Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                          Dated: 26th July,2019

Post-kala-azar dermal leishmaniasis patients are potentially infectious
According to a study, patients who have been successfully cured of visceral leishmaniasis can continue to infect hundreds of people for years, if they develop a skin condition known as post-kala-azar dermal leishmaniasis (PKDL).

In the largest study to date of patients with PKDL published in July 2019 issue of the journal Clinical Infectious Diseases, researchers found that 60% of people with the skin condition passed the leishmaniasis parasite on to sandflies. This means the insects could then go on to infect more people with the disfiguring and potentially deadly disease. “PKDL is a rash, it is not a life threatening skin condition, so it is often ignored. But patients are transmitting the parasite, they’re a huge reservoir of the disease,” Dr Jorge Alvar, senior leishmaniasis advisor at the Drugs for Neglected Diseases initiative (DNDi) and co-principal investigator of the study.

The study recommends that active PKDL case detection and prompt treatment should be instituted and maintained as an integral part of visceral leishmaniasis control and elimination programs (The Telegraph, Clinical Infectious Diseases).

The disease is endemic in Bangladesh, India and Nepal. The South-East Asia Region Kala-azar Elimination Programme, a joint initiative of Bangladesh, India, and Nepal focuses on control of PKDL as a priority strategy.

Safe dose of alcohol
Established recommendations for safe levels of drinking differ between men and women

These recommendations advise no more than two drinks daily for men and one drink daily for nonpregnant women.

However, no level of alcohol consumption can reliably be regarded as safe for some patients. Contraindications to alcohol use include pregnancy, personal or strong family history of alcoholism, or alcohol-associated hepatic or pancreatic disease and fatty liver.

On the other hand, cardiovascular disease remains the most common cause of death in many countries and moderate alcohol consumption may decrease cardiovascular risk. The absolute benefit from modest alcohol use needs to be weighed against the risk of alcohol consumption.

For non-pregnant women and patients without other co-morbidities, the healthiest dose of alcohol has not been determined. Based on the available evidence, the ideal dose of alcohol for mortality benefit is likely around 6 grams (about one-half of a standard drink) per day

Dose associated with lowest mortality was lower in women than men (4 grams/day and 6 to 7 grams/day, respectively).

Delhi High Court allows HCFI PIL and requests government to have separate CSR/charitable entity/account in government hospitals
Dr KK Aggarwal & Advocate Ira Gupta

Recently, vide order dated 15th July, 2019 one of the public interest litigation (PIL) of Heart Care Foundation of India (HCFI) has been disposed off by the Hon’ble Chief Justice of Delhi High Court whereby Hon’ble Delhi High Court has requested the government to consider and take appropriate action on the issues raised in the PIL being WP© No. 2513/2019 “Court on its own Motion versus Union of India”.

The said PIL was by way of representation filed by HCFI with Hon’ble High Court and then the same was duly accepted by the Hon’ble High Court. The said PIL was mainly on the issues and suggestions given by theHon’ble High Court of Delhi vide judgment dated 17.04.2014 in the matter titled as“Mohd. Ahmed (minor) versus Union of India & Others, Writ petition (Civil) No. 7279/2013which are as follows:.....read more

Ivacaftor reduces common respiratory infections in cystic fibrosis patients
Patients with cystic fibrosis who take ivacaftor have fewer respiratory infections due to major pathogens compared to those not taking the drug, suggests a new study.

The retrospective cohort study analyzed data from the United Kingdom CF Registry 2011-2016 and compared patients (age 6 and older) who took ivacaftor with patients who did not take the drug, over a period of 3 years.

Early and sustained reduction in Pseudomonas aeruginosa infections (32%) was seen with the use of ivacaftor, which was also associated with a 15% reduction in Staphylococcus aureus infections. A decline in Aspergillus infections was also noted. But, no decline in Burkholderia cepacia complex infections was seen......read more

The Science behind Training and Development
Training in any field requires gaining knowledge, skills and positive mental attitude towards the object of learning.

Knowledge is everything about what and why. In Yoga, it correlates with the Gyan (Gnana) Marg. Skill is all about how to do it and correlates with Karma Marg.....read more

Healthcare News Monitor

New medicines to treat cancer, cardiac diseases may soon become part of Essential Medicines' list
ET Healthworld-Sushmi Dey

New medicines to treat cancer and cardiac diseases along with antibiotics may soon be part of the National List of Essential Medicines (NLEM), which forms the basis for price regulation in India.
Taking cue from the World Health Organisation’s (WHO) revised list of essential medicines, the government’s Standing National Committee on Medicines has called for a stakeholder consultation on Thursday to discuss revision of NLEM 2015. Representatives from the pharmaceutical companies, industry associations as well as civil society are expected to attend the meeting. The idea behind the stakeholder consultation is to evaluate the WHO list in the Indian context by determining the “essentiality” and “affordability” factors of these medicines. The committee will have to grapple with several critical issues including how closely India chooses to follow the WHO list on addition of highly priced cancer drugs, expansion of the list to add more medical devices and contextualizing WHO recommendations on classifying antibiotics keeping in mind local regulations and access frameworks,” said public health expert Malini Aisola of All India Drug Action Network (AIDAN).

PGI, AIIMS among top 10 medical institutes with the most publications, says study
ET Healthworld-Shimona Kanwar

Chandigarh: Among the top 10 medical institutions in the country, AIIMS, New Delhi and PGIMER, Chandigarh were at the top for having more publications and citations than the other eight institutions combined. AIIMS was the leading institution when other indices were calculated. Among the most-cited articles, more than 80% had first/ corresponding authors from outside India. This has been the findings of a study, conducted by the department of Physiology of the Government Medical College and Department of Pharmacology, PGI published in the journal of The Association of Physicians of India. In the top papers, the corresponding authors and the first authors belonged to the same institutions, but for the top five among the selected 10 institutions, more than 80% of the papers had first/corresponding authors from outside the country, mostly from US or UK. The top 10 medical institutions widely considered to be the best are: AIIMS, New Delhi, Postgraduate Institute of Medical Education and Research, Chandigarh (PGIMER), Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry (JIPMER), along with the Christian Medical College, Vellore (CMCV), Sanjay Gandhi Postgraduate Institute, Lucknow ( SGPGI ), King George Medical University, Lucknow (KGMU), Maulana Azad Medical College, Delhi (MAMC), Kasturba Medical College, Manipal (KMC), Seth G S Medical College and KEM Hospital, Mumbai (KEM) and Banaras Hindu University, Varanasi (BHU).

UN calls nations to join ''clean air initiative''
Outlook India

New Delhi: Ahead of the 2019 Climate Action Summit, the United Nations, the World Health Organisation (WHO) and the UN Environment and Climate and Clean Air Coalition on Tuesday announced the clean air initiative and urged governments’ participation. The announcement was made by Ambassador Luis Alfonso de Alba, the Secretary-General’s Special Envoy for the Climate Action Summit, here after two-day meetings with representatives of governments, business and civil society. "The climate and the air pollution crisis are driven by the same factors and must be tackled by joint actions. The governments at all levels have both an urgent need and huge opportunity not only to address the climate crisis, but also to improve the health and save the lives of millions of people around the world, all while making progress on the Sustainable Development Goals (SDGs)," said the Ambassador. "We call on governments at all levels to step up to this challenge and bring powerful commitments and concrete plans to the upcoming Climate Action Summit," de Alba said. UN Secretary-General António Guterres is convening the Climate Action Summit in New York on September 23 and has called on the government, business and civil society leaders to bring bold actions and much greater ambition. Prime Minister Narendra Modi will also attend the summit.

Ernakulam district declared Nipah virus free, says Kerala health minister
India Today- PTI

The Kerala government on Tuesday declared Ernakulam district Nipah-free as a 23-year-old man, who had tested positive for the deadly virus, was discharged from hospital after nearly two months. The man, hailing from a village near North Paravur, was undergoing treatment at a private hospital for the last 54 days. Addressing a function at the hospital, Kerala Health Minister KK Shailaja said public and private health sectors had worked to successfully check the Nipah outbreak. KK Shailaja said the government had taken precautionary measures to contain the virus. The Health Department had kept 338 people under observation and 17 of them were kept in the isolation ward of a government hospital in Kalamassery. KK Shailaja also congratulated doctors and other medical professionals for their efforts to check the outbreak. The minister had announced on June 4 that the blood samples of the 23-year-old man were tested at the National Institute of Virology in Pune and the results had confirmed Nipah.

Naturopathy, Yoga, Ayurveda qualify as health care, exempt from GST
The Economic Times - Pranbihanga Borpuzari

Reiterating that services like Naturopathy, Yoga, Ayurveda fall under health care, a recent Authority of Advance Ruling (‘AAR’) verdict has provided parity among India’s traditional system of medicines and allopathy-based system. It also states that such ‘health care services’ rendered at clinical establishments by authorized medical professionals would be exempt from GST. The case came before the AAR, Goa, when Devaaya Ayurveda & Nature Cure Centre, a provider of treatment services to patients through Ayurveda, Naturopathy and Yoga wanted to know if it qualifies as a clinical establishment and whether the services provided qualify to be health care services which are exempted under Central Tax (Rate). Devaaya says it provides health services for both international and Indian patients for neuro-muscular problems, post-chemo therapy, post-radio therapy treatment, skin problems, metabolic issues like obesity, life style problems and orthopedic problems like rheumatoid arthritis, osteoarthritis etc. Devaaya says it has a team of doctors specialized in naturopathy, yoga and Ayurveda that conduct body composition assessment and records detailed history of the ailment including present medication of the guests. Based on such analysis medications, diet restrictions and daily treatments are planned. The Centre added that it has an in-house pharmacy from where Ayurvedic products are dispensed for treatment. Everyday treatment and follow up treatment is done to know the progress and responsiveness for the line of treatment prescribed.