Editor in Chief Dr KK Aggarwal, Padma Shri Awardee


Dated: 20th May, 2019

ABORTION BAN: REPUBLICAN STATE ALABAMA PASSES MOST RESTRICTIVE LAW IN US

Advocate Ira Gupta

On Tuesday, the Alabama Senate passed the most restrictive abortion bill in the United States, which places a near-total ban on the termination of pregnancy – even in cases of rape and incest – and could punish doctors who perform the procedure with life in prison.

The text passed by the Republican-led senate has been sent to Governor Kay Ivey’s desk for signature into law and, if approved is expected to trigger a legal battle which could reach the Supreme Court.

Under the bill, performing an abortion is a crime that could land doctors who perform it in prison for 10 to 99 years. Abortions would only be legal if the life of the mother is in danger or the fetus has a fatal condition.

The largest human rights defense organization in the United States, the ACLU, promised to file a lawsuit to block its implementation.


Early weight-loss surgery may improve diabetes, blood pressure outcomes

NIH-funded study: Despite similar weight loss, teens who had gastric bypass surgery were significantly more likely to have remission of both type 2 diabetes and high blood pressure, compared to adults who had the same procedure. Results are from an NIH-funded study comparing outcomes in the two groups five years after surgery.

Researchers evaluated 161 teens and 396 adults who underwent this surgery at clinical centers participating in Teen-LABS (Teen-Longitudinal Assessment of Bariatric Surgery) and its adult counterpart, LABS. Teens in the study were under 19 years old at the time of surgery, and adults in the study reported having obesity by age 18. Teen-LABS clinical centers had specialized experience in the surgical evaluation and management of young people with severe obesity, and both studies were funded primarily by NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The results were published in The New England Journal of Medicine(link is external).

Key findings of the research include:

  • Overall weight loss percentage was not different between the groups. Teens lost 26% of their bodyweight and adults lost 29% at five years after surgery.
  • Type 2 diabetes declined in both groups, but teens with type 2 diabetes before surgery were 27% more likely than adults to have controlled blood glucose (blood sugar) without the use of diabetes medications.
  • No teens in the group needed diabetes medications after surgery, compared to 88% of teens before surgery. 79% of adults used diabetes medications before surgery, and 26% used diabetes medications five years later.
  • Before surgery, 57% of teens and 68% of adults used blood pressure medications. Five years after surgery, 11% of teens and 33% of adults used blood pressure medications.
  • Among those with high blood pressure before surgery, teens were 51% more likely than adults to no longer have high blood pressure or take blood pressure medication.


Healthcare Monitor

Assistant Ambulance Officers: Save a Life First

India Legal

A scheme started by the Delhi government in February seems to have run into trouble and has reached the Delhi High Court. A PIL has said that Assistant Ambulance Officers (AAOs) who are assigned the job of driving two-wheeler First Responder Vehicles should also be trained paramedics. However, the Delhi government has said that they will not transport patients and will only give basic medical assistance until an ambulance arrives. AAOs have been trained in basic life-support techniques, have commercial driving licences and a work experience of more than 20 years. However, in this scheme, there is not much efficacy due to the limited knowledge and training of AAOs. They are not even authorised (or qualified) to administer an injection. To understand their job, we need to first understand the laws. The government has powers to allow healthcare workers to give treatment under Clause 23 of Schedule K of the Drugs and Cosmetics Act. As per the Clause, drugs supplied by certain categories of workers are exempted from the provisions of Chapter IV of the Act and the Rules which require them to be covered by a sale licence, provided the drugs are supplied under the Health or Family Welfare Programme of the central or state government.

Pharma News

Potential addiction-free painkiller identified

Business Standard-PTI

Scientists have identified an enzyme that can help control inflammation and may pave the way for non-addictive painkillers which produce few side effects. Millions of people suffer from substance abuse disorders related to opioid use for pain relief, and thousands die as a result of drug abuse involving opioids and related drugs, researchers said. As the problem amplifies, researchers are seeking non-addictive chronic pain treatment options that produce few or no negative side effects. Ken Hsu, a professor at the University of Virginia in the US, and his graduate student, Myungsun Shin, identified an enzyme that "chews up fat" molecules to produce chemical signals that control inflammation. The naturally occurring enzyme, called diacylglycerol lipase-beta (DAGL-b), is a possible new drug target for reducing pain.

Electric field-based dressing helps heal wound infections: research

ET Healthworld-PTI

Scientists, including those of Indian origin, have developed a wound dressing that uses an electric field to disrupt bacterial biofilm infection. Bacterial biofilms are thin, slimy films of bacteria that form on some wounds, including burns or post-surgical infections, as well as after a medical device, such as a catheter, is placed in the body. These bacteria generate their own electricity, using their own electric fields to communicate and form the biofilm, which makes them more hostile and difficult to treat. Researchers including Chandan Sen and Sashwati Roy from the Indiana University in the US are the first to study the practice of using an electric field-based dressing to treat biofilms rather than antibiotics. They discovered the dressing is not only successful in fighting the bacteria on its own, but when combined with other medications can make them even more effective.

After US FDA, CDSCO issues device alert on 3 Medtronic pacemakers

The Indian Express- Prabha Raghavan

India’s apex drug regulator has issued an alert to healthcare providers, heart patients and medical device distributors on measures they have to take to prevent safety issues with three models of Medtronic’s pacemakers. The Central Drugs Standard Control Organisation (CDSCO) alert on Saturday comes over a week after the US Food and Drug Administration (US FDA) flagged five such models of Medtronic’s pacemakers and cardiac resynchronisation therapy pacemakers (CRT-P) for issues related to their batteries. In one such case, the issue led to the death of a patient, according to the regulator. However, no adverse events have been reported in India so far, according to the Indian arm of the US medical device giant. A pacemaker or CRT-P is an essential device used by patients if their heartbeat is too slow or in the treatment of heart failure to help their heart beat normally.

Cartelisation among pharma cos will hit the sector hard

The Hans India- Amit Kapoor

The Indian firms that have slowly expanded their market share in the generics segment have been facing increased American scrutiny over quality issues. While that has been an ongoing process, fresh allegations have been levelled by 44 US states against 20 drug manufacturers for conspiring to artificially inflate prices of more than 100 drugs; some of them by more than 100 per cent. While Israel's Teva Pharmaceuticals, the world's largest producer of generics, is supposedly at the epicentre of the alleged cartel, reputed multinational like Pfizer and Sandoz have been named in the anti-trust lawsuit. Seven of India's top pharmaceutical companies are also among the 20. The allegations are serious, and the case is being dubbed as the single biggest act of cartelisation in the US. If found guilty, this could serve a serious blow to the Indian pharmaceutical exporters, which consider the US a major market for generics. In a market with exorbitantly high drug prices, generic drugs, which are copies of branded drugs that are no longer patented, are supposed to be the cheaper alternatives.

New potential breast cancer drug identified

CNBC TV18

Scientists, including an Indian-American researcher, have identified a molecule that can help treat breast cancer, giving hope to patients who have become resistant to traditional therapies. The first-in-class molecule shuts down oestrogen-sensitive breast cancer in a new way, researchers said. First-in-class drugs are those that work by a unique mechanism - in this case, a molecule that targets a protein on the oestrogen receptor of tumour cells. The potential drug offers hope for patients whose breast cancer has become resistant to traditional therapies. "This is a fundamentally different, new class of agents for oestrogen-receptor-positive breast cancer," said Ganesh Raj, professor at the University of Texas Southwestern (UT Southwestern) Simmons Cancer Center.

Indian pharma industry unfairly targeted in the book “Bottle of Lies” : Pharmexcil

Telangana Today- Y V Phani Raj

Pharmaceuticals Export Promotion Council of India (Pharmexcil) has raised objections over the book written by a former US FDA auditor Katherine Eban, where the author has made unsubstantiated, unqualified and unsolicited comments about select Indian pharmaceutical companies based on out-of-date allegations from more than a decade ago. The inferences in the book, which was published on May 14, are based on past information of select cases and do not present the current situation. In the book, “Bottle of Lies” written by Katherine Eban, the Indian pharmaceutical industry has been unfairly targeted, observed Pharmexcil. Udaya Bhaskar, director general, Pharmexcil, told Telangana Today, “The book solely relies on the experience of an ex-US FDA auditor. It completely fails to capture the humongous and massive successful strides made by the Indian pharmaceutical industry in the past several years.”

Healthcare News

Doctor: Robotic surgery has many advantages

The Times of India

Robotic surgeries have a distinct advantage like 3D view, degree of freedom its arm possesses and most importantly, it does not falter on a doctor’s command as it acts precisely, said Dr Abhinav Deshpande, a robotic onco-surgeon, on Sunday. He was delivering a lecture on ‘Can robots perform a surgery inside human body’, organized by Professors Colony Mitra Mandal in memory of Jagmohandas Kinariwala, a renowned businessman in the field of printing and packaging, at Gruhini Samaj Hall, Hanuman Nagar. Telesurgery helps get rid of distance hindrance and ensures precision. Robotic surgery has many advantages for patients as there is less blood loss, decreased hospital stay, small scars and less painful, he said. Deshpande also showed the video of a live robotic surgery to make the audience understand the process. However, robotics also has its own disadvantages such as cumbersome size, no haptic feedback as it cannot feel the sensation, accessibility as only specialized people can work with it and cost issues.

Doctors perform risky procedure on patients with irregular heart rhythms

The Times of India

Doctors at a private hospital in the city have successfully performed a procedure to close the left atrial appendage using a cardiac plug which will prevent occurrence of strokes in patients. They have performed this on four patients till date. The technically-challenging procedure was performed using angiography like technique by taking a plug from the right side of the heart to the left side and fixing it. According to doctors at Aster Medcity, patients with irregular heart rhythms have a greater chance of developing strokes from clots forming in the heart and moving to the brain. They pointed out that atrial fibrillation, as it’s called, is the rhythm which poses five times greater risk of strokes. Such strokes are a result of the clot forming in one part of the atrium, which is the upper chamber of the heart, called the left atrial appendage. The clots can be prevented from forming by giving blood thinners called anticoagulants. But atrial fibrillation is often found in elderly people with higher risk of bleeding and people other illness, who could not be given blood thinners. The new treatment option, which requires closing of the left atrial appendage, is beneficial to such patients.

NIMS docs demand more security at hospital

The Times of India

After a recent incident of a mob barging into the Nizams Institute of Medical Sciences (NIMS) hostel in search of a resident doctor and frequent incidents of attack on doctors, the resident doctors at NIMS met health minister Etela Rajender on Sunday and submitted a memorandum for enhancing the security. They also urged the health minister to resolve other pending issues like lowering tuition fees, increase of salary and paternity leave. “There is a need to improve security at a few critical areas which are vulnerable, including the old AMC, ICU, EMD buildings and the hostel premises. Fencing in and around the hostel corridor as well as enhancing CCTV coverage within the hospital is required,” read the memorandum. About two months ago, two general medicine resident doctors in the emergency department were attacked by a patient’s relatives, following which the doctors had launched an agitation. Although, the authorities had promised to take necessary measures for the safety of doctors but no action has been taken yet

Maharashtra government charges private hospitals with milking state insurance scheme

The Times of India- Sumitra Debroy

A standoff between the state government and private hospitals on a health insurance scheme for the poor has affected scores of cancer patients, who are forced to scramble for funds or queue up at government facilities to complete treatment. Doctors allege they have been repeatedly told to justify treatment choices, or worse, even advised about the "best way" to treat cancer patients by third party administrators (TPAs) during pre-authorisation. The insurers, on the other hand, claim to have observed "abuse" of high-end radiotherapy packages, ranging from Rs 75,000- Rs1.5lakh, allegedly recommended to most patients whether or not indicated, thereby wiping out the entire insurance cover of families. On a scarier note, they said they fear patients may have been advised radiotherapy when they didn't need it, a charge vehemently refuted by the medicos. A state official said several hospitals are probably trying to recover their investments by "milking" the state scheme.

Government hospital to offer safe, fast cancer therapy with CT simulator

The Times of India

The Coimbatore Medical College and Hospital) (CMCH) has acquired a new equipment that would allow doctors to provide more precise radiotherapy to cancer patients. Called CT simulator, it would allow radiologists to determine the exact location, shape and size of tumour to be treated and provide radiation. It would make treatment easier and faster for doctors and safer for patients, said the hospital authorities. CMCH, the tertiary care hospital for the western region, is one among the nine government hospitals in the state to get a CT simulator. The machine, valued at Rs 2 crore, arrived at the hospital earlier this week. Authorities have begun modifying the regional cancer centre in the hospital to install the machine. “We hope to install the equipment and utilize it within two months,” said Dr B Ashokan, CMCH dean. At least 100 cancer patients undergo treatment at CMCH, the first government hospital in the region to get a regional cancer centre, at any given point of time.’

Seepage, cracked walls plague Kotkapura hospital building

The Times of India- Sanjeev Verma

Inaugurated just four years ago in May 2015, Kotkapura civil hospital’s double-storeyed building, accommodating the 30-bedded mother and child care department, is a classic example of the substandard construction material used in government projects. It also stands testimony to health department’s neglect, putting patients’ lives in danger. Except the inauguration stone put up at the entrance on May 25, 2015, depicting names of then chief minister Parkash Singh Badal, health minister Surjit Kumar Jyani, chief parliamentary secretary and then Kotkapura MLA Mantar Singh Brar, one can easily scrape off plaster from any of the walls. The complete wall facing the old hospital building, which was inaugurated in 1936, has been completely worn out due to massive seepage. Medical staff share that they have even felt electric shock from the wall during last monsoon.

Parents try to remove doctor in French right-to-die case

Business Standard-AFP

The parents of a Frenchman kept alive in a vegetative state for a decade will on Monday try to have the doctor caring for their son removed before he halts life-sustaining treatment the same day, their lawyers said. The last-ditch move by the parents of Vincent Lambert -- left quadriplegic with severe brain damage after a 2008 car accident -- aims to have the doctor immediately struck off France's medical register, the lawyers said in a statement Sunday. The parents would also seek to have the doctor, Vincent Sanchez, criminally prosecuted and lodge new appeals to continue care for Lambert, they added. The flurry of legal action spoke to the desperation of the parents just ahead of the planned halt Monday of the nutrition and hydration Lambert receives in the Sebastopol Hospital in the northern French city of Reims.

Vizag kidney racket: Private hospital likely to be sealed

The New Indian Express

District Collector K Bhaskar has issued orders to seal the Sraddha hospital immediately on Saturday. The illegal kidney transplantation took place in the hospital, according to the final report (FR). The hospital is likely to be sealed tomorrow. These orders were issued after the three-member committee, appointed to follow up on the case, submitted the five-page FR along with 150 records of the hospital to the District Collector. Bhaskar also told the investigation committee to inspect some more hospitals conducting organ transplantations in the city. He also asked the panel to check the records of kidney transplantation operations performed in the past five years and submit a report in another 10 days.

Hindu Rao Hospital doctors to strike work over unpaid salaries

The New Indian Express- Somrita Ghosh

After holding protests for two days, the resident doctors of North Delhi’s Hindu Rao Hospital have decided to go on an indefinite strike from next week to press for a resolution of their salary issues. However, they have said that they will A plea has also been filed in the Delhi court through advocate Ashok Agarwal, seeking directions to North civic body to disburse salaries pending for three months, along with the wages of primary teachers as well as run a separate Out Patients Department (OPD), so that patients are not inconvenienced during the stir. “We have given 48 hours to the authorities concerned to come up with a concrete solution to our salary issues. From May 20 onwards, we will go on an indefinite strike if our demands are not met by then. However, we don’t want the patients to suffer and will, hence, run a parallel OPD,” Rahul Chaudhary, President, Resident Doctors Association, Hindu Rao Hospital, said.

Attempt to sell new born baby, case registered

The Siasat Daily - Syed Qayam Ali

In a private nursing home located at Bodhan, a lady doctor and a nurse made an attempt to sell an illegitimate newly born child. According to the report of the police, Parvati, native of Maharashtra gave birth to a boy on 2nd May at a private nursing home at Bodhan. It is reported that her husband had die 15 years back. The lady doctor Prasunna and nurse, Shaheen Begum made an agreement to sell the new born child to a relative of the lady doctor. In order to take the child, the relatives of the lady doctor were to reach the bus stand. Shaheen Begum was waiting for the persons who wanted to take the new born baby. Meanwhile, the baby started crying for milk. Some of the passengers suspected Shaheen Begum and contacted the police. When police interrogated, Shaheen Begum confessed the Crime.

Girl Dies After Being Administered ‘Wrong Injection’

Odisha TV- Suryakant Jena

Tension erupted at a private clinic in Soro of Balasore district on Sunday after death of a girl following alleged administration of wrong injection. The girl, a resident of Bagudi area under Soro police limits was suffering from fever and was admitted to the private clinic at Adang Bazar. According to family members of the girl, the doctor at the clinic checked her condition and referred her to a different hospital after administering an injection. When the girl was shifted to the hospital, she was declared dead. “The girl was suffering from severe cold fever, following which she was brought to Dr Shashank. The doctor checked up the patient and prescribed some medicine. Later, he administered and injection and referred her to another hospital where the doctors declared her brought dead,” Debendra Dash, relative of the deceased girl said.


Ignore TSH up to 10

An international panel of experts has concluded that patients with subclinical hypothyroidism should not be routinely offered thyroid hormone replacement therapy.
In the recommendations published online this week in the BMJ, the expert panel writes "for adults with subclinical hypothyroidism, thyroid hormones consistently demonstrate no clinically relevant benefits for quality of life or thyroid-related symptoms, including depressive symptoms, fatigue, and body mass index (BMI)."
The guidance, based on findings from a systematic review and meta-analysis of 21 trials with 2192 participants published in November (JAMA. 2018;320:1349-1359) represents a "strong recommendation” against prescribing thyroid hormones (primarily levothyroxine LT4) in adults with subclinical hypothyroidism....read more


Low LDL levels but high hsCRP increase risk of adverse cardiac events post-PCI

Patients undergoing percutaneous coronary intervention (PCI), who had well-controlled LDL cholesterol (LDL-C) but persistently high levels of high-sensitivity C-reactive protein (hsCRP) were at a more than twofold greater risk for major adverse cardiac and cerebrovascular events, compared with those who had low LDL-C and low hsCRP levels.
Over a 1-year follow-up there was a stepwise increase in major adverse cardiovascular and cerebrovascular events.
Patients were categorized according to their serial hsCRP levels, with high hsCRP defined as at least 2 mg/L....read more


eSpiritual

The very purpose of life is to face sufferings