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

Cleveland Clinic Top 10 Medical Innovations for 2020 (Part 2)

6.Biologics in orthopedic repair:Biologics – cells, blood components, growth factors, and other natural substances – have the power to replace or harness the body’s own power and promote healing. These elements are finding their way into orthopedic care, allowing for the possibility of expedited improved outcomes.

7.Antibiotic envelope for cardiac implantable device infection prevention:Antibiotic-embedded envelopes are now made to encase implantable cardiac electronic device, effectively preventing infection.

8.Bempedoic acid for cholesterol lowering in statin intolerant patients: IBempedoic acid provides an alternative approach to lowering of LDL-cholesterol while avoiding these side effects.

9.PARP inhibitors for maintenance therapy in ovarian cancer: One of the most recent important advances ovarian cancer treatment, PARP or poly-ADP ribose polymerase inhibitors have improved progression-free survival and are now being approved for first-line maintenance therapy in advanced stage disease. Several additional large-scale trials are underway with PARP inhibitors set to make great strides in improving outcomes in cancer therapy.

10.Drugs for heart failure with preserved ejection fraction:Currently, recommendations for treatment are directed at accompanying conditions and mere symptom relief. But SGLT2 inhibitors, a class of medications used in the treatment of type 2 diabetes, is now being explored in HFpEF (Heart failure with preserved ejection fraction, also known as diastolic heart failure) alluding to a potential new treatment option.

(Source: Cleveland Clinic)

HCFI PHM Consensus statement: Fabric hygiene

  Fabric hygiene is an important component of personal hygiene.

  Clothes are a potential vehicle of transmission of infections.

 Dirty clothes may be contaminated with resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) in healthcare settings. ....read more

Bed time anti-hypertensive medication better controls BP
People with high blood pressure who take all their anti-hypertensive medication in one go at bedtime have better controlled blood pressure and a significantly lower risk of death or illness caused by heart or blood vessel problems, compared to those who take their medication in the morning, according to results from the Hygia Chronotherapy Trial published in the European Heart Journal

The Hygia Chronotherapy Trial is the largest to investigate the effect of the time of day when people take their anti-hypertensive medication on the risk of cardiovascular problems. It randomised 19,084 patients to taking their pills on waking or at bedtime with a follow-up period of more than six year average, during which time the patients’ ambulatory blood pressure was checked over 48 hours at least once a year. ....read more

Why do we put on Tilak on the forehead?
The Tilak is a mark of auspiciousness and invokes a feeling of respect in the wearer and others. It is recognized as a religious mark. Its form and color vary according to one’s caste, religious sect or the form of worship of the person in question.

Tilak is applied on the forehead with sandal paste, sacred ash or kumkum, a red turmeric powder. In a wedding, a Kumkum tilak is applied on the forehead of both the bride and groom....read more

Healthcare News Monitor

Liver transplant registry off to a good start
The Hindu-Jyoti Shelar

India’s first voluntary liver transplant registry that started on August 15 has picked up pace. In a span of a little over two months, it has received data of 74 transplants carried out by 11 hospitals across six States. Initiated by the Liver Transplantation Society of India, the registry aims to collate national data of the procedures and their outcomes. Nearly 2,000 liver transplants are carried out in the country annually, highest in the world, yet there is no India-specific data. This leaves doctors to take help from the evolved U.S. and the U.K. registries. “Hospitals from Delhi NCR, Kerala, Karnataka and Tamil Nadu have voluntarily reported their transplants to the registry. More hospitals are in various stages of signing up and by December, we hope to get the majority of liver transplantation centres on board,” Bengaluru-based transplant surgeon Sonal Asthana told The Hindu. Dr. Asthana, secretary of the Indian Liver Transplant Registry committee, said the registry would be the largest in the world. “In the U.S. and the U.K., it is mandatory to report all transplants and the outcomes. But that’s not happening here which is why there is lack of Indian data,” he said. The members of the LTSI had four month-long consultative discussions on various important aspects like patient confidentiality, data sharing techniques, designing a user-friendly interface, etc. A beta version was first tested before starting the registry.

India develops regulatory guidelines to promote nano-pharmaceuticals
Business Today - Joe C Mathew

India has developed technical guidelines to evaluate nano-pharmaceuticals for regulatory approvals in the country. The guidelines, released by Union Health Minister Harsh Vardhan on Thursday, are expected to aid translational research towards development of novel nano-formulations that are more efficacious, less toxic and safer than conventional drugs. Nano-formulations are not entirely new drugs but medicines that have better quality because of the technology-led delivery mechanisms that are used to make its administration in the body more effective. There are no internationally accepted uniform guidelines for nano-pharmaceuticals. The usual consensus for evaluation of quality, safety and efficacy of nanotechnology-based products is to have a case-to-case approach. It takes into account the physical, chemical and biological characteristics of the nano-material used and the product, route of administration, the indication for which the product is intended to be used and other related aspects. The Indian guidelines also advocate the similar approach. The guidelines define the nano-pharmaceuticals and categorise it according to its level of degradability and organic or inorganic nature.

Medical devices are not drugs
The Indian Express - Dinesh Thakur

Astonishing things are happening in the Ministry of Health and Family Welfare these days. In less than 30 days, the ministry is going to put in place a regulatory framework for medical devices that will likely give lobbyists for the medical device industry a wonderful Christmas present. Amazingly enough, the ministry aims to implement this new framework without the Parliament casting a single vote to determine the future of an industry which has already proven itself to be brazenly irresponsible towards patients in India as we are seeing in the ongoing hip-implant scandal. Rather than moving a new law in Parliament to regulate the medical device industry, the ministry is creating an entire regulatory framework out of notifications and rules, using powers delegated to it under the Drugs and Cosmetics Act, 1940 — a pre-independence legislation that was enacted almost 80 years ago. The first move towards the new framework was made in 2017 when the ministry, using powers under the Drugs and Cosmetics Act, notified the Medical Device Rules, 2017. At that time, only a few medical devices were notified as “drugs”. In a notification a few days ago, the government announced its intention to treat all medical devices, be it an implant or a MRI machine as “drugs” under the Drugs and Cosmetics Act.

Can't control dengue, pay Rs 50 lakh: Telangana HC
ET Healthworld-IANS

Hyderabad: The Telangana High Court on Thursday said if the government failed to control dengue, it should pay Rs 50 lakh compensation to the families of those who died of the disease. The High Court pulled up the state authorities for their failure to control the mosquito menace, resulting in people dying of dengue and other mosquito-borne diseases. A division bench comprising Chief Justice R.S. Chauhan and Justice A. Abhishek Reddy was not satisfied with the steps listed out by senior government officials on measures taken to control the mosquito menace. On summons by the bench, Chief Secretary S.K. Joshi, Municipal Administration Secretary Aravind Kumar, Greater Hyderabad Municipal Corporation (GHMC) commissioner Lokesh Kumar and superintendent of government-run Fever Hospital Dr Shankar appeared before the court on Thursday and briefed it on the steps taken. The officials informed the court that municipal authorities identified 427 points prone to mosquito breeding and took the steps to check the menace. The court, however, observed that the measures exist only on paper. It asked officials to visit Musi River in front of High Court building to see the situation for themselves. As the mosquitoes from the dried river enter into High Court complex, the judges remarked that people would not come to the court if the problem was not addressed. The bench also remarked that the IAS officers were not even reading newspapers, which carry stories about problems faced by people. It observed that it is the duty of the government and officials to look after people's welfare and when they fail, they should pay the compensation. For the second day, the High Court heard the petitions questioning official apathy in tackling dengue epidemic and in curbing mosquito breeders.

Dehradun: 50 patients at Coronation infected with Hepatitis C
TNN-Ishita Mishra

Dehradun: An inquiry has been ordered by the administration of state-run Coronation Hospital in the city, after 50 of its patients, receiving dialysis at the hospital’s dialysis unit, were diagnosed with Hepatitis C. The chilling revelation has posed a serious question mark on the quality of treatment and sterilization methods being used at the hospital. While hospital authorities passed the buck to the private agency that has been running its dialysis unit under public-private partnership mode, the private company, claimed innocence. Dr B C Ramola, chief medical superintendent (CMS) of the hospital, told TOI the problem was identified when a patient receiving dialysis at its privately-run centre, approached him to complain that he had been prescribed costly medicines by doctors at the dialysis centre. “We found that the prescribed medicines, costing around Rs 9,000 per month, were not for nephrological (kidney) issues, but for Hepatitis C (a liver disease). Our curiosity was also aroused because the private doctor had prescribed medicines from outside, when the government gives out Hepatitis C medicines for free. Upon enquiry, it was found that 50 patients undergoing dialysis at the centre have been diagnosed with the infection in the past two months. All of them had got blood tests done at the private centre, whose doctors had subsequently prescribed medicines from outside,” said Dr Ramola. He added that a committee of three senior doctors has been set up to probe the matter, which has to submit its report in three days.