Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                           Dated:20th September,2019

Distribution of Generic Zantac stopped worldwide amidst contamination concerns

Distribution of generic versions of the popular heartburn drug ranitidine (Zantac, Novartis) is being halted in markets worldwide by the manufacturer, according to a spokesperson for Novartis, after findings that the medication may have become tainted with a cancer-causing agent.

Dana Kahn Cooper, a spokesperson for Novartis, told Medscape Medical News: "A precautionary distribution stop of all Sandoz ranitidine-containing medicines in all our markets will remain in place under further clarification. This includes capsules in the USA. Our internal investigation is ongoing to determine further details. In case of concerns, adequate additional measures will be implemented in alignment with relevant Health Authorities as required.” Sandoz/Novartis is one of several generic drug makers that distribute it. The action was taken after regulators in the United States and Europe began investigating the discovery of a likely human carcinogen called NDMA, or N-Nitrosodimethylamine, in the medications last week… (Source: Medscape)

Consider pre-procedural ultrasound guidance for all lumbar punctures
Lumbar puncture is an important diagnostic tool for the doctor, especially in an emergency. However, at times the procedure may be unsuccessful and fail to yield desired results. Sometimes, LP can be traumatic, which is difficult to interpret. Both situations can delay the diagnosis, which can be life-threatening at times, and increase costs for the patient; they are also a cause for patient dissatisfaction. And, in this age of litigation, a disgruntled patient is a cause for concern.

A failed LP may be due to poor positioning of the patient or incorrect technique. A patient with spinal abnormalities such as kyphosis, scoliosis, calcification of ligaments or an anxious patient or an obese patient can make the procedure difficult. Knowledge of the anatomy is important for a safe and successful attempt.

Static bedside ultrasound has been used to identify the site and the course (maximum depth during passage of the needle) for the procedure. Evidence has also supported the use of ultrasound in performing a LP. ....read more

Never disclose your weaknesses to others
I am the best, so my profession is the best

Of late I see a lot of frustration and unhappiness about medical profession amongst the young medical professionals. This may not be right.

People exhibit mainly two types of responses to a situation; there are those who will feel happy about a situation and then there will be others who will be indifferent. Only a minor percentage will be with you and get concerned.

“???????????? ? ?????????”, is a saying from Chanakya Niti, which means never disclose your weaknesses to others.

As per Vedic sayings, never disclose your goals, income, property assets, personal life, good deeds, good health, beliefs, gossip about others and differences to others. ....read more

Aastik vs. Nastik
Traditionally, people believe that Nastik are the persons who do not go to temples or related places of worship. They also do not believe in God.

To differentiate between Astik and Nastik, we need to first understand the concept of Sanatan Dharma and Arya Samaj Dharma. People who believe in Sanatan Dharma consider God as separate from the self and worship him in the form of an idol. They believe in Dualism theory. ....read more

Healthcare News Monitor

Most states won't meet Poshan Abhiyaan targets to curb child malnutrition: Study
ET Bureau - Aanchal Bansal

New Delhi: Terming the targets framed by the Centre to tackle malnutrition and stunting under Poshan Abhiyaan ‘aspirational’, a study by the Indian Council of Medical Research (ICMR) estimated that many Indian states are running behind and may not be able to achieve them. The study presented trends and estimates of disease burden caused due to child and maternal malnutrition in India between 1990 and 2017. Some of the states, which have reported the worst cases include Rajasthan, Bihar, Uttar Pradesh, Madhya Pradesh, Odisha, Assam and Tripura. Poshan Abhiyaan, earlier called the National Nutrition Mission, was launched by Prime Minister Modi in 2017-18 to reduce instances of malnutrition and stunting in children by 2022. Apart from Poshan Abhiyaan, the study claimed that malnutrition trends between 1990 and 2017 show that the country may also miss global targets for 2030, set by WHO and UNICEF. The report further recommended the need for higher rates of improvement and the setting ‘bold’ yet 'achievable' targets for 2030. Balram Bhargava, secretary in the department of health research in the health ministry and also director general ICMR, said the apex body and other Poshan Abhiyaan partners are looking at ways of getting more statespecific data to tackle malnutrition.

Delhi: Checklist to cut chances of errors during surgery
ET Healthworld- Durgesh Nandan Jha

NEW DELHI: No one should be harmed while receiving healthcare. Yet, according to the World Health Organization (WHO), five patients die every minute due to unsafe care globally, including surgical errors. On World Patient Safety Day on Tuesday, the Lok Nayak hospital introduced a surgical safety checklist to reduce the risks of errors during a surgery. The hospital’s medical director, Dr Kishore Singh, issued orders to all surgical departments to conduct workshops for its orientation. “The checklist will be mandatory from November 1, 2019, after which no surgery — elective and emergency — related file will be accepted in the records without a completed and signed checklist,” the order said. It added that every department must appoint an officer in-charge for the same. Dr Lovenish Bains, assistant professor in the department of surgery at Maulana Azad Medical College, said the draft list had been prepared using WHO guidelines under the guidance of the head of surgery, Dr Pawanindra Lal. “Till now, we had an informal handwritten checklist. The nurses, anaesthetists and the surgeons, for example, had their own checklists. But the new list is a comprehensive and single-page document that has to be filled by all,” he said.

Going for medical check-up? This ‘ATM’ tests 58 diseases in minutes!
Financial Express - Rajeev Kumar

Hassle-free and superfast medical check-up may soon become a reality for all, thanks to an ATM-like kiosk that helps people to walk in and test over 55 basic and advanced pathology tests and get instant reports. Developed by Sanskritech Smart Solutions Private Limited, a healthcare startup, ‘Swayam-Anytime Health Monitoring (AHM)’ device is probably India’s first advanced self-monitoring health diagnostic POCT system. The startup’s representative told FE Online today, “Swayam AHM has very easy to use User Interface with simple process, which can be managed by any person with basic computer knowledge. Step by Step process for conducting tests is mentioned below.” Currently, the machine can provide 58 types of tests, including Blood Glucose, Dengue, Hemoglobin, Typhoid, HIV, Malaria, Chikungunya, Elephantiasis, Urine tests, ECG, ear test, skin test etc. This hi-tech diagnostic system provides test reports instantly within few minutes in both print and electronic format. Generally, it takes a few hours to days to get such reports. Swayam AHM is a ‘Made in India’ device which, the startup claims, is set to “revolutionize the pathology panorama” in India. Swayam-AHM: Tremendous response - The startup said that there has been a positive response to its innovation. “We have received tremendous response from private and as well as government sectors organizations where we had done POC (Proof of concepts) in last six months. We have already received orders and have also delivered machines in various parts of India eg. Bhubaneshwar, Gurgaon, Indore etc.”

Industry experts contest FSSAI ban on methylcobalamin in Gujarat
Pharmabiz India - Shardul Nautiyal

Pharmaceutical consultant Dr Sanjay Agrawal has contested Food Safety and Standards Authority of India (FSSAI) ban on methylcobalamin in Gujarat. Though the notification on ban was issued on June 11, 2019, FSSAI also released a list of 73 approved formulations which included methylcobalamin taking manufacturers by surprise. As of today, FSSAI regulation has listed two forms of vitamin B12 namely methylcobalamin and cyanocobalamin which are widely available in the Indian market. Cyanocobalamin a form of vitamin B12 is cheap, synthetic, mild toxic and an inactive form of B12 not absorbed well orally and is converted to methylcobalamin after 48 hours of entering into body where only a small amount is converted. Methylcobalamin is a naturally found ingredient in food sources like fish, meat, eggs and milk. It bypasses several phases of absorption cycle and helps reverse symptoms. Cyanocobalamin takes a lot of effort to reduce it to the active form; hence cyanocobalamin absorption varies greatly between individuals. Methylcobalamin is better utilized and is direct active form. It is around 2.5 times more potent and less amount is excreted in the urine than cyanocobalamin so more amount stays in the body for a long time. Vitamin B12 (named as cobalamin) is considered to be the largest vitamin, involved in the synthesis of red blood cells, neuronal protection and DNA synthesis which are the vital functions of the body. Around 99 per cent people in the world are in need of extra vitamin B12.