Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 18th May, 2019

Avoidable mistakes

  • Treating the wrong patient
  • Surgical souvenirs:Surgical staff miscounts (or fails to count) equipment used inside a patient during an operation.
  • Lost patients:Patients with dementia are sometimes prone to wandering.
  • Fake doctors:Con artists pretend to be doctors.
  • The ER waiting game: Emergency rooms get backed up when overcrowded hospitals don't have enough beds.
  • Air bubbles in blood:The hole in a patient's chest isn't sealed airtight after a chest tube is removed.
  • Operating on the wrong body part
  • Infection infestation:Doctors and nurses don't wash their hands.
  • Lookalike tubes:A chest tube and a feeding tube can look a lot alike.
  • Waking up during surgery:An under-dose of anesthesia.

  • A woman lost her spleen during a operation intended to remove a kidney at a Hong Kong private hospital.

    The 57-year-old woman underwent surgery performed by a visiting urologist at St Paul’s Hospital in Causeway Bay on March 25 to remove a tumorous kidney, according to the Department of Health and the hospital. But pathological tests after the surgery showed the organ removed was her spleen, a hospital spokesman said on Wednesday. The doctor, the patient and the department were alerted immediately.

    The patient was discharged on April 16.

    Doctor’s admission rights and privileges for the establishment had been suspended. A hospital investigation showed that the preoperative check had met the standard.


    How can it happen

    1.Wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant but is found lower in the abdomen or in the pelvic region because of the laxity of the peritoneal attachments. Many patients with wandering spleen are asymptomatic, hence the condition can be discovered only by abdominal examination or at a hospital emergency department if a patient is admitted to hospital because of severe abdominal pain, vomiting or obstipation.

    2.Accessory spleen is a variation of spleen development. The most common location of an accessory spleen is at the splenic hilum. Wandering accessory spleens may mimic tumors, such as pancreatic tumor, adnexal tumor, abdominal tumor, retroperitoneal tumor, adrenal tumor, or testicular tumor, according to its location. Accessory spleens are usually smaller than 3 cm but upto 6 cm have been reported. These wandering accessory spleens are indicated for surgery when there are symptoms, such as pain, rupture, infarction, or vascular torsion.

    Is it a blunder?

    Yes: If it was not a case of wandering spleen. In which case it will be error of judgment.

    Current Temperature Status and Warning for next 24 hours

    Heat Wave and Temperature observed yesterday (Past 24 hours from 0830 hrs IST of 17 May to 0830 hrs IST of 18 May, 2019)

    Heat Wave:

    Yesterday, heat wave conditions were observed in some parts over Vidarbha.

    Maximum Temperature

    Maximum temperature more than 40.0°C were recorded at most places over East Madhya Pradesh, Vidarbha, Marathwada, Rayalaseema, Telangana; at many places over East Uttar Pradesh, West Madhya Pradesh, Chhattisgarh, Jharkhand; at a few places over Bihar, Odisha, Madhya Maharashtra, North Interior Karnataka, Tamil Nadu & Puducherry; at isolated places over West Uttar Pradesh, Gangetic West Bengal, East Rajasthan, Gujarat and Coastal Andhra Pradesh.

    Maximum temperature departures as on 17-05-2019: Maximum temperatures were appreciably above normal (3.1°C to 5.0°C) at most places over North Interior Karnataka; at a few places over Bihar, Madhya Maharashtra and Kerala and at isolated places over Telangana, South Interior Karnataka and Tamil Nadu & Puducherry; above normal (1.6°C to 3.0°C) at most places over Jharkhand, Gangetic West Bengal and Vidarbha; at a few places over East Uttar Pradesh, Odisha, Coastal Karnataka and Andaman & Nicobar Islands and at isolated places over Assam & Meghalaya, Sub-Himalayan West Bengal & Sikkim and East Madhya Pradesh. They were markedly below normal (-5.1 or less) at most places over Punjab and West Rajasthan; at a few places over Jammu & Kashmir and at isolated places over Himachal Pradesh; appreciably below normal (-3.1°C to -5.0°C) at isolated places over East Rajasthan; below normal (-1.6°C to - 3.0°C) at a few places over Arunachal Pradesh and Haryana, Chandigarh & Delhi and at isolated places over Gujarat state and West Madhya Pradesh and near normal over rest of the country. Yesterday, the highest maximum temperature of 45.8°C was recorded at Chandrapur (Vidarbha).

    Heat wave warnings for next 24 hours (From 0830 hrs IST of 18 May to 0830 hrs IST of 19 May 2019):- :-

    Heat wave conditions in some parts very likely over Vidarbha and in isolated pockets very likely over Chhattisgarh, Coastal Andhra Pradesh, Rayalaseema, North Interior Karnataka and Telangana.

    Healthcare Monitor

    Doctors call for better monitoring of pregnancy-induced hypertension

    The Hindu-Afshan Yasmeen

    Hypertension-related disorders during pregnancy remain among the most significant problems in India. Nearly 10 million women worldwide develop pregnancy-induced hypertension every year, more than 76,000 of whom die due to complications directly related to hypertension. About 50,000 of these deaths occur in India. The prevalence of hypertensive disorders of pregnancy in Karnataka is estimated to be around 8%. Research also indicates that women with high blood pressure, especially during pregnancy, are at a two-fold risk of heart failure post-delivery. The need of the hour is to monitor women all through pregnancy and even after childbirth, through the postpartum period, say doctors. According to K.K. Aggarwal, president of Heart Care Foundation of India, hypertension during pregnancy can be detrimental to both the mother and the baby. “Women with high blood pressure can develop resistance in their blood vessels. This hampers the flow of blood throughout the body, including the placenta and uterus, leading to problems with fetal growth. It can also cause premature detachment of the placenta from the uterus, disruption in the flow of oxygen to the placenta leading to delayed fetal growth, or in worst cases even stillbirth,” he said.

    Pharma News

    Cardiac drug sales grow by double digits across India

    The Times of India- Kalpesh Damor & Niyati Parikh

    Higher incidence of cardiovascular diseases has pushed up sales of cardiac medicines across India. Cardiovascular drug sales have been clocking double digit growth every quarter in fiscal 2018-19 with the growth rate peaking at 14.8% in January to March period. The double-digit growth has continued in 2019-20. The sales of cardiovascular medicines in April increased by 13.2% to Rs 1,492 crore, shows data compiled by AIOCD AWACS, a market research wing of All India Organization of Chemists and Druggists (AIOCD). The overall sales stood at Rs 16,523 crore in fiscal 2018-19. Experts believe the consistent increase in the sales of cardiac medicines is a clear reflection of rising incidence of cardiovascular diseases. “Rapid urbanization has triggered an unhealthy lifestyle which includes lack of exercise as well as increased consumption of junk food. This has led to the rising incidence of cardiovascular diseases,” said Ameesh Masurekar, director, All India Organization of Chemists and Druggists (AIOCD) – AWACS. “Moreover, increasing incidence of these diseases is also a reflection of better diagnosis and higher degree of detection of cardiovascular diseases,” he added. An industry player said, “Maximum illness is detected in chronic segment due to lifestyle related problems. The demand of drugs for chronic diseases such as cancer, diabetes and cardiovascular issues is growing not only in India but across the world.”

    Prescription for a healthy career

    The Times of India- A Ragu Raman

    Today’s focus: Pharmaceutical Sciences more manpower require as India becomes leader in drug development. Indian pharmaceutical companies supply more than 50% of the global demand for various vaccines as well as a significant amount of generic drugs. With the need for drugs growing every year, the pharmaceutical industry is witnessing a big boom. From developing drugs to manufacturing them — there is a huge requirement for manpower, despite artificial intelligence and machine learning playing a large part in drug development. The Indian biotechnology industry which is also a major component of the pharmaceutical industry and comprises biopharmaceuticals, bioagriculture, bio-services, bio-industry and bioinformatics is expected to reach $100 billion by 2025, growing at an average of 30% per year. The Government of India’s ‘Pharma Vision 2020’ also aims at making the country a global leader in end to-end drug manufacture. To enter the pharmaceutical company, students need to do a BPharm. “Even students who do BSc chemistry can join the industry if they do MSc in either analytical or organic chemistry as it gives them a wide scope,” said professor K Ravichandran, department of analytical chemistry, Madras University. “Chemistry students can do drug analysis, which includes analysing the shelf life and quality of each drug. Synthetic organic chemistry plays a key role in drug development,” he said. Drug discovery and designing are also providing opportunities to BTech students.

    Pharmacists can help track TB patients

    Hindustan Times- Rhythma Kaul

    Pharmacists can be crucial in helping track undiagnosed tuberculosis (TB) patients in the country as for most sick patients, they are the first point of contact, a new study published in BMJ Global Health has revealed. The study, “Can community pharmacists improve tuberculosis case finding? A mixed methods intervention study in India”, showed that engaging pharmacies in TB screening services could improve case detection. The pilot study was conducted among 105 pharmacists over 18 months in Patna, Bihar, where the incidence of TB is as high as 326 per one lakh population, as opposed to the current India estimates of 204 new cases per one-lakh population. The rate of registration of symptomatic patients was 62 times higher in the intervention group as compared with the control group, and TB diagnosis was 25 times higher.

    Prices of few cancer drugs slashed; second consecutive cut this year

    Business Today

    The Maximum Retail Price (MRP) of some cancer drugs has been slashed by the National Pharmaceutical Pricing Authority (NPPA) by up to 60 per cent. This is the second time since March that prices of some cancer drugs has been cut. In March, the rates were brought down for around 380 drugs, with some cuts going to as much as 80-90 per cent under trade margin rationalisation. According to NPPA, the prices of nine non-scheduled anti-cancer medicines were reduced by 30 to 60 per cent. Some of the drugs whose prices have been slashed are Erlotinab, Pemetrexed, Epirubician, Leuprolide acetat and Everolimus. These medicines treated different type of cancers including prostate and breast. This reduction in price comes as part of NPPA's focus on slashing of anti-cancer drugs prices. The VP of a cancer drug firm, however, told Hindu Business Line that that reduction announced by NPPA only sees marginal rationalisation at individual drug level.

    Kilo lab to boost drug’s production

    Deccan Chronicle

    A kilo lab, the first of its kind established in a public institution which helps to complete most of the drug manufacturing process at one-go in one particular lab, was inaugurated in CSIR-IICT Hyderbad on Friday. Scientists stated that it was basically a scale up of production with high purity and almost reaching the end stage of the manufacturing process. Speaking on the occasion, director general CSIR and secretary DSIR Dr Shekhar C. Mande, said, “If a product is manufactured in a Kilo lab, it almost reaches the clinical trials stage. Earlier, the manufacturing process of drugs used to take a lot of time. For instance, if there are 19 steps in a manufacturing process of a drug, one particular manufacturing unit can complete only eight-nine steps and later the process will be continued in other units. This used to take a lot of time and there used to be a high chance of impurities. So, after the process, at the last stage it is again put to another process to get rid of the impurities. The whole process can be eliminated and drugs manufactured in high quantities at one go in this kilo lab.”

    World’s first ‘Darwinian’ cancer drug plan could be a game changer

    Down to Earth- Susan Chacko

    A few days ago a global study projected that cancers are expected to rise from 17 million to 26 million between 2018 and 2040 and a large proportion of those patients are likely to use chemotherapy. Treatments such as chemotherapy sometimes fail because the deadliest cancer cells adapt and survive, causing the patient to relapse. Thus, the ability of cancer cells to adapt, evolve and become drug resistant is the cause of the vast majority of deaths from the disease and the biggest challenge we face in fighting it. The good news is that the world’s first ‘Darwinian’ cancer drug programme may soon see the light of day. Developed by the Institute of Cancer Research (ICR), it is specially designed to tackle cancer’s lethal ability to evolve resistance to treatment and is to be launched in a £75 million state-of-the-art global centre of expertise in anti-evolution therapies in London. Scientists aim to harness evolutionary science within a new Centre for Cancer Drug Discovery to ‘herd’ cancers with anti-evolution drugs and combinations. They believe this new approach can deliver long-term control and effective cures, just as comparable approaches have with HIV. More cancer patients are living longer and with fewer side effects, but “unfortunately, cancer can become resistant very quickly to new drugs—and this is the greatest challenge we face”, says Olivia Rossanese, the newly appointed head of biology in the Centre for Cancer Drug Discovery. So, this programme focuses on meeting the challenge of cancer evolution and drug resistance through completely new ways of attacking the disease.

    Healthcare News

    Don’t use telemedicine, mobile apps for non-communicable disease: WHO

    The Times of India- Chaitanya Deshpande

    Using online consultation and medicines given on health-related websites or mobile apps for diseases like diabetes, hypertension, cataracts, and asthma may land you in trouble. The World Health Organization (WHO) has made it clear that it will not encourage the doctor-patient communication for non-communicable diseases at least for now. “If digital technologies are to be sustained and integrated into health systems, they must be able to demonstrate long-term improvements over the traditional ways of delivering health services,” says the official statement by Dr Soumya Swaminathan, chief scientist at WHO. Earlier this week, the WHO had released recommendations on the use of digital health technology accessible via mobile phones, tablets and computers, to improve health and essential services. While encouraging the use of digital platforms for sexual, reproductive, maternal, newborn, child and adolescent health, the WHO has kept the non-communicable diseases out of digital intervention.

    Water-starved, hospitals in critical care in Chennai

    The Times of India-TNN

    Chennai: Water crisis in the city has hit a new high – it’s pushing up cost of procedures, room rents and consultation in most neighbourhood hospitals and nursing homes. As of now, most big corporate hospitals say they have been able to absorb the cost but may not be able sustain without hiking prices. On an average, a hospital with 30 beds is spending Rs 12,000 to Rs 15,000 more a day as supply of piped water dwindles and borewells go dry “That would mean up to Rs 4.5lakh a month. It is impossible for small hospitals to absorb that loss every month. We will have to pass it on to our patients,” said Indian Medical Association past state president Dr T N Ravishankar, who heads Sudar Hospitals in Tambaram. In the past two weeks, room rents in some city hospitals have increased by up to Rs 350 a day and the cost of out-patient water intensive procedures such as dialysis are up by at least Rs 150 per session.

    92-year-old man’s heart valve replaced through TAVR

    The Times of India- Chaitanya Deshpande

    Nagpur: City-based Arneja Heart and Multispecialty Hospital on Friday claimed to have performed Transcatheter Aortic Valve Replacement (TAVR) of a 92-year-old male patient successfully. Hospital director Dr Jaspal Arneja said TAVR process is a nonsurgical for patients with severe aortic stenosis who are ineligible for open heart surgery. “The procedure was performed on April 12 and the patient was discharged in two days. Today, the patient came for a follow-up with absolutely no complaints and with full mobility,” Dr Arneja said. Arneja institute is the first and only hospital in Central India where the TAVR process is performed. Till now, three such surgeries have been successfully performed here. However, treating a 92-year-old patient was a big challenge, said Dr Arneja. “This was a milestone for us. I can claim with all authority that our patient is oldest in India to undergo this operation,” he said.

    Oncologists warn against misleading ‘miracle’ treatments on social media

    The Hindu- Jyoti Shelar

    Indian oncologists are increasingly battling unscientific miracle treatments for cancer shared widely on social media. On Thursday, Mumbai’s Tata Memorial Centre (TMC), the country’s premier cancer institute, issued a rebuttal on a strange cancer remedy attributed to them in a widely circulated WhatsApp message, which stated that hot coconut water can destroy cancer cells of all types. “There is no data to suggest that hot coconut water can provide cures for any type of cancer. Public are requested not to be misinformed by such false and harmful messages sent on social media,” read a statement issued by the TMC’s director Dr. Rajendra Badwe.

    Hospital quashes claim of cancer cure using coconut

    Daily News & Analysis

    While there has been a viral message of social media platforms such as WhatsApp and Facebook about a renowned surgical oncologist and director of Tata Memorial Hospital claims that hot coconut water can cure cancer, the doctor and the hospital specialised for cancer treatment has given out a statement that the viral message is false and people should not trust the viral message. The message circulating on social media with the name of Dr Rajendra A Badwe, TATA Memorial Hospital stated that the doctor claims hot coconut water can save you a person. It kills cancer cells. Looking at the viral message, the doctor and the hospital has given out a statement, "It has come to our notice that there is a message circulating in social media that Dr Rajendra Badwe, Director, Tata Memorial Center has suggested that hot coconut water can destroy cancer cells and is the latest treatment for all types of cancer. We would like to clarify to all concerned that this is a fake message and neither Dr Badwe nor the hospital subscribes to this view."

    New Delhi: Health ministry asks centre-run hospitals to set up 'dengue corners'

    ET Health World- PTI

    Ahead of the monsoon season, the health ministry has asked all centre-run hospitals to set up 'dengue corners', dedicated areas to provide treatment to dengue patients, as part of the National Vector Borne Disease Control Programme (NVBDCP) guidelines. The 'Dengue Corners' will have designated staff that will cater to dengue patients. "The aim of setting up these dengue corners is to provide seamless and efficient healthcare service to the patients during surge in dengue incidence. These instructions are part of the guidelines of the NVBDCP," Dr Ashutosh Biswas, a professor of medicine at the AIIMS, said. With no specific drug and vaccine currently available in the country to cure dengue, AIIMS Director Randeep Guleria said that a good supportive treatment accompanied with early diagnosis helps in the treatment of the mosquito born viral disease. According to Dr Guleria, the India Council of Medical Research (ICMR) is conducting research on the safety and efficacy of the vaccine on the Indian population.

    Apollo hospitals script new era in cardiac care

    Millennium post

    Apollo Hospitals Enterprise Ltd, Asia's largest and most trusted multi-specialty chain of hospitals, recently showcased the group's prowess in cardiac care in the largest cohort of cases treated with advanced cardiac interventional methods. These include three key innovations – MitraClip, TAVI (Trans-catheter Aortic Valve Implantation) or TAVR (Trans-catheter Aortic Valve Replacement) and MICS CABG or MICAS (Minimally Invasive Coronary Artery Bypass Surgery). Specialists in structural and interventional cardiology at Apollo Hopsitals have successfully performed 6 MitraClip procedures out of the 9 performed in India, over 85 TAVI/TAVRs with excellent clinical outcomes and a nation-leading 1250+ MICS CABGs with superior outcomes at par with international standards, at only 1/2 or 1/3rd the cost compared to global price matrix.

    Manipal Hospitals Dwarka launches First of Its Kind ‘Suraksha Card’

    United News of India

    Manipal Hospitals Dwarka on Friday announced the launch of first of its kind 'Suraksha Card', a healthcare privilege membership programme aimed at providing best of hospital care to the patients at affordable costs. The benefits of Suraksha Card include, unlimited OPD Consultations for a year, 15 per cent discount on Lab & Radiology investigations, 10per cent discount on pharmacy, one Preventive Health Check package worth 499 Free in a year, Free Ambulance Pick up, Free Home sample collection and 10 per cent discount on IPD – Room Rent Only.

    Malaysia: Social Media ordered suicide of a teen girl. Know the sad story and dark side

    Never ignore any post of social media, which suggests suicidal ideation. It is a medical emergency. Never take it lightly.
    Not just on social media, if someone calls you that I am feeling like committing suicide do not take it lightly.
    Most patients who commit suicide successfully will talk to someone minutes before they commit suicide. The commonest precipitating factor is that they are not been loved or cared by the society.....read more

    Breaking news: Glucosamine supplements can lower CVD risks

    (Medscape Excerpts)
    Patients who regularly take glucosamine supplements may have a moderately lower risk for cardiovascular disease (CVD) events, results from 22 centers participating in the UK Biobank suggest.
    Glucosamine use was associated with a 15% lower risk for total CVD events and a 9% to 22% lower risk for stroke, coronary heart disease and CVD death after adjustment for age, sex, body mass index, race, lifestyle factors, diet, medications, and other supplements....read more


    Vaishakha Purnima