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

Poor hand hygiene may be biggest transmitter of superbug E.coli

One of the best ways to cut down on antibiotic-resistant E. coli infections would be making sure that everyone washes their hands after using the toilet, a UK study suggests.

Outbreaks of E. coli - a potentially fatal illness - are commonly blamed on undercooked meat or raw vegetables, but when researchers did a genetic analysis of thousands of samples, they found that most E. coli infections in the UK were caused by a strain often found in the human gut and in sewage, but not seen much in the food supply… (Reuters, November 23, 2019)

National and International opinions requested: What should be the TDS levels in water in kidney patients?

Is TDS linked to health and disease? Should we use RO water and if yes at what TDS levels

Presence of chemicals in groundwater has contributed to the prevalence of Chronic Kidney Disease of Unknown Origin (CKDu) in parts of Sri Lanka, although the exact combination of factors remains a mystery. Removing all the natural minerals from water could mitigate the spread of CKDu.Many studies link high TDS levels to CKDU and suggest that the levels should be < 100 in kidney patients.

Total dissolved solids or TDS is the term used to describe the inorganic salts and small amounts of organic matter present in solution in water.The principal constituents are usually calcium, magnesium, sodium, and potassium cations and carbonate, hydrogencarbonate, chloride, sulfate, and nitrate anions. The presence of dissolved solids in water may affect its taste.

According to the Bureau of Indian Standards(BIS), the upper levelof TDS levelsin water is 500mg/litre (500 parts per million); however,TDS level in the range of 300 ppm is considered excellent per WHO Guidelines. ....read more

You are born with a quota, use it judiciously

Everyone is born with a passport with a defined battery life to live up to 100 years after which one has to go back to renew or recharge the batteries.

If the battery is overused or misused and is depleted early, one may have to go back prematurely for recharging, but this time when one comes back, he or she may come back with a different body which may not be the human one. There are 84 lakh Yonis as described in the Vedic Literature.

According to the Vedic description, if one dies prematurely, there are chances that the rebirth will not be in the same species.

To live up to the time period defined at the time of birth by Dharamaraja, one has to follow the principles as described in Yogashastra. ....read more

Healthcare News Monitor

Medicine delivery startup Gmedes secures funding in 500 Startups-led round
Tech in Asia

Singapore-based healthtech startup Gmedes has raised an undisclosed amount of pre-series A funding in a round led by 500 Startups’ Southeast Asia funds, 500 Durians and 500 Tuk Tuks. Claiming to be the world’s first global e-pharmacy delivery service, Gmedes has developed the G-Meds app to enable doctors, clinics, and hospitals to prescribe, bill, and deliver medicines to their patients. The app takes care of both the front-end and back-end compliant processes, including delivery, customs clearing, logistics tracking, and import taxes. It plans to use the new funds to establish partnerships to implement the G-Meds service for medical institutions across Singapore, Indonesia, China, Malaysia, the Philippines, and Indochina. Gmedes CEO Dennis Susay said there is a significant opportunity for a global medicine delivery service, especially with patients traveling from China, Central Asia, Indochina, and India. “This is especially important for Southeast Asia, which is a significant global medical tourism hub, with an estimated annual 5 million traveling patients,” he added. In addition to foreign patients, the company also launched a local prescription delivery service in response to demand from doctors, clinics, and caregivers. Gmedes also looks to launch a specialty therapies sourcing and delivery solution soon, aiming at hospitals seeking specialized medications not readily available in their markets. Through its partnerships, Gmedes has available medication on its platform for key chronic and specialty therapeutic areas such as cardiology, respiratory, arthritis and rheumatoid arthritis, dermatology, and mental health.

How POC diagnostics are as essential as life saving medicines
Express Healthcare - Viveka Roychowdhury

Without POC AMR diagnostic tests, doctors are literally shooting in the dark. According to WHO statistics, across the world, Antimicrobial Resistance (AMR) kills an estimated 700 000 people annually, including 230000 from multi-drug resistant tuberculosis. As we put one more World Antibiotic Awareness Week behind us, will we lose sight of the dire situation in India? Imagine the scene in a doctor’s clinic in Mumbai or any one of India’s metros. Crowded, children crying, people coughing. The lone doctor struggles to cope with the load, especially during monsoons, when infections spread easily. She gets just a few minutes per patient, to decide the course of treatment. The doctor‘s decision in those crucial moments is crucial to the AMR crisis. Because if the doctor misdiagnoses a viral infection for a bacterial one, and prescribes an antibiotic, the patient might just be one step closer to creating antibiotic-resistant microbes. Because antibiotics don’t work against viral infections so not only did the patient pay for medicines she did not need, but she also runs the risk that the bugs will be resistant to these antibiotics the next time she really needs them. Even if the doctor doesn’t prescribe antibiotics, many patients will either pester the doctor to prescribe an antibiotic or self medicate. What if the doctor could prescribe a quick blood test to get a more definite idea of the patient’s illness? Rather than relying solely on symptoms reported by the patient, the doctor now has evidence to base her decision on. The next step is, if its a bacterial infection, can the test also identify the drug resistance profile and extent of the infection?

Construction ban disrupts mohalla clinic expansion
ET Healthworld – TNN

New Delhi: Delhi government’s plan to expand mohalla clinic services has hit a roadblock. Due to the construction ban imposed by the Supreme Court in view of increased pollution levels, sources said, work is halted at more than 72 identified sites. “We had planned to open 100 new mohalla clinics by November 20. However, due to the construction ban, this may not be possible. We are targeting to complete the project by next month,” said a senior official. At present, there are 302 mohalla clinics across the state. According to health officials, the government had recently identified 52 sites to put up porta cabins from where the mohalla clinics would operate. Additionally, 48 sites were selected through tendering promises to be hired on rent. “There are some sites where the government has signed the agreement with the owner and is paying rent. But due to lack of maintenance work, the clinic work has not started yet,” said an official. In case of the porta cabins (temporary structures), the government officials said, at least 30 are nearly ready and merely three to five days of work is pending to make them operational. “However, there are a few other sites where finishing the work may take over a fortnight,” the officials said.

‘Patients use own money to foot 97% of hospital bill’
ET Healthworld – TNN

NEW DELHI: Close to 97% of expenditure on hospitalisation is borne by people using their own income or savings or borrowings and sale of assets and the private sector, excluding charitable or NGO-run hospitals, accounts for over 55% of hospitalisation expenses, not including admission for childbirth. This was revealed by a National Statistical Office (NSO) survey conducted from July 2017 to June 2018 covering almost 1.14 lakh households across India. The survey was done before the launch of the Ayushman Bharat scheme in September 2018 and therefore cannot reveal what impact it has had, but it shows that a plethora of pre-existing schemes by governments at the Centre and states have made little difference. Medicines constituted almost 50% of expenditure in the case of hospitalisation in public facilities followed by almost 18% on diagnostics and just 4% on doctor’s or surgeon’s fees. ‘Package components’ constituted just 12.5%. In the case of private hospitals, package components constituted the biggest chunk of almost 32% followed by medicines (22%) and doctor’s or surgeon’s fees (18%). Bed charges accounted for barely 3% in public hospitals and 11.6% in the private sector.