Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 28th May, 2019

E Coli from flour and crypto from recreational pools

1.USA: The Centers for Disease Control and Prevention said that 17 people in eight states have been sickened with a strain of E. coli. The reports of the illness started on Dec. 11, 2018, to April 18, 2019 and affected people ages 7 to 86. Epidemiologic and laboratory evidence indicates flour is a likely source of this outbreak. Symptoms of E. coli can vary in people, but often include severe stomach cramps, diarrhea (often bloody), and vomiting, according to the CDC. Most people get better within 5 to 7 days and sustain a mild infection, but others can be severe or life-threatening. Some people with an STEC (E. coli) infection may get a type of kidney failure called hemolytic uremic syndrome.

2.USA: Nationally, from 2000 to 2014, close to 500 outbreaks of waterborne illnesses were reported in recreational venues in 46 states and Puerto Rico, causing 27,219 cases of sickness and eight deaths. Pool chemicals can take care of many problems, but not always. Getting optimal results for safety comes down to having the right balance. And, to be frank, it comes down to having the right users — those who adhere to, let’s just say, proper pool etiquette.

Most of the illnesses in pools, hot tubs and water playgrounds are caused by Cryptosporidium. Crypto is a parasite that causes Cryptosporidiosis, which leads to diarrhea.

Crypto is spread by swallowing water that has been contaminated with fecal matter. Most germs are killed within minutes by common pool disinfectants like chlorine or bromine, but Crypto is a germ that can survive in properly chlorinated water for more than seven days.The diarrhea it causes can last for up to three weeks. And the number of Crypto cases have been steadily rising, with twice as many in 2016 as in 2014.

Can Estrogen help treat Women With Schizophrenia?

A systematic literature review conducted at the University of Maryland in Baltimore showed the addition of estrogen reduced schizophrenia symptoms in women with schizophrenia in a dose-dependent, and statistically significant, manner compared with stand-alone antipsychotic treatment.

Study investigator Dr Viviana Alvarez Toro presented the data at the American Psychiatric Association (APA) 2019 annual meeting.

Schizophrenia affects about 1% of the population and previous research shows that although the prevalence of schizophrenia is similar in men and women, it often presents differently between the sexes.

The researchers noted that young women typically develop symptoms 3 to 4 years later than their male counterparts and that symptoms in women can develop at times of hormonal flux, including during the post-partum or post-menopausal periods.

Previous research suggests overall estrogen levels are typically lower in women with schizophrenia compared with their counterparts without the disorder.

Estrogen enhances dopamine antagonists in animal models and may serve as a "natural antipsychotic agent"

Estrogen may play a protective role in neuronal injury by promoting neurogenesis and re-myelination.

Healthcare News Monitor

OCD can be a lifelong condition and require treatment: HCFI

The Indian Awaaz

Recent findings suggest that people who report intense feelings of responsibility are susceptible to developing obsessive compulsive disorder (OCD) or generalized anxiety disorder (GAD). Those who suffer from the condition may not even know they have it. There is a need to raise awareness that OCD symptoms can interfere with people’s day-to-day functioning or cause distress. OCD is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over. Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “Addiction is commonly associated with substance abuse such as alcohol, tobacco and drugs. The National Institute on Drug Abuse has listed different reasons (as below) for why people take drugs: to feel good: feeling of pleasure, ‘high’; to feel better: to relieve stress; to do better: improve performance; curiosity; and peer pressure. However, it is not just drugs but also certain behaviors that can be categorized as addictive. OCD falls under the latter. People suffering from this condition have uncontrollable, recurring thoughts and behaviors, and feel the urge to repeat an action over and over again – mounting to an addiction with one or more habits. When this behavior starts interfering with one’s daily life and routine in a significant manner, it is time to seek help.”

Lifestyle changes are a must to reduce the risk of acquiring dementia later in life: HCFI


The World Health Organization (WHO) recently released a set of guidelines indicating that a range of lifestyle modifications may help reduce the risk of cognitive decline and dementia. The guidelines put the focus on regular exercise, a healthy diet, and controlling obesity, diabetes and hypertension. The need of the hour is to raise awareness on the importance of taking preventive measures in averting the risk of dementia and other diseases. Dementia can be defined as a group of symptoms involving loss of memory and other thinking skills. The WHO has termed it as one of the greatest global challenges for health and social care in the 21st century.

Pharma News

Ingen Capital's fresh resolution plan for Orchid Pharma rejected again

Business Standard- T E Narasimhan & Gireesh Babu

A resolution professional (RP) in Chennai has rejected US-based Ingen Capital Group LLC's fresh bid for bankrupt drug maker Orchid Pharma, over two months after the country's insolvency tribunal refused its similar plan earlier. The RP said Ingen Capital didn't give any earnest money deposit and neither did it provide "essential details" on how is it going to arrange funds. Ingen Capital didn't even submit an expression of interest, said the RP. Orchid, earlier in May, had said that potential investors wanted to see the provisional financials of the company for 2018-19, but the RP said that the statutory audit could not be completed before the end of the financial year.

Glenmark Pharma receives final approval from USFDA for antiplatelet drug

Business Standard- PTI

Glenmark Pharmaceuticals Monday said it has received final approval from the US health regulator for antiplatelet agents Aspirin and extended-release Dipyridamole capsules. The approved product is a generic version of Aggrenox capsules of Boehringer Ingelheim Pharmaceuticals Inc. Glenmark Pharmaceuticals Inc, USA has been granted final approval by the United States Food & Drug Administration (USFDA) for Aspirin and extended-release Dipyridamole capsules in the strength of 25 mg/200 mg, the company said in a BSE filing. Citing IQVIA sales data, Glenmark said, the Aggrenox capsules, 25 mg/200 mg market achieved annual sales of approximately USD 165.6 million in the 12-month period ended March 2019.

Community pharmacists can help track tuberculosis patients, study finds

The Indian Express- Anuradha Mascarehnas

Community pharmacists can help in detecting undiagnosed cases of tuberculosis (TB), as they are the first point of contact for many sick patients, a new study in Patna has found. The study found that pharmacies trained in TB screening that referred patients with TB to doctors led to higher rates of diagnosis and registration of symptomatic patients. Amrita Daftary, lead researcher from McGill International Tuberculosis Centre and Department of Epidemiology and Biostatistics at McGill University, Canada, told The Indian Express, “On an average, a tuberculosis patient experiences a delay of 55 days before being diagnosed and undergoing treatment. So, taking steps to strengthen symptom screening and diagnosis is a priority.”

New drug for stroke, a first for Pudukkottai GMCH

Deccan Chronicle- R Valaypathy

A team of doctors and paramedical staff of the Government Medical college hospital (GMCH), Pudukkottai, saved a 40-year-old patient, who suffered a stroke recently. In a release on Monday, Dr AL. Meenakshi Sundaram, dean, GMCH said that the patient Rajkumar of Melur village had suffered left hemiplegic stroke on May 23, whereby the left upper and lower limb were paralysed in addition to difficulty in speech. He was given first aid at Government hospital, Thirumayam and referred to GMCH for treatment.

Fungal infection resistant to drugs could be treated by limiting its feed

The Asian Age- ANI

Fungal infection resistant to drugs could be treated by limiting fungus' access to its feed, critical for the organism's survival, research has found. Researchers repurposed drug to deny drug-resistant fungus of iron, an element crucial to its survival. "In the absence of novel drug candidates, drug repurposing aimed at using existing drugs to treat diseases is a promising strategy," said Mira Edgerton, co-lead investigator of the study. The research was published in the 'Antimicrobial Agents and Chemotherapy'. To treat Candida albicans, common yeast that can cause illness in those with weakened immune systems, researchers limited the fungus' access to iron, an element crucial to the organism's survival.

USFDA approves $2.1 mn drug that treats spinal muscular atrophy


The USFDA on May 24 approved ‘Zolgensma’, a $2.125 million medicine sold by Novartis, which treats spinal muscular atrophy, as per a Mint report. This is the most expensive medicine ever to get a USFDA approval. Spinal muscular atrophy is an inherited disorder due to a faulty gene that weakens a child’s muscles and affects their ability to swallow or breathe, killing most afflicted by it within a couple of years. The treatment is a one-time infusion gene therapy that takes about an hour and the USFDA has approved it for children under two years of age who are confirmed to have any of the three types of the disease by a genetic test, the paper stated.

A slew of drug regulations implemented by govt to bolster Indian pharma exports: Dr A Ramkishan

Pharmabiz- Nandita Vijay

A series of drug regulations implemented by the government recently will now spur the Indian exports which could further reassert the high quality and efficacy of Indian medicines, said Dr. A.Ramkishan, Deputy Drugs Controller, Central Drugs Standard Control Organization (CDSCO). Some of these regulations are notification of Mundra port in Gujarat and Kamarajar port in in Chennai under Rule 43A of Drugs and Cosmetics Rules and implementation of 24X7 service for import/export of drugs at airport/seaport offices of CDSCO with effect from May 11, 2019.

KDPMA and Karnataka DC department urge Pharmexcil to conduct iPHEX 2021 in Bengaluru

Pharmabiz- Nandita Vijay

The Karnataka Drugs and Pharmaceutical Manufacturers Association (KDPMA) and the Karnataka drugs control department have requested the Pharmaceuticals Export Promotion Council of India (Pharmexcil) to conduct iPHEX 2021 in Bengaluru. iPHEX is the biggest industry exposition organised every year by the Pharmexcil to showcase the diverse range of products including formulations, APIs, Ayush, nutraceuticals, health services, biotechnology and biotechnology products, R&D services, etc in the country. A proposal to this effect was put forth by both the KDPMA and the Karnataka drugs control department during the recently concluded day-long event organised by Pharmexcil in Bengaluru on 'Recent advancements in the regulatory landscape of the emerging markets'. A decision on this will be taken by the Pharmexcil Committee of Administration.

Healthcare News

City docs use new way to treat cardiac ailment

The Times of India

Madurai: Doctors at Velammal Medical College Hospital & Research Institute here have performed a new procedure called “left bundle pacing” to treat a 56-year-old man who suffered from a serious cardiac condition that ruled out conventional treatment. They claimed that the procedure was introduced in countries like the US and China only in the past few months and this was the first time it was performed in India. Left bundle pacing involves implanting a pacemaker at the normal electrical circuit of the heart itself (at the left bundle branch) rather than following the usual procedure of implanting it in the right ventricle. The patient, Ponnar, who hails from a village near Batlagundu in Dindigul district, was diagnosed with dilated cardiomyopathy (DCM), after he came for consultation with giddiness and breathing difficulties. The doctors found that this was due to slow heart rate and poor pumping capacity of the heart. He had a slow heart rate of 30 beats per minute as compared to the normal rate of 60 to 100 beats a minute.

GMC receives funds from Centre for SOTTO

The Times of India

Goa Medical College (GMC) has received funds from the centre for setting up an organ transplant facility on its premises. It was notified State Organ and Tissue Transplant Organisation (SOTTO) more than year ago. For the last six months the process of setting up the facility has been expedited. Dean GMC S M Bandekar, the nodal officer for setting up SOTTO in the government-run hospital, said they have received Rs38 lakh from the Centre. The laboratory for carrying out cross matching is being set-up, Bandekar said. “The machinery is being installed,” he said. To start cadaveric transplant, GMC will require to have a cross matching laboratory in its premises. In August 2018, the high court of Bombay at Goa had directed the state and central governments to take steps to make the SOTTO expeditiously functional within a period of four months. The order was given in a petition filed by a voluntary organisation seeking court intervention over they delay in having getting the cadaveric transplant facility functional in Goa.

Fire breaks out on fifth floor of doctors' hostel of GB Pant Hospital; no casualty

Business Standard- PTI

A fire broke out on the fifth floor of a doctors' hostel in the premises of G B Pant hospital on Monday, Delhi Fire Service said. However, no injury or casualty was reported, fire officials said. The fire department said they received a call about the blaze at around 10.30 am after which six fire tenders were rushed to the spot, and by 10:45 pm it was brought under control. "A fire broke out in the room of the doctors' hostel on the fifth floor of the building. The fire started from an air-conditioner in the room," a senior DFS official said. A senior official of the hospital also said the fire has occurred on the fifth floor of the doctors' hostel, but no one was injured.

Ahmedabad Municipal Corporation crackdown on, Apple Hospital 'Building Use' permit cancelled

Daily News & Analysis

Ahmedabad Municipal Corporation, on Monday cancelled 'Building Use' (BU) permission of Apple Children's Hospital near Parimal Garden area, that witnessed a major fire recently. It also removed illegal structures of Blue Rooftop Restaurant along CG Road. These are among two dozen illegal structures, causing risk to the lives of people, that were removed on Monday. The crackdown follows the gruesome fire incident in Surat resulting in the loss of 22 young students. Apple hospital was recently served a notice for allowing illegal canteen on the terrace, which led to a fire. Blue Rooftop Restaurant had constructed a shade on the terrace that could obstruct rescue measures by fire brigade. Municipal Commissioner Vijay Nehra told media persons that over 2,200 tuition classes, restaurants and other business establishments have been served notices over past week.

What doctors need to know before they venture into hospital business: Dr Jithendra Kumar KH

ET Healthworld- Guest Article

India is one of the few countries in the world wherein Government is encouraging doctors to venture into private healthcare service without a set of standards on defining the jurisdiction for the hospital. At one side it allows doctors to venture into Hospital project under the entity private limited company that is meant to make a profit and at the same time limits the business of hospital through various policies. As per our experience, the majority of the doctors take up the decision of venturing into Hospital business just by their gut feeling. They will never work on the virtual hospital and business plan but will have enough contacts to mobilize funds to build a hospital. A busy clinician ends up spending more time on administrative stuff rather than excelling his patient care. This is the story of many doctors in India and there are very fewer case studies that come to the public for one to learn from mistakes because the majority of these doctors do not admit such mistakes.

Uttar Pradesh Medical Apathy: Helpless mother carries dead child in arms after hospital denies ambulance

Times Now

Days after the video of an emergency ambulance being pushed to ignition surfaced from Uttar Pradesh, another incident of medical apathy has come to the fore. In this incident, a woman carried the body of her child home in her hands. The woman was forced to carry her child in her arms because the hospital could not provide her with an ambulance. The deceased child had been admitted to the hospital after he encountered high fever. It was alleged that three ambulances were parked at the hospital but the authorities failed to spare one.

Hindu Doctor Arrested on Blasphemy Charges in Pakistan


A Hindu veterinary doctor was arrested on Monday after a local cleric filed a police complaint accusing him of committing blasphemy in Pakistan's southern Sindh province. The doctor, identified as Ramesh Kumar, was taken into custody while angry protestors set fire to shops owned by Hindus and burnt tyres on road in Phuladyon town in Mirpurkhas district in the province, media reports said. The head cleric of the local mosque, Maulvi Ishaq Nohri, filed the complaint with the police alleging that the doctor had torn pages of a holy book and wrapped medicines in them. Zahid Hussain Leghari, the Station House Officer of the local police station, said that a case was registered against the doctor.

BU of children’s hospital suspended

Ahmedabad Mirror

ALLEN INSTITUTE SEALED Tightening the noose on non-compliers of fire safety norms in the city, Ahmedabad Municipal Corporation sealed 13 premises in the city. The building use (BU) permission of Apple Super-Specialty Children’s Hospital in Dev complex opposite Parimal Garden has been suspended. A major fire had recently erupted in the hospital, putting at risk the lives of newborns admitted there. The fire had started in the hospital’s illegal terrace kitchen on May 13. On May 17, AMC sealed the consultation room and other parts of the hospital. On Monday, hospital officials were instructed to stop admitting new patients and being transferring the current ones to other hospitals. The indoor unit will be closed in seven days. Dr Abhishek Bansal, one of the partners of Apple hospital, told Mirror, “We received the notice for unfortunate incident, after which we complied with all the rules and regulations. Now we will approach the appropriate authority of AMC on the matter.”

Mumbai witnesses its first pancreas transplant

The Week- Pooja Biraia Jaiswal

Mumbai witnessed its 37th organ donation and the first instance of donation of pancreas. A 16-year-old boy met with a road accident and was rushed to MGM hospital in Vashi, Navi Mumbai where he was declared brain-dead. His family was counselled on how organ donation can save lives after which they consented to donate his pancreas, heart, liver, kidneys and cornea. The pancreas donated by the boy helped a 33-year-old woman suffering from diabetes and kidney failure, making her the first in the city to undergo a kidney and pancreas transplant at Jupiter hospital in Thane. The woman was suffering from insulin-dependent diabetes, also known as Type 1 diabetes and was put on dialysis due to kidney damage. While only transplanting the kidney would not have been a suitable option for the woman as then the replaced kidney too would have been subject to damage given that she was a diabetic, it was suggested that she wait for both, kidneys and pancreas, so as to be able to lead a normal life later on. Pancreas is a gland which produces the hormone insulin which is responsible for maintaining blood sugar levels in the body and a transplant would ensure that the woman could live with normal sugar levels for the rest of her life.

Drug Formulations: Banking on Brands

Reproduced from: http://www.indialegallive.com/health/drug-formulations-banking-on-brands-65964, published May 26, 2019
Retaining the brand name in a new formulation is misleading and harmful for patients and state drug controllers can crack down on companies which do so
The central government has ordered state drug controllers not to allow pharma companies to market drug formulations in which the composition has been tweaked while retaining the old brand name. With this in place, certain companies will not be allowed to retain the brand name in medicines that have undergone a change in raw material or active pharmaceutical ingredient.....read more

How to deal with leftover food: Tips from the Cleveland Clinic

1.For cookouts and barbeques, when you're thinking about your leftover food, anything that's been sitting out for more than 2 hours, you probably shouldn't save
2.Avoid letting foods get into the 'temperature danger zone', which ranges from 40-140°F. When food has been sitting out in that temperature range, it will begin to grow bacteria, and there's a higher likelihood of getting sick from eating it.
3.There are some food items that are likely able to be saved such as snacks like nuts or pretzels....read more

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