re sorry for something, you are implicitly taking some degree of responsibility for whatever has happened. In other words, you are pleading guilty. The complainant’s lawyers may use a doctor’s apology to the maximum extent possible to show the doctor knew what they did was wrong. The usual approach is deny and defend. But, ....read more

Healthcare News Monitor

Print warning about kidney injury on antacids: Drug Controller asks pharma
The Hitavada - Rajendra Diwe

EVERY alternate prescription of registered medical practitioners contains at least one molecule of antacid drug. However, rampant use of antacids belonging to ‘Proton Pump Inhibitors’ (PPIs) has increased ‘Acute Kidney Damage’ in patients. Taking note of this problem, the Drug Controller General of India (DCGI) V G Somani has directed the state regulators to ask pharmaceutical companies manufacturing proton pump inhibitors to include ‘acute kidney injury’ as an adverse drug reaction on patient information leaflets of drug packs. According to Pharmacology, Proton Pump Inhibitors (PPIs) are a class of drugs used to treat gastroesophageal reflux disease commonly known as heartburn, stomach ulcers and other conditions caused by overproduction of stomach acid. These drugs include pantoprazole, omeprazole, rabiprazole, esomeprazole, lansoprazole etc. Despite researches by many associations of medical practitioners, use of these ‘antacids’ is continuing over the years. According to a study from market research firm AIOCD-AWACS, “This year till September, people of India have consumed PPIs worth Rs 1,854 crore.” A pharmacist, on condition of anonymity, said, “These Proton Pump Inhibitors are special class of drugs to be used for chronic conditions like ulcers. Unfortunately, each manufacturing company in India, whether it is of generic drugs or Propaganda Cum Distributors or loan licence or having patent, is busy in promoting PPIs to each and every doctor from urban as well as rural areas. More than 1000 brands of these drugs are on sale in the market. This may be the reason for rise in acute kidney diseases.”

Patient’s complaint against Wadia hospital, doctors dismissed
ET Healthworld- Rebecca Samervel

MUMBAI: Observing that it is the duty of the tribunals or courts to protect doctors dragged into frivolous litigations, the national consumer commission dismissed a medical negligence complaint filed against Parel-based Wadia Hospital and two of its doctors by a 41-year-old man suffering from congenital spinal issues. “We feel it is the duty of tribunals or courts to protect bona fide doctors dragged into such frivolous litigation. Though we think some cost would have been imposed upon the complainant, we are sympathetically deferring it considering his health status,” the commission said. In the complaint before the National Consumer Disputes Redressal Commission in 2016, the complainant said he was operated for urinary bladder augmentation at the hospital in 2002. He said in May 2016, he underwent another operation for removal of bladder stones and the operating doctor told him the stones were formed because of the “incomplete surgery” in 2002 and the continuous use of catheter put in then. He also claimed one of his legs had to be amputated later due to the negligence of the anaesthesiologist in 2002.

ESIC pharmacists to move SC for removal of medical professionals from holding charges of drug stores and pharmacies
Pharmabiz India – Peethaambaran Kunnathoor

The ESIC Pharmacist Association (ESICPA) is learnt to have decided to approach the Supreme Court for a direction to the Corporation to remove medical professionals from holding charges of drug stores and pharmacies in corporation-run hospitals, and appoint pharmacists in these posts. Sources from the association informed that they will wait till a decision on a pending contempt petition with Central Administrative Tribunal (CAT) is come out. The contempt case is with respect to an order by CAT in November 2017 on promotional cadre creation by ESIC which is allegedly using delaying tactics in implementing the Tribunal order. The ESICPA’s prayer in the tribunal court was for creation of five promotional posts. Presently the pharmacists have only one promotion post, ie, senior pharmacist. They had wanted for promotion posts of senior pharmacist, chief pharmacist, pharmacy officer, deputy director of pharmacy and director of pharmacy. Although the Tribunal ordered the Corporation to create these posts, countering the order the Corporation filed a case in the Delhi High Court by assuring that they will create two promotional posts, senior pharmacist and chief pharmacist, and a decision on the rest would be taken later. But they did not keep their promise given to the court even after one year, following it ESICPA filed a contempt case with the CAT, said Sunil Dhankhar, chairman of the association.

How safe are your cosmetics? Products containing toxic chemicals sold as beauty-care items

While the Indian beauty and cosmetics market is booming, thanks to the rising demand for personal care products from the youth, the sector is largely operating in a vacuum in terms of regulations and safety, raising concerns among public-health advocates. At present, most of the personal care products, categorised as hair care, skin care, bath and shower products, makeup and colour, fragrances and deodorants, are regulated under the provisions of the Drugs and Cosmetics (D&C) Act, which, according to industry experts, are absolutely inadequate. Though the health ministry had notified a draft regulatory framework for cosmetics towards the end of 2018 in view of the current laws’ ineffectualness, the ‘Cosmetics Rules, 2018’ is yet to see the light of the day and remain snarled in red tape. The upshot — numerous products, many of them containing potentially toxic chemicals, are sold in the market without any regulatory watch. The problem with lack of regulations - The new regulations were proposed as the D&C Act focuses mainly on medications. Only seven of the 169 sections in the existing Act refer to cosmetic products. In the absence of separate rules, the safety of many of the cosmetics products sold in the domestic market is now up to the discretion of manufacturers and importers.

‘Govt alone cannot invest in telemedicine space’
The Times of India

While an engineering student in Jaipur, Ayush Mishra met with a grisly road accident. It set in train a chain of events that would lead him to set up Tattvan E-Clinic (with Ranga Sudhakar, once of Apollo). But back in 2007, doctors in Bareilly, his hometown, gave him little chance of survival unless he was taken to Delhi. “Luckily, my father had a cousin who had just started interning at Apollo Indraprastha, and he connected my father to a surgeon at Apollo, over telephone,” recalls Mishra. “Now, that was a teleconsultation that was happening, between my father and the surgeon, and my father just had to follow his advice.” More than a decade on, Mishra’s telemedicine retail startup is helping fill a gap in Indian healthcare. The first clinic came up in Bareilly, in July 2018, and this was followed (through a franchise) by centres in Kashipur, Pilibhit, Dehradun and Saharanpur. Tattvan has plans for another 1,000 centres in India in the next 36 months, to come up via its Smart Clinic franchise model (it also, incidentally, has a presence in Afghanistan and Iraq.

Bareilly: Government hospital discharges 70-year-old man sans treatment, probe on
ET Healthworld- Priyangi Agarwal

The district administration in Bareilly ordered a probe on Tuesday after a 70-year-old man was discharged by government district hospital, with doctors allegedly saying that his treatment was not possible there. Narayan Das, a rickshaw puller, met senior district administration officials with his complaint, prompting them to launch a probe. Later, a complaint against doctors was also filed with the UP health minister, and also on IGRS portal. A few hours later, Das was again taken back by the hospital for treatment. "My neighbour Narayan Das, a resident of Azam Nagar locality, was admitted to district hospital on Thursday for urology-related problem. However, the doctors forcefully discharged him on Tuesday claiming that no treatment was possible. If they couldn't treat him, they should have referred him to another hospital," said Jaiprakash Rajpoot, who helped Das. Rajpoot, along with the kin of the patient, carried Das on a hand cart to the office of additional district magistrate (ADM) and gave him a complaint. It was then that ADM (city) Mahendra Singh asked chief medical officer (CMO) Dr Vineet Shukla to "probe the matter and take appropriate action into the matter." On the intervention of the CMO, Das was again admitted to district hospital on Tuesday. CMO Shukla said, "After the matter was brought to my notice, I asked emergency medical officer to admit the patient. We will start an inquiry into the incident on Wednesday and action will be taken accordingly."