Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                           Dated:17th September,2019

Health Ministry guidelines for transportation of Sputum samples potentially containing TB bacteria

The sputum specimen is packaged in triple layers in such a manner that it arrives at the destination in good condition and presents no hazard to the transporter. The triple layer packaging contains the following:

  Primary container:A watertight, leak-proof, unbreakable tube containing the specimen. The tube is packaged with enough absorbent material to absorb all fluid in case of breakage or leakage.

   Secondary packaging:A watertight, leak-proof packaging to enclose and protect the primary container. Several primary containers may be placed in one secondary packaging.

  Outer packaging:Secondary packaging is placed in rigid outer packaging to protect the contents from physical damage during transport. Gel packs to maintain temperature along with suitable absorbent/ cushioning material is also placed inside.

The transporter must ensure the following:

1. The outer packaging is not damaged and is properly sealed.

2. Biohazard label is pasted on the outer packaging

3. “From” and “To” addresses are clearly labeled.

4. Contact details (name, phone no.) of receiver is pasted

5. Upright symbol ( ) is pasted appropriately.

6. Transport at the earliest (to reach the destination within 72 hours)

(Source: Central TB Division, Ministry of Health and Family Welfare)

One health (human, animal, plant and environment)
Hyderabad veterinary doctor booked over medical negligence over the treatment of a dog

Following the death of an 11-month-old pet dog belonging to Telangana Chief Minister K Chandrasekhar Rao's official residence Pragati Bhavan, a case has been registered against a private veterinary doctor based on a complaint from the dog's caretaker. The dog was shifted to Animal Care clinic located in Banjara Hills where the dog was provided treatment. While the doctor was administering some injections, the dog died.

The Banjara Hills police have registered a case against Dr Ranjit of 'Animal Care' under IPC Section 429 (Mischief by killing or maiming cattle, etc., of any value or any animal) and section 11 (1) (c) of Prevention of Cruelty to Animal Act, 1960. ....read more

Mera Asia Mahan 7: Panchakam Sadhana for CMAAO unity (One country, One Asia, One World)
The Bhagavad Gita describes Panchakam Sadhana (five steps) for happy living.

1.Get detached from the attachments (Moha) which can only be done be aspiring for a higher achievement. Choose chitta (intelligence) over mind; mind over Gnanendriyas (motor organs) and Gnanendriyas (sensory organs) over karmendriyas. Convert likes and dislikes in life to right and wrongs in life.

2.Do not be in company of people who take you away from spiritual aspirations.

3.Learn from the teachings and experiences of the spiritual Gurus on a continuous basis. Ask yourself before retiring for the day “what did I learn today” read more

Prayer for Inner Happiness
Stress is defined as the physical and mental reaction to the interpretation of a known situation. In absence of a known situation, there cannot be stress. One cannot be stressed out for a person who has just died in New York in an accident unless he/she is a person known to us.

There has to be a right, conscience-based interpretation of the situation as the same situation can bring happiness to one and stress to the other. The most important consequence of stress, whether physical or mental, therefore, depends on the right interpretation of the situation. ....read more

Healthcare News Monitor

Pharma wrap: Ranitidine carcinogen impurity scare and rising problem of drug contamination
moneycontrol - Viswanath Pilla

The US Food and Drug Administration (USFDA) on September 13 said it had detected low level of a cancer-causing impurity in samples of commonly used heartburn or acidity medicine Ranitidine. Ranitidine is sold by French drug maker Sanofi in US under the brand name Zantac. Patents of the drug expired long back and several generics are also in the US market. The impurity or contaminant is a type of nitrosamine called N-nitrosodimethylamine, or NDMA. NDMA is classified as a probable human carcinogen or a substance that could cause cancer. NDMA is water-soluble, yellow in colour and has little or no taste and odour. The substance is a known environmental contaminant and is found in water and food, including meat, dairy products and vegetables. While USFDA has so far not asked people to stop taking ranitidine, the agency has advised patients who wish to discontinue to consult their doctors about other treatment options. The New York Times has reported that the agency’s announcement came on the same day that an online pharmacy, Valisure, petitioned the USFDA to request a recall of all products containing ranitidine, saying its own tests had revealed high levels of NDMA, above USFDA’s daily limit.

Health ministry to roll out EIS programme to equip health professionals to control epidemics
Pharmabiz India - Shardul Nautiyal

To equip the public health professionals with the expertise to control epidemics, the National Centre for Disease Control (NCDC), India in collaboration with Centers for Disease Control and Prevention (CDC), USA will roll out two-year pan India Epidemic Intelligence Service (EIS) Programme from November this year. Epidemiology is the branch of medicine which deals with the incidence, distribution and control of diseases and other factors relating to health. NCDC comes under the Directorate General of Health Services (DGHS) of the Union health ministry. The programme is very much relevant as many states lack applied epidemiological capacity despite the fact that there is a dedicated cadre of public health professionals in some states of India. India EIS programme in applied epidemiology will help public health professionals develop their skills while working with various public health agencies and programmes in the country. The programme focuses on hands-on training in epidemiologic service for public health professionals. Trainees, called EIS Officers, engage in outbreak investigations, design and analyses of epidemiological studies, analysis and evaluation of surveillance data. It also involves scientific communication and other activities in preparation for their careers as field epidemiologists. Selection of qualified medical doctors is through a highly competitive process by a committee of experts. The programme is modeled after the EIS programme at the US CDC and is implemented in collaboration with CDC.

Registered pharmacists ask govt to amend Schedule K to remove exemption given to doctors to stock & dispense medicines
Pharmabiz India - Yash Ved

The registered pharmacists have urged the Union Health Ministry to amend Schedule K of Drugs and Cosmetics Rules, 1945 to remove exemption given to registered medical practitioners to stock and dispense medicines. As per section 5 of Schedule K of Drugs and Cosmetics Rules, 1945, a registered medical practitioner is allowed to stock and dispense medicines to his patients from his premises without obtaining a drug selling license under provision of Drugs and Cosmetics Rules, 1945 and without employing the services of a registered pharmacist. Schedule K contains various substances and drugs and their corresponding regulation of Drugs and Cosmetics Rules, 1945. Schedule K consists of those drugs that are exempted from Chapter IV of the Drugs and Cosmetics Act, 1945 which deals with manufacture, sale and distribution of drugs and cosmetics. In a memorandum to Union Health Minister Dr Harsh Vardhan, a registered pharmacist and an RTI Activist Jaideep Kumar Gupta mentioned that the reason for introduction of such exemption was probably due to drugs in form of tablets/capsules or other dosage forms ready to consume were not available and hence practice of compounding/mixing was prevalent at those times. During course of time drug industry in India has grown in a big way and today it has established as a world leader, in its own way. Because of this advancement in drug manufacturing area, “ready to consume” drugs in various dosage forms are easily available. So we should have long back omitted this exemption and should have encouraged doctors to serve the patients by indulging in clinical practice alone.

India ranks 6th for highest cyber attacks on pharma firms
ET Healthworld – IANS

India is the sixth country in the world where more and more pharmaceutical companies are being targeted by cyber criminals, a new report said on Sunday. Nearly 45 per cent machines in the Indian pharmaceutical organisations more than four in 10 devices were detected with malicious attempts, said cyber security firm Kaspersky. From 44 per cent of machines infected in 2017 and a 1 per cent increase in 2018, this year's number of detected attempts shows that nearly every 5-in-10 devices inside a pharmaceutical facility are now being targeted globally. Amongst the countries which logged the most number of attacks are Pakistan (54 per cent), Egypt (53 per cent), Mexico (47 per cent), Indonesia (46 per cent) and Spain (45 per cent), with India at sixth position. "While it is a known fact that money-hungry cyber criminals can easily earn by attacking banks, we also observe that these hackers as well as cyberespionage groups are slowly paying a lot of attention towards the industry of advanced medicine," said Yury Namestnikov, Head of Global Research and Analysis Team (GReAT) Russia at Kaspersky.

Delhi DCA issues advisory to chemists as part of implementing Delhi declaration on AMR, decides to strengthen enforcement of Rule 65
Pharmabiz India - Peethaambaran Kunnathoor

In the wake of WHO’s findings that anti-microbial resistance (AMR) is on the rise in India and as part of implementing the Delhi Declaration on AMR, the drugs control administration (DCA) under the government of NCT of Delhi has issued advisory to all chemist and druggist associations in Delhi state asking them to sensitize their members to follow the warnings. Along with, the government of NCT of Delhi has constituted a Technical Committee to formulate the state’s action plan to deal with the rising AMR within the area of the state. Sources from the drugs control department informed that it has decided to strengthen enforcement of Rule 65 of Drugs and Cosmetics Rules, 1945 to support the initiative of the government with regards to AMR and the Delhi Declaration. As per the advisory, from now on all drugs including antimicrobial agents should strictly be dispensed in accordance with prescription by a registered medical practitioner (RMP). This will help avoid emergence of resistance due to over use or under use of medicines by patients. Besides, antimicrobial agents should be dispensed under the supervision of the registered pharmacist of the pharmacy as per provision of Rule 65 (2) of the Drugs and Cosmetics Rules, 1945. Similarly, the pharmacists in the medical shops should counsel the patients about the use of medicines and storage conditions at home. At any rate, care should be taken to avoid self-medication by people. They should be discouraged from the tendency of avoiding doctors and going with self-medication.