Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                          Dated:25th September,2019

How can I prevent acne breakouts?

  Never go to bed with makeup on.

  Check labels: when purchasing cosmetic and skincare products, always look for the terms “non-comedogenic,” “oil-free,” or “won’t clog pores.”

  Avoid facial oils and hair products that contain oil.

  Some acne spots are not actually acne but are post-inflammatory pigment changes from previous acne lesions or from picking at acne or pimples. Wear sunscreen with SPF 30+ daily, rain or shine, to prevent darkening of these spots.

There is some evidence that specific dietary changes may help reduce the risk of acne. For example, one meta-analysis of 14 observational studies that included nearly 80,000 children, adolescents, and young adults showed a link between dairy products and increased risk of acne. And some studies have linked high-glycemic-index foods (those that cause blood sugar levels to rise more quickly) and acne. [Harvard]

ACC principles for overcoming compensation and opportunity inequity
The American College of Cardiology (ACC) believes that

9.Cardiologist compensation plans should define those activities and behaviors that will result in an increase or decrease in compensation.

10.Cardiologist compensation plans should not utilize salary history in setting cardiologist compensation.

11.Cardiologist starting compensation at a given institution or practice should be the same for all individuals at a given rank or position within a given subspecialty of cardiology at that institution or practice.

12.Cardiologist compensation plans should be transparent in terms of the approach, methodology, and calculations used to determine individual compensation.

13.Cardiologist compensation plans should include the tools and education required to achieve a fundamental understanding of compensation terms and processes in aggregate as well as how these apply in determining individual compensation.

14.Cardiologist compensation should recognize that equity in cardiologist compensation ultimately depends on equal access to career opportunities.

15.As part of ensuring opportunity equity, cardiology leadership should be responsible for mitigating the effects of unconscious or implicit bias and creating a culture of inclusion.

16.Cardiology practice/division leadership should be responsible for equity in compensation and opportunity and should be accountable for creating and implementing fair policies and adhering to compensation best practices.

17.Both cardiology leadership and impartial external experts should regularly and frequently review cardiologist compensation models, metrics, and actual total compensation, including bonuses, and access to resources and opportunities, and do so with reference to national benchmarks.

(Source: Journal of the American College of Cardiology, Sept 12, 2019)

'Think Fungus'? Blastomycosis and coccidioidomycosis manifest with flu-like symptoms
There are over 5.1 million species of fungi on Earth, from the mushrooms that we eat to the microscopic fungi that can infect us. Most live on soil, trees, air and water. Only a small subset of the 5.1 million – some 300 species - pose a health threat and are capable of causing serious life-threatening infections.

The US CDC has designated the week of Sept. 23-27 as Fungal Disease Awareness Week. CDC handles between 3 and 5 fungal outbreaks per year. This number was between 1 and 2 in the 90s. This increase in overall number of outbreaks is alarming.

Fungi are all around us and people are infected when they inhale the microscopic fungi, fungal spores or through direct contact.

In 2012 outbreak more than 13,534 people were exposed to methylprednisolone, which was contaminated with a fungus called Exserohilum rostratum that typically infects plants but not humans. In this outbreak, 753 cases of contaminated-product related fungal infections were reported and 61 people died. ....read more

“I am the Best”: The mantra of success
Most people lack self-confidence and self-esteem and face episodes of depressions. They suffer inferiority complex and are in habit of comparing themselves with others.

Whether an organization is good or bad is decided by its people. If the people are good the organization is good and if the people are bad the organization is bad. Imagine a situation where two students of a school are asked “how is your school”. The first student answers: “the school is the worst in the city” and the second one says: “the school is the best in the city”. The teacher’s reply to both the students is the same: “it has to be because student like you are there in this school”.

Whichever organization you work for, it must be the best, because you are working there, and you are the best. If it was not the best, you would not have been there. ....read more

Healthcare News Monitor

Govt to come up with list of over-the-counter drugs soon
The Times of India

The government is set to come up with a list of over-the-counter (OTC) medicines under a separate schedule by making changes in the drug law with stringent regulations on quality, advertisement and pricing of such products. "The move is aimed at promoting self-care and reducing the cost of treatment without compromising patient safety. It will also help us ensure that ‘prescription-only’ drugs are not misused, while other commonly used medicines which are not toxic are easily available to patients,” a senior official told TOI. Recommended By Colombia The decision to have separate provision for OTC under the Drugs and Cosmetics Act was taken in a meeting of the Drugs Consultative Committee (DCC) under the health ministry last month. DCC’s decision is based on recommendations of a sub-committee formed earlier to examine the issue. “The sub-committee is of the opinion that there is an urgent need for defining OTC drugs and to lay down specific provisions for the regulation of OTC drugs in the country,” the DCC noted in its minutes of the meeting. The DCC has directed the sub-committee to identify such list of OTC products along with conditions and frame draft for amendments in the law. At present, there is no definition of OTC medicines and therefore, any medicine that is not a ‘prescription-only’ product, automatically qualifies as OTC. Pharmacists are free to sell such products on their own and patients can buy them without any medical advice or consultation. Commonly used analgesics like paracetamol and ibuprofen and medicines for cough, cold and flu fall under the OTC category. Apart from the advertisement norms and definition, the proposed changes will include basic characteristics of OTC drugs and their classification into OTC-1 and OTC-2 based on safety, therapeutic index, need for accessibility to patients, availability, non-habit forming nature, supply chain mechanism and socio-economic conditions of the country. It will also define criteria and conditions for any medicine to switch from prescription drugs to OTC category as well as regulation for new OTC drug approval, distribution & sale.

Make drugmakers upload data in SUGAM portal: CDSCO Committee recommends State Drug Authorities
Business Medical Dialogues

The Drugs Consultative Committee (DCC), functional under Central Drugs Standard Control Organisation (CDSCO), recently recommended the State Drug Control Authorities for issuing orders under Drugs and Cosmetics Rules, and direct drugmakers to mandatorily upload data pertinent to the licenses granted for manufacture, sale and distribution of drugs in the online portal- SUGAM. SUGAM portal provides a single-window for all its stakeholders to access the services provided by the portal by implementing role-based access control and actions. It has consolidated the entire Drug Regulatory framework at the centre and provides a centralized dashboard for monitoring the various regulatory clearances all over the country. SUGAM enables online submission of applications requesting for permissions related to drugs, clinical trials, ethics committee, medical devices, vaccines and cosmetics. The system also builds up the database of approved drugs, manufacturers & formulations, retailers & wholesalers in India. The project also enables the complete digitization of the old CDSCO records having primarily application within the File, noting in Green sheet, and supporting documents. Central Government has amended the Drugs and Cosmetics Rules, 1945 incorporating Rule 84AB making online submission of data through SUGAM portal as a mandatory requirement under D&C Rules.

Haryana: Patient breaks out of MRI machine after hospital staff forgets him inside
India Today- Manjeet Sehgal

In a shocking incident, a patient in Haryana's Panchkula was compelled to break the MRI machine belt to come out of it after the doctors and technicians conducting the scan allegedly forgot him inside the machine. Ramhar Lohan, a 59-year-old patient, had dislocated his shoulder while driving a two wheeler and the doctors adviced him a MRI scan. Lohan went to Panchkula civil hospital for the MRI scan on Sunday evening. The technicians at the hospital told him that he will have to remain inside the machine for 10 to 15 minutes. However, when they did not remove the patient from the machine for over 30 minutes he started feeling suffocated as the machine temperature was rising. "I was advised MRI scan by Dr Lalit Kaushal. The staff which was conducting my MRI scan had told me that it will take only 10 to 15 minutes. But when they did not remove me for more than 30 minutes I started crying. Nobody responded," Lohan told India Today TV. Despite his cry for help nobody came to help as Lohan remained stuck inside the machine. "Nobody was in the machine room when I was struggling to come out," he said. "The machine was overheating and I was feeling suffocated. I tried to release myself but I was tied to the machine with belt. When I noticed that if I did not come out of the machine I may die, I made last attempt and was able to broke the belt," Lohan.

DCGI directs manufacturers of FDC Aceclofenac 100mg + Drotaverine Hydrochloride 80mg to conduct post marketing surveillance
Pharmabiz India – Shardul Nautiyal

Drugs Controller General of India (DCGI) has directed all the manufacturers of FDC Aceclofenac 100mg + Drotaverine Hydrochloride 80mg tablet to conduct active post marketing surveillance for the treatment of colicky pain due to smooth muscle spasm as per Drugs and Cosmetics Rules. The study should be completed within one year and results of study should be placed before the committee for further review. The FDC of Aceclofenac 100mg + Drotaverine Hydrochloride 80mg tablet was initially approved by DCGI on September 15 2008 in favour of Themis Medicare. Based on the report of Parliamentary Standing Committee (PSC) dated May 08, 2012, it was decided that FDC of Aceclofenac 100mg + Drotaverine Hydrochloride 80mg tablet would be referred to New Drug Advisory Committee (NDAC)/Subject Expert Committee (SEC) for examination and review related to its continued marketing and updation of productmonograph in light of recent knowledge and regulatory changes in overseas. Accordingly, the matter was discussed in a series of meetings of the NDAC/SEC. Based on the recommendations of Subject Expert Committee, it was decided that the FDC of Aceclofenac 100mg + Drotaverine Hydrochloride 80mg tablet shall be indicated for treatment of ''colicky pain due to smooth muscle spasm" for its continued marketing. However, manufacturers of this product shall conduct clinical trial.

Pune: Leptospirosis infects three more persons this month
ET Healthworld – Umesh Isalkar

PUNE: Leptospirosis, the dreaded bacterial disease, has infected three more persons in the city this month. The latest report by the Sassoon General Hospital referral laboratory stated that 27 cases were recorded in August. A state health department official said the number of samples collected from suspected patients was significantly high last month. "As many as 131 samples of urine and blood were tested for leptospirosis just in August. These patients were mainly from the municipal limits of Pune, Pimpri Chinchwad, the rural parts and adjoining areas," the official said. Leptospirosis is a non-contagious disease. People are at risk of infection if they wade through contaminated flood water, especially if it comes in contact with eyes, nose or broken skin on the feet. Sanjeev Wavare, head of Pune Municipal Corporation's insect control department, said they have started administering free medication at civic-run hospitals. "Considering the floods, we have succeeded in keep a fair check on the disease in the city," Wavare said.