Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                          Dated: 24th July,2019

WHO recommends dolutegravir as preferred HIV treatment option in all populations
(WHO, July 22, 2019): Based on new evidence assessing benefits and risks, the WHO recommends the use of the HIV drug dolutegravir (DTG) as the preferred first-line and second-line treatment for all populations, including pregnant women and those of childbearing potential.

Initial studies had highlighted a possible link between DTG and neural tube defects (birth defects of the brain and spinal cord that cause conditions such as spina bifida) in infants born to women using the drug at the time of conception. This potential safety concern was reported in May 2018 from a study in Botswana that found 4 cases of neural tube defects out of 426 women who became pregnant while taking DTG. Based on these preliminary findings, many countries advised pregnant women and women of childbearing potential to take efavirenz (EFV) instead.

New data from two large clinical trials comparing the efficacy and safety of DTG and EFV in Africa have now expanded the evidence base. The risks of neural tube defects are significantly lower than what the initial studies may have suggested.

DTG is a drug that is more effective, easier to take and has fewer side effects than alternative drugs that are currently used. DTG also has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and nevirapine-based regimens. In 2019, 12 out of 18 countries surveyed by WHO reported pre-treatment drug resistance levels exceeding the recommended threshold of 10%.

Do herbs contain modern drugs?
Herbs are pharmacologically active and therefore can positively and negatively impact patient health. Positive effects may include improvement of disease-specific outcomes. Negative effects may include adverse effects and drug-herb interactions. For these reasons, the Joint Commission in the United States now requires that herb and supplement use be recorded as part of the medication list in the hospital medical record

Water is a precious resource: Each one of us must make efforts to conserve water
Last week, the UP Government issued a circular vide which the Assembly Speaker has directed that only half glass of water should be served in the state secretariat, offices and canteens at first. If needed, more water can be provided. This is to be implemented with immediate effect.

This step has been taken to check wastage of water because it has often been seen that people only take few sips of water when offered and leave the rest of the water in the glass......read more

Do Your Duty with Discipline and Devotion
“Vasudhaiva kutumbakam” (the whole world is one family) and “Ekam Sat Viprah Bahudavanti” (truth is one but the wise call it by various names) are two basic statements, which come from the ancient Rig Veda and form the fundamentals of Vedic philosophy.

One should do one’s duty with devotion and discipline. This principle can be remembered as the principle of three Ds

In daily routine ‘one should remember the purpose for which one is born, which is to fulfil Dharma (duty), Artha (wealth), Kama (desire) and Moksha (liberation). To achieve them, one needs to follow the four Fs: (i) Follow the teacher; (ii) Face the negative devils of the mind; (iii) Fight till the end; and (iv) Finish at the goal.....read more

Healthcare News Monitor

Doctors should provide only generic medicines: DCC
ET Healthworld-ANI

New Delhi: To promote usage of generic medicines, the Central Drugs Control Standard Organisation's (CDCSO) - Drug Consultant Committee (DCC) has proposed that doctors should prescribe only generic instead of branded medicines to patients. In the 56th meeting of the DCC, it was proposed that Registered Medical Practitioners (RMP) shall supply 'generic medicines' only. However, it has also been recommended that RMP shall supply the 'physician sample' free of cost. It may be noted that under schedule K of the Drugs and Cosmetics Rules, 1945 - RMP can supply different categories of medicines including vaccines to their patients as per exemptions provided with certain conditions. "We have proposed to amend the exemptions provided under schedule K regarding supply of medicines by Registered Medical Practitioners (RMP) to their patients. These additional conditions are being incorporated to prevent the misuse of the exemptions," a senior official of the Health Ministry requesting anonymity said. "This is being done to promote generic medicines in the country. The process will take at least six months and after that, the Health Ministry will give its green signal for implementation,' he said.

India participates in only 2 to 3% of global clinical trials under evolving regulatory scenario
Pharmabiz India- Shardul Nautiyal

India participates only in 2 to 3% of global clinical trials due to lack of clarity on approval timelines among other factors, according to experts. They rue that longer time is required for approvals in India which is minimum three months as compared to that in developed countries which is one month. It is therefore being recommended to streamline and reduce approval timelines which can boost clinical trial industry phenomenally. Another step could be to allow parallel trials in the same phase as in other countries. “The current regulatory scenario is yet to mature in India as compared to developed countries despite India having tremendous potentials in terms of large patient pool, well trained and English speaking investigators and potential for fast recruitment under the current regulatory regime,” explains Venkat Rao Sadhanala, chief executive officer, Vanta Bioscience Limited. Vanta Bioscience Limited, which has been in the business of pre-clinical services, has now entered in to clinical services as well. “As expansion into clinical research area, Vanta's clinical research facility as a CRO - Vayam Research Solutions Ltd is getting operational by October 2019 with 140 beds. The unit has already entered into an agreement with anchor client Emcure Pharmaceuticals Ltd for guaranteed business of Rs.29 crore for the next two years, informs Sadhanala.

Govt unable to provide therapy to children suffering from rare diseases citing lack of funds
Pharmabiz India- Shardul Nautiyal

The Central as well as the state government of Uttar Pradesh (UP) are having a tough time in providing timely therapy to children suffering from rare disease in UP under the Umbrella Scheme of Rashtriya Arogya Nidhi (RAN) citing lack of funds. In May 2019, after witnessing the plight of these patients, the UP High Court had done multiple hearings in a span of one month to understand the situation. The case which is still sub judice will come up for hearing on 31 July 2019. It was brought to the knowledge of the Court that the Centre has been running RAN scheme and a perusal of the aforesaid scheme clearly indicates that the rare disease "Mucopolysaccharoidosis" (MPS) is covered by the said Scheme. It has further been stated that an amount of Rs.15 lakh as a one time aid is granted by the Centre in favour of the persons affected by the disease. After considering all the aspects, HC had ruled in the favor of the children and ordered Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) Lucknow to re-initiate treatment. The order had directed treatment for these children under RAN and had asked the patients to submit their files to the Central government through SGPGIMS on July 15, 2019. Post which treatment was to be provided to these children at SGPGI. The patients have requested immediate treatment as the condition of these patients has already deteriorated due to discontinuation of treatment.

Tissue bank operational at Maulana Azad Institute of Dental Sciences
ET Healthworld- PTI

New Delhi: A tissue bank has been made operational at the Maulana Azad Institute of Dental Sciences to provide bone and tissue grafts to different streams of medical sciences. This is the country's only such facility in a dental institute and one of the few in the country to employ gamma irradiation for terminal sterilization. A team of doctors from the institute had undergone training at the Medical school at University Sains Malaysia. After their return, the tissue bank was set up. Dr Mahesh Verma, the Director-Principal of Maulana Azad Institute of Dental Sciences (MAIDS) said besides orthopaedic surgeries, knee replacements and trauma care, bone and tissue grafts are also needed for treatment of bone deformities, gum diseases, cleft lip and cleft palate. "The tissues and bones are procured from live donors at the orthopaedic department of LNJP hospital under the Maulana Azad Medical College and are then processed following international guideline regarding tissue banking. These are then used for regeneration of bones," he said.

Private hospitals need to temper expectations, govt may not review Ayushman Bharat package rates
Moneycontrol- Viswanath Pilla

Private hospitals that are expecting revision of package rates offered under Ayushmaan Bharat may have to temper their expectations going by the statement by Health Minister and other top officials of National Health Authority (NHA). Earlier this week, Health Minister Harsh Vardhan said there is no proposal to review the prices of packages being offered under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). "One of the underlying principles were that the full capacity of private hospitals was not being utilized and PMJAY is to provide additional volumes to them without additional investments in infrastructure and manpower etc.," Harsh Vardhan said in the Lok Sabha. The health minister was responding to a question raised by Congress Member of Parliament (MP) from Telangana Komati Reddy Venkat Reddy, on whether there will be any review of package rates under Ayushman Bharat.