Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 23rd April, 2019

Medtalks with Dr KK

1.Older adults with end-stage kidney disease who start dialysis--a treatment that keeps their blood free of toxins--appear to die at higher rates than previously thought, according to findings of a new study by researchers at Harvard Medical School, Brigham and Women's Hospital, Veterans Affairs Boston Healthcare System and Icahn School of Medicine at Mount Sinai, among other institutions. More than half of older adults who started dialysis died within a year of beginning treatment, according to the research, and nearly one in four succumbed to the disease within a month of doing so.

2.Universal screening is better in diagnosing woman with hemoglobinopathies. Carrier screening for thalassemia should be offered to all pregnant women attending antenatal clinic during early pregnancy.

3.The US Food and Drug Administration (FDA) has granted marketing authorization to NeuroSigma for its Monarch external trigeminal nerve stimulation (eTNS) system. It is the first device to treat attention-deficit/hyperactivity disorder (ADHD), the agency announced. The eTNS system will be available by prescription only and is indicated for children aged 7 to 12 years who have not already been prescribed an ADHDmedication.

4.The World Health Organization is pleased to announce the staging of the second edition of the “Walk the Talk: The Health for All Challenge” event on Sunday 19 May 2019 in Geneva.

5.WHO calls on everyone to be inspired by the global movement to achieve universal health coverage (UHC), i.e. achieving better health and well-being for all people at all ages, including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. Infection Prevention and Control, including hand hygiene, is critical to achieve UHC as it is a practical and evidence-based approach with demonstrated impact on quality of care and patient safety across all levels of the health system.

Practise changing update: For patients undergoing colostomy or ileostomy with a permanent stoma do not routinely placing prophylactic mesh

Parastomal hernias occur in up to 50 percent of patients with a colostomy or ileostomy. A larger, more recent trial (STOMAMESH) now reports that prophylactic mesh did not reduce the incidence of parastomal hernia at one year.

PREVENT and STOMAMESH had similar designs but, unlike the earlier trial, clinical assessment in STOMAMESH included blinding to the intervention and routine computerized tomography follow-up to assess for hernia.

Given the potential for rare mesh-related complications, and that the sole benefit of prophylactic mesh to prevent parastomal hernia is in question, in todays date one should not routinely place mesh at the time of permanent stoma construction.

Aspirin for primary prevention of cardiovascular disease and cancer

The current recommendation is that primary prevention with aspirin is appropriate for most patients over age 40, but now advise that the decision whether to use aspirin for primary prevention of cardiovascular disease and cancer be made based on shared decision-making, taking into account the probable benefits and harms of aspirin relative to the specific patient.

Healthcare News Monitor

Pharma News

Alembic Pharma gets USFDA nod for 2 generic products

The Times of India-PTI

New Delhi, Apr 22 () Drug firm Alembic Pharmaceuticals Monday said it has received approvals from the US health regulator for its Teriflunomide tablets and Tobramycin ophthalmic solution.
The company has received approval from the United States Food and Drug Administration (USFDA) for its abbreviated new drug application (ANDA) for Teriflunomide tablets in the strengths of 7 mg and 14 mg, Alembic Pharmaceuticals said in a filing to BSE. The product is generic version of Sanofi-Aventis US LLC's Aubagio tablets in the same strengths, it added. According to IQVIA, teriflunomide tablets, 7 mg and 14 mg have an estimated market size of USD 1.6 billion for 12 months ending December 2018, Alembic Pharma said. Teriflunomide tablets are indicated for the treatment of patients with relapsing forms of multiple sclerosis, Alembic Pharma said. The company has also received approval from the USFDA for its ANDA for Tobramycin ophthalmic solution USP, 0.3 per cent, it added.

Carlyle-Zydus and Advent join race to acquire Bharat Serums and Vaccines Ltd

The Economic TimesReghu Balakrishnan

MUMBAI: A consortium of Carlyle and Zydus Cadila is competing with private equity group Advent International to acquire Mumbaibased bio-pharmaceutical company Bharat Serums and Vaccines Ltd. (BSV). The two have submitted non-binding offers in the range of Rs 3,450-3,600 crore ($500-520 million), said multiple sources aware of the matter. They are up against domestic pharma companies Dr Reddy's Labs, Chrys Capital-backed Mankind Pharma and Goldman Sachs which have also made offers in the range of Rs 3,000 crore ($400-440 million), said one of the persons cited above.

WATCH: How incubator-turned-medtech company InnAccel is innovating for India’s needs

Your Story-Vishal Krishna

A report by FICCI and Assocham reveals that India imports 85 percent of its medical devices - a market worth $4.6 billion. In fact, a FICCI list identifies only one Indian medical device startup in the top 30 companies in the Medical Devices and Equipment Industry: YourStory’s Tech30 company Forus Healthcare, which has raised $13.4 million from Accel and Chiratae so far. So, it is not surprising that a growing number of investors and companies, dominated by the likes of GE, Philips, and other MNCs, would want a share of this pie. Yet, surprisingly, for incubator-turned-medtech company InnAccel, which focuses on building novel medtech devices in the areas of Critical Care, ENT, and Maternal Care, that's not the core reason. For InnAccel, along with its subsidiaries Coeo Labs and Sattva Medtech, the emphasis is on building innovative medical devices to serve the healthcare needs of India and emerging markets.

Ministry of AYUSH, CSIR sign MoU to promote traditional medicines

Bio Spectrum

A Memorandum of Understanding (MOU) has been signed between the Ministry of AYUSH and Council of Scientific and Industrial Research (CSIR), New Delhi for cooperation in research and education in areas of traditional systems of medicine and its integration with modern science. The MoU was signed by Vaidya Rajesh Kotecha, Secretary, Ministry of AYUSH and Dr. Shekhar C. Mande, Director General, CSIR and Secretary, DSIR in the presence of senior officials from both the organizations. Speaking on the occasion, Secretary stated in due cognition of the growing interest of traditional medicines worldwide, there is a need of multipronged and innovative approaches for the acceptance of this science. He said that the combination of traditional healthcare and modern basic science has a huge possibility to do innovative and path-breaking researches which can be used for the explanation of various basic concepts.

Medlife unveils #HealthForTheNation campaign


With the election campaign in full swing, online pharmacy and e-diagnostic player, Medlife, unveiled the #HealthForTheNation campaign on Monday. The idea behind the initiative is to make people aware that they are not only voting for a new government but also for the nation’s health and well-being. The campaign encourages voters to upload a picture of their fingernail with the election ink, along with with the hashtag #HealthForTheNation to avail exciting offers from Medlife. The company has collected health-related data for 29 Indian states which brings to the forefront some alarming statistics. From startling gaps in doctor-to-patient ratios in states to the incidence of diseases, the findings are an eye-opener for everyone.

Revise antibiotics safety data, pharma cos told

The New Indian Express

CHENNAI : The Central Drugs Standard Control Organisation (CDSCO) has issued directions to manufacturers to revise safety data for various antibiotics based on the data from the Pharmacovigilance programme on India. Under the programme, the organisation collects adverse drug reactions reported from adverse drug reactions monitoring centres in the country, said S Eswara Reddy, Drugs Controller General of India, on Monday. Speaking at the 29th convocation of Sri Ramachandra Institute of Higher Education and Research (SRIHER) here, Eswara Reddy said, “Under the Pharmaco vigilance programme of India, the CDSCO collects adverse drug reactions reported from across 250 adverse drug reactions monitoring centres, majority of these are located in various medical colleges. Due to a large patient pool, the CDSCO is able to generate robust and quality data which is further analysed for signals.”

Healthcare News

From Bareilly to Baghdad, Tattvan is using telemedicine to connect doctors and patients

Your Story- Sindhu Kashyap

In 2008, Ayush Mishra realised getting good health treatment at his home town Bareilly, Uttar Pradesh, was next to impossible. He had met with a fatal accident and realised there was a huge demand and supply gap between doctors and patients, especially in Tier II and Tier III cities. An engineer in Biotechnology, Ayush took a few years to understand the situation on ground. After working in healthcare for close to 10 years, and working for different startups, Ayush decided to start Tattvan E-Clinic in 2017, based out of Gurugram. It is a telemedicine healthcare clinic that aims to transform healthcare services in remote regions across India and Asia. Tattvan E-Clinic brings doctors and specialists from reputed hospitals in big cities to the smaller regions, catering to their various medical requirements.

Japan’s M3 now acquires a majority share in Bengaluru-based DailyRounds

Your Story-Tarush Bhalla

Japanese healthcare venture M3 Inc on Monday said that it has acquired a majority stake in Bengaluru-based DailyRounds, a mobile and web-based applications for doctors and medical students in India. According to the company, this move marks M3’s foray into case-based problem-solving community platform and medical test preparation business in India. Neuroglia Health Private Limited (NHPL) owns and operates ‘DailyRounds’ mobile app, a case-based problem-solving community platform for doctors in India, as well as ‘Marrow’, a test-preparation platform to enter post-graduate specialty courses in medical schools in India.

Doctors seek protection bill from Ranchi candidates

The Times of India

The doctors demanded implementation of Medical protection Bill at the earliest which is stuck in Jharkhand assembly. Apart from that they also asked the candidates to provide relief to doctors from several provisions of Clinical establishment Act, 2010 which are becoming an obstacle in running small clinics. “We are already short of around 3200 doctors in state and if the clinical establishment Act isn’t modified, no doctor will be able to provide healthcare
services in rural areas as it has provisions like having an emergency service facility even in small clinics which isn’t logical. A doctor who wants to provide medical facilities to people by running his clinic will never be able to open one due to the provisions of the Act which will further deteoriate the facilities,” said Dr Shyam Sidana, President IMA Ranchi. On being asked on medical protection bill BJP candidate Sanjay Seth said that the bill is still pending in house and BJP is committed to bring the bill, however it was congress legislators who blocked it in the house.

Government wants to impose draconian laws on doctors: State IMA president

The Times of India-Chaitanya Deshpande

Dr. Hozie Kapadia, president of IMA Veteran Mumbai physician Dr Hozie Kapadia, who is the president of the Indian Medical Association’s (IMA) state unit, spoke to TOI and other media about the proposed idea of the National Medical Council (NMC), issue of crosspathy and how increasing health budget up to 4% of total GDP can solve most of public health-related problems of the country. Excerpts from the interaction. By dissolving the Medical Council of India (MCI) and introducing the NMC, the Centre intends to take control of entire health service and education field. The NMC bill clearly mentions that medical colleges will have up to 60%
management quota seats. This will promote corruption right from the admission stage. The MCI structure was such that every state can send at least one representative on the national body. But NMC will have only 5 representatives from across the country and all of them would be nominated by the Centre. The bill shows that the central government is wanting to apply draconian laws on doctors. We will not accept this in its current format.

Navia Launches Navi: Voice Assistant For Doctors

Express Healthcare

Navia Life Care, a healthcare technology startup launched Navi – a voice-based virtual assistant for doctors. Navi like any other virtual assistant is an application that can understand voice commands and complete tasks for a user but with a slight difference that separates it from the rest. It creates and completes a digital prescription for the patient which can be printed or sent via SMS. Thus making it not only a mere passive listening device that will respond once it recognises a command but also record and analyse both the doctor’s behaviour and the patient’s medical history. Besides, using an algorithm it will also predict possible re-modification diagnosis, medication schedules and investigations for patients, thus recommending them to doctors.

Controlling stent prices may show benefits in short-run, but does long-term damage

Financial Express

A new study by doctors and policymakers at public hospitals posits that the price cap on coronary stents may have helped a larger number of patients from lower-income groups undergo life-saving angioplasty since their number went up sharply after the price-regulation move. The study, led by Dr Bhanu Duggal, the head of cardiology at AIIMS, Rishikesh, found that the number of patients who underwent procedures involving stents in Maharashtra rose by 43% after the state reduced prices of drug-eluting stents in 2014—while only 40.7% of the patients could afford the high-end stents in 2013, the number jumped to 71.3% in 2015.

Apollo Hospitals: Powered by proton

Fortune India-Debjyoti Ghosh

Suneeta Reddy is a name that carries considerable heft in the healthcare sector in India. The 59-year-old managing director of Apollo Hospitals Enterprise, along with her three sisters, has transformed a 180-bed hospital, started by her father in 1983 in Chennai, into the largest hospital chain operator in the country. Reddy joined Apollo in 1989. Her Financial acumen made her spearhead the finance and strategy divisions of the hospital chain. Despite operating in a highly competitive and regulated industry, she has managed to grow the group’s revenues. She was ranked No.3 on Fortune India’s Most Powerful Women in business list last year. With over 10,000 beds across 70 hospitals, Apollo now has a presence in India, Oman, and Bangladesh.

Increase in seats will not reduce competition: DME

The New Indian Express

HYDERABAD: An increase in the number of medical colleges and subsequent increase in MBBS seats in Telangana are on the cards. This means that there are more number of seats up for grabs for the students, who are working hard, preparing for NEET-2019. The State has 1,150 MBBS seats and the number might go up by another 300, as and when the Medical Council of India (MCI) clears the proposed medical colleges in Nalgonda and Suryapet. This is apart from the two medical colleges in Mahbubnagar and Siddipet, which have already received the required permissions.

300 MBBS students of Subharti medical college still await Transfer to GMCs

Medical Dialogues

Dehradun: Government’s delay in enhancing seats at state-run Medical Colleges is constantly impacting the education of aggrieved 300 MBBS students of the defunct Shridev Suman Subharti Medical College (SSSMC). According to a recent report by TOI, nine days since the Supreme Court rejected the review petition of Medical Council of India (MCI), the authorities concerned are yet to approve the increase in seats of the Government Medical Colleges (GMCs) in Uttarakhand. In the first week of April, the MCI had moved the apex court seeking a review of its order that directed the Uttarakhand government to accommodate 300 students, including those of the first and secondyear MBBS course of the defunct Subharti medical college to GMCs in the state.

Students, colleges warned against blocking medical seats

The Times of India

HYDERABAD: Following complaints of blocking of management quota post-graduate medical seats, Directorate General of Health Services (DGHS) and medical counselling committee (MCC) has warned students and colleges of stern action. As the admission process for medical seats is underway, the Healthcare Reforms Doctors Association (HRDA) alleged that several meritorious
students were blocking management quota seats. Seat blocking is a common practice every year among meritorious students, who opt for a seat during initial rounds of counselling and vacate it after securing better seats in other colleges during the subsequent rounds.

22nd April, 2019

Current Temperature Status and Warning for next five days

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 21 April to 0830 hrs IST 22 April, 2019)

Heat Wave:

Yesterday, No heat wave conditions were observed over any part of the country (Annexure 1 & 2).

Maximum Temperature

Maximum temperatures were appreciably above normal (3.1°C to 5.0°C) at a few places over Arunachal Pradesh and Jammu & Kashmir; above normal (1.6°C to 3.0°C) at a few places over Nagaland, Manipur, Mizoram & Tripura, Saurashtra & Kutch, Konkan & Goa and Coastal Karnataka and at isolated places over Assam & Meghalaya, Gujarat Region, Gangetic West Bengal, Odisha, Coastal Andhra Pradesh and Tamilnadu & Puducherry. Yesterday, the highest maximum temperature of 42.2°C recorded at Akola (Vidarbha) and Barmer (West Rajasthan) over the country (Annexure 1 & 2).

Temperatures Recorded at 1430 Hours IST of Today, the 22nd April, 2019

  • Barmer (Rajasthan) recorded the maximum temperature of 43.2°C each (Annexure 3).
  • Temperatures recorded at 1430 hours IST of today have risen by 3-6°C at one or two pockets of Jammu & Kashmir, Himachal Pradesh, East Rajasthan, Jharkhand, Tamilnadu and Kerala and risen by 1-3°C at most parts of Punjab, Haryana, Delhi, Rajasthan, Madhya Pradesh, Konkan & Goa, Kerala and South Interior Karnataka; at a few places over Gujarat, Rayalseema, Chhattisgarh and Jharkhand and at one or two pockets over Marathwada, Vidarbha, Coastal Karnataka, Assam & Meghalaya and Gangetic West Bengal (Annexure 4).

Supreme Court to decide about apology: Will the Apex Court’s decision on apology have implications on medical mistakes?

Yesterday, the Congress president Rahul Gandhi expressed regrets in the Supreme Court over his remarks related to Rafaele.
If the Apex Court decides to accept the apology of Rahul Gandhi, this will provide another tool for councils to decide about medical apology.
The council has powers to accept the mistake. As per Regulation 8.2 of MCI Code of Ethics,"…If the medical practitioner is found to be guilty of committing professional misconduct,.....read more

Time for DCGI to respond

We in practice are confused about "sartans" (ARBs or angiotensin receptor blockers). Every other day, a preparation is withdrawn from the market.
Now Torrent Pharmaceuticals Limited is expanding its recall for Losartan Potassium Tablets USP and Losartan Potassium/hydrochlorothiazide tablets, USP, to the consumer level due to detection of trace amounts of an unexpected impurity found in an active pharmaceutical ingredient (API) manufactured by Hetero Labs Limited.....read more


Gambling in Indian Mythology