Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 29th May, 2019

Overtraining syndrome vs Burnout

OTS is a complex clinical disorder identified in the athletic population that represents a maladaptive response to training. OTS has also been described in sports that rely on power and anaerobic performance.

Members of occupations requiring intensive physical training in combination with other biologic, psychologic, and social stressors (eg, firemen, police officers, military personnel) may suffer from OTS.

A term frequently associated with OTS is "burnout." While burnout may develop in athletes, it is also found in numerous occupations, including health care providers.

OTS is thought to be the result of an imbalance between training and recovery, while burnout is secondary to mental overload.

Asbestos: A Public Health Crisis of 'Unprecedented Scale'


Brazil, Russia, India, and China "face an impending public health crisis of an unprecedented scale" because they continue to produce and use asbestos.

In 2016, these four countries accounted for almost 80% of the estimated 1.37 million metric tons of asbestos consumed globally as per Tianhui Chen, MD, PhD, of Zhejiang Academy of Medical Sciences, in Hangzhou, China, and colleagues say in an article in May 23 in JAMA Oncology.

The incidence of malignant pleural mesothelioma a rare but highly aggressive cancer associated with long-term asbestos exposure, will increase for decades.

Because the latency period can be 20 to 50 years, the incidence of mesothelioma dramatically increases after asbestos exposure, even if the usage is completely prohibited.

In 2013, the WHO proposed a 7-year global plan to help nearly 200 member states reduce the incidence of asbestos-related diseases, especially mesothelioma.

WHO estimates that 125 million people worldwide are exposed to asbestos at work. The International Labour Organization says more than 107,000 workers die each year from an asbestos-related disease.

In addition to mesothelioma, asbestos exposure is associated with cancer of the lung, larynx, and ovaries and diseases such as asbestosis and the occurrence of plaques, thickening, and effusion of the pleura.

Asbestos exposure is particularly deadly for those who smoke combustible cigarettes, exponentially increasing the risk for lung cancer.

The naturally occurring fibrous minerals in asbestos give it high tensile strength. It conducts heat poorly and is resistant to chemicals. These qualities have made asbestos a key ingredient in many products, including roofing shingles and water supply lines. It is also used in cars and can be found in transmission clutches, brake linings and pads, and engine gaskets.

Workers at major construction or reconstruction sites and shipyards are exposed to asbestos, as are those working in close proximity to boilers and insulation pipes.

Workers' families who are exposed to asbestos-contaminated clothing are equally susceptible.

About asbestos

1."Asbestos" is the name of a group of minerals that are shaped like long, thin fibers. For many years, asbestos was commonly used in insulation, car brakes, ships, ceiling tiles, fabrics, fireproofing, and many other materials.

2.Asbestos was used in many types of construction materials. People who worked with these materials in the past might have been exposed to it. This includes plumbers, pipefitters, electricians, insulation workers, construction workers, roofers, welders, and many other types of workers.

3. Also, even though asbestos is no longer used in construction, demolition workers can be exposed when they knock down old buildings.

4.People can also be exposed to asbestos through the work clothes of someone they live with. This can happen when the person who works with asbestos brings their work clothes home.

5.Plus, people are exposed to low levels of asbestos in nature.

6.India uses an estimated 350,000 tons of asbestos annually, trailing behind China as the world’s most prodigious consumer of the naturally occurring carcinogen.

7.Only a fraction of the asbestos used in India originates in the country. The majority is imported from Russia and Brazil, the world’s two biggest exporters of the product.

8. Although its toxicity has prompted 52 countries to ban its use, India continues to utilize the material in cement roofing sheets, cement piping, friction materials, textiles and insulation.

9.Most patients who develop asbestosis are asymptomatic for at least 20 to 30 years after the initial exposure

10.The latency period between exposure and symptoms is inversely proportional to the intensity of asbestos exposure.

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 28 May to 0830 hrs IST of 29 May, 2019)

Heat Wave:

Yesterday, Heat Wave Conditions observed in many parts with severe heat wave in isolated places over of Vidarbha; in some parts over West Rajasthan and southeast Uttar Pradesh and in isolated pockets over Madhya Pradesh and Telangana. (Annexure 1 & 2).


Maximum Temperature more than 40.0°C were recorded at most places over Jharkhand, Punjab, Haryana, Chandigarh & Delhi, Uttar Pradesh, Rajasthan, Madhya Pradesh, Chhattisgarh, Vidarbha, Marathwada, Telangana, Rayalaseema; at many places over Gujarat Region, Madhya Maharashtra, North Interior Karnataka; at a few places over Odisha Saurashtra & Kutch, Coastal Andhra Pradesh, Tamilnadu & Puducherry and at isolated places over Gangetic West Bengal and Jammu & Kashmir.

Maximum temperature departures as on 28-05-2019: Maximum temperatures were markedly above normal (5.1°C or more) at isolated places over Madhya Maharashtra and Kerala; appreciably above normal (3.1°C to 5.0°C) at most places over Vidarbha, Marathwada, Rayalaseema and Jharkhand; at many places over North Interior Karnataka, Tamilnadu & Puducherry and Telangana; at a few places over Coastal Karnataka, Madhya Pradesh, East Uttar Pradesh and Bihar and at isolated places over South Interior Karnataka, Coastal Andhra Pradesh, Rajasthan, Gangetic West Bengal and Saurashtra & Kutch; above normal (1.6°C to 3.0°C) at most places over Punjab and Nagaland, Manipur, Mizoram & Tripura; at many places over Gujarat Region and West Uttar Pradesh and at isolated places over Haryana, Chandigarh & Delhi; They were below normal (-1.6°C to -3.0°C) at a few places over Andaman & Nicobar and near normal over rest parts of the country. Yesterday, the highest maximum temperature of 47.8°C recorded at Chandrapur (Vidarbha).

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 29 May to 0830 hrs IST of 30 May 2019):-

Heat Wave Conditions in many parts with severe heat wave in isolated pockets very likely over Vidarbha, Heat wave conditions at some parts over Madhya Pradesh and Chhattisgarh and in isolated pockets very likely over Haryana, Chandigarh & Delhi, Uttar Pradesh, Rajasthan, Bihar, Jharkhand, Gujarat state, Madhya Maharashtra, Marathwada, Telangana, Tamilnadu & Puducherry and Rayalaseema.

Healthcare News Monitor

Hyderabad: Antibiotics in rivers can affect treatment

Deccan Chronicle- Kaniza Garari

An assessment of 72 rivers around the world has found antibiotic pollution in rivers and soil to be a global health emergency. The study shows that pathogens that originate from environmental bacteria are becoming resistant to antibiotics, and this resistance is becoming a major challenge in treating patients in the intensive care unit of hospitals. Contamination of rivers and land soil with antibiotics is caused by the discharge of untreated medical waste into domestic sewers and aggravated by the lack of a sufficient number of waste management treatment plants. Dr K.K. Aggarwal, a senior member of the Indian Medical Association, said, “There are 12 classes of resistant bacteria, and these have further been classified into critical, moderately critical, and safe.

Pharma News

Pharma sector hopes Modi 2.0 will start reforms

The New Indian Express- Sunitha Natti

The Indian pharmaceutical industry, which is battling a host of challenges, including scrutiny by the US FDA, litigation on alleged drug price rise in the US, and global headwinds, hopes that the Modi government will kick off reforms and policy initiatives that couldn’t be rolled out in its previous tenure. For instance, in 2015, the government announced setting up of a uniform code for pharmaceutical marketing practices but is yet to introduce a law or issue any relevant regulations. The proposed code prevents alleged unfair practices and nexus between pharma companies and medical practitioners to market drugs.

Firm on pharma, Dilip Shanghvi surrenders NBFC licence

The Economic Times- Divya Rajagopal, Shilpa Sinha

Dilip Shanghvi’s personal investment company has surrendered its nonbanking finance company (NBFC) licence, according to documents seen by ET. Shanghvi Finance Pvt Ltd (SFPL) is part of the Dilip Shanghvi Group, which runs Sun Pharmaceutical IndustriesNSE -1.36 %, India’s largest drug company. Shanghvi had said in January that he’s committed to the pharma business and he does not plan to diversify away from it. SFPL had wanted to surrender the NBFC licence and convert it into a core investment company (CIC) licence but the latter proposal hasn’t been cleared by the RBI, which has asked it to meet certain criteria, sources told ET. According to the RBI, a CIC must hold 90% of its investment in shares and debentures.

WHO agrees watered-down resolution on transparency in drug costs

ET Healthworld- Tom Miles

Countries at the World Health Organization agreed on Tuesday to push for clearer drug pricing, after watering down a draft resolution that would have also required pharmaceutical firms to disclose the cost of making medicines. The deal calls on governments to share more information about the prices they pay for drugs, which can vary widely around the world and are often kept shrouded in secrecy. It was hailed as a landmark by WHO chief Tedros Adhanom Ghebreyesus and "enthusiastically welcomed" by the United States, which had advocated making pricing clearer while allowing firms to keep their research costs secret.

Lopez Obrador says will shop abroad if necessary to fix medicine shortages

ET Healthworld- Diego Ore

Mexican President Andres Manuel Lopez Obrador vowed on Monday to alleviate a medicine shortage in public hospitals, pledging to shop abroad for essential drugs if necessary and blaming the situation on companies upset about his crackdown on overpricing. The government promised on Friday to release about $126 million (2.4 billion pesos) to help alleviate shortages at Mexican public hospitals. The head of the largest public health system resigned last week citing budget cuts, a complaint echoed by several hospital directors.

Canada's BC will be first province to switch patients to biosimilars

ET Healthworld- Reuters

The Canadian province of British Columbia said on Monday that its public drug plan will switch as many as 20,400 patients from three branded biologic drugs to cheap near-copies called biosimilars, saving an estimated C$96.6 million ($71.9 million)over three years. The new policy from the province's PharmaCare program targets Janssen's Remicade and Amgen's Enbrel which treat arthritis, among other conditions, and Sanofi's long-acting insulin Lantus. It is the first of its kind in a Canadian public plan and could pave the way for similar programs across the country. Biologic drugs are large molecules made using biological processes, and they tend to be expensive. Biosimilars work in the same way as biologics, making them appealing to governments grappling with how to pay for high-priced drugs. Unlike generics, however, biosimilars are not identical versions of the drug they are copying.

Newron delays schizophrenia drug trial after FDA raises concerns

ET Healthworld- Reuters

Swiss-listed drugmaker Newron must delay a trial of its prospective schizophrenia medicine evenamide after the U.S. Food and Drug Administration raised concerns about central nervous system (CNS) events that have emerged in rats and dogs. The company, whose Xadago against Parkinson's disease is already on the market, aims to broaden its stable of approved medicines with evenamide, which it is testing in concert with other drugs against schizophrenia. While the company reported positive preliminary results for evenamide in 2017, the FDA's concerns now will push back work on the project as Newron seeks to understand more about the issues that emerged. It did not describe the CNS events in detail.

New compound which kills antibiotic resistant super bugs discovered

ET Healthworld- Reuters

Swiss-listed drugmaker Newron must delay a trial of its prospective schizophrenia medicine evenamide after the U.S. Food and Drug Administration raised concerns about central nervous system (CNS) events that have emerged in rats and dogs. The company, whose Xadago against Parkinson's disease is already on the market, aims to broaden its stable of approved medicines with evenamide, which it is testing in concert with other drugs against schizophrenia. While the company reported positive preliminary results for evenamide in 2017, the FDA's concerns now will push back work on the project as Newron seeks to understand more about the issues that emerged. It did not describe the CNS events in detail.

New compound which kills antibiotic resistant super bugs discovered

ET Healthworld

A new compound which visualises and kills antibiotic resistant superbugs has been discovered by scientists at the University of Sheffield and Rutherford Appleton Laboratory (RAL). The team, led by Professor Jim Thomas, from the University of Sheffield’s Department of Chemistry, is testing new compounds developed by his PhD student Kirsty Smitten on antibiotic resistant gram-negative bacteria, including pathogenic E. coli. Gram-negative bacteria strains can cause infections including pneumonia, urinary tract infections and bloodstream infections. They are difficult to treat as the cell wall of the bacteria prevents drugs from getting into the microbe.

Neuraxpharm inks licensing pact with Bened Biomedical to introduce probiotic product, PS128 in European market


Neuraxpharm Group, a leading European specialty pharmaceutical company focused on the treatment of central nervous system (CNS) disorders, announces it will soon launch its first probiotic in the European market following an exclusive licensing agreement with the probiotics company Bened Biomedical Co., Ltd. Bened Biomedical, an award winning 2015 spin-out from Taiwan-based National Yang-Ming University, develops functional probiotic strains that can alter human microbiome. The agreement secures Neuraxpharm exclusive rights to market its first probiotic, PS128, in the European market. This is Neuraxpharm's first launch of a probiotic product expanding the Company's portfolio of marketed Consumer Healthcare products. This is in line with its ambition of covering CNS therapeutics from prevention over standard therapeutics to value-added medicines. As the European Consumer Healthcare market continues to grow, this agreement opens new opportunities to promote the benefits of a broader range of probiotics to healthcare professionals and consumers.

China-India joint summit discusses bilateral trade to improve pharma industry

Pharmabiz- Shardul Nautiyal

The China-India joint summit held recently discussed bilateral trade to improve Indo- China pharma industry and address issues like long product registration time and high fees for product registration in China’s drug regulatory system, among other issues. Besides this, other relevant key issues related to transparency in public procurement system in China and clinical trial related approvals were also deliberated at the summit organised under the aegis of Indian Pharmaceutical Association (IPA), Shengjie and SaSPinjara, China between May 16 and May 17, 2019 at Pullman Shanghai South, China. The summit was focused on enhancing export business for both the nations across the globe.

Bangalore Medical Service Trust teams up with Germany-based DKMS to bolster stem cell donors in India


Bangalore Medical Service Trust (BMST), a centre of excellence service provider in the areas of blood banking, transfusion and immunohematology, has partnered with Germany-based DKMS to encourage stem cell donors in India. On the occasion of the World Blood Cancer Day, observed annually on May 28, DKMS commemorates its 28 years of existence in this space. Now DKMS BMST Foundation India will provide access to a large pool of potential blood stem cell donors to provide patients suffering from blood cancer and other blood disorders such as Thalassemia or Aplastic Anaemia, both in India and worldwide, with a second chance at life.

Healthcare News

MP: Woman doctor booked for graft in Ujjain community health centre

The Times of India- Salil Mekaad

A woman doctor was booked accepting a bribe of Rs 3,500 for performing a surgical procedure on a woman who underwent a miscarriage at a community health centre (CHC) in Ujjain district on Tuesday. Lokayukta police caught Dr Huma Rehman when she took Rs 3,500 from the family of the patient Khushbu Sharma at the community health centre in Narvar town, through a retired employee who brokered the deal, DSP Lokayukta police Shailendra Singh Thakur told reporters. Khushbu’s husband Prakash Sharma had approached the Lokayukta police with a complaint against Dr Rehman, alleging that a bribe of Rs 5,000 was demanded for performing surgical procedure on his wife who suffered from a miscarriage.

Hooch claims 10 lives in UP, 39 in hospital

The Times of India- Pathikrit Chakraborty

Just three months after 44 people died in hooch tragedies in the state, spurious liquor again claimed at least 10 lives in Barabanki, 27 km from the state capital, Lucknow. Thirty-nine others are battling for life in three hospitals in Lucknow. The liquor vend in Raniganj village, under Ramnagar police station, has been sealed and samples sent to the Forensic Science Laboratory for investigation. Chief minister Yogi Adityanath condoled the deaths and announced an ex gratia payment of Rs 2 lakh for the kin of the deceased. He has ordered a high-level probe and set a 48-hour deadline for the report.

KCB-run hospital to get new maternity ward

The Times of India

A new maternity ward will be opened in June at the Khadki Cantonment Board (KCB)-run Dr Babasaheb Ambedkar Cantonment General Hospital (DBACGH). The old ward of the hospital, established in 1914, was constructed in 1930. The size of the rooms was small and there was no proper ventilation. Moreover, the bathrooms were in a precarious condition. The board has demolished it and is now constructing a new one. “The 22-bed new facility will be equipped with necessary equipment and infrastructure. It will provide relief to poor residents in Cantonment and neighbouring areas,” resident medical officer (RMO) Dr Ranjit Bhonsale of DBACGH told TOI on Tuesday. The project, worth over Rs one crore, is in the final stages. According to board sources, as many as 30 expecting mothers seek admission at the hospital every month. “Most of our patients are from below poverty category. They cannot afford the expenses of private clinics. Our bed charges are miniscule, and medicines are free. Therefore, our ward is often filled to full capacity. We have procured necessary advanced equipment, which will be installed once we complete the civil work at the facility,” said chief executive officer Amol Jagtap of KCB. At present, the hospital has only two permanent gynaecologists and as many on contractual basis.

Tribal doctor's suicide: Rallies held in Thane, Palghar

Business Standard- PTI

Two separate rallies were held in Thane and Palghar in Maharashtra Tuesday for action against those responsible for allegedly driving a tribal medical student to suicide in a Mumbai hospital by harassing her over her caste. Dr Payal Tadvi, who belongs to a Scheduled Tribe (ST) community, had hanged herself in the hostel of a Brihanmumbai Municipal Corporation (BMC)-run medical college on May 22. Her family has alleged that she took the extreme step because of harassment over her caste by three doctors. The rallies were held under the aegis of the Shramajivi Sanghatana.

J&K HC asks SKIMS hospital director to explain leakage of rape victim's medical report

Business Standard- IANS

The Jammu and Kashmir High Court on Tuesday came down heavily on the director of Sher-e-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, directing him to explain how the medical report of the Bandipora rape victim was leaked on social media. Since Tuesday morning, a medical report purportedly related to the medical examination of the three-year rape victim of Bandipora district had been doing the rounds on social media sites in the Valley. The lawyer of the victim's family told the court that the report pertaining to the medical examination of the rape victim had been leaked on social media which has also carried the name of the victim thereby violating the child's privacy.

Boy dies in UP after hospital refuses ambulance

Business Standard- PTI

A critically ill boy died after he was allegedly refused an ambulance by the state-run district hospital here. A probe by the city magistrate has found the hospital guilty of lapses in the death of the child on Sunday night. Afroz, 9, was brought to the district hospital in Shahjahanpur with complaints of high fever and was referred to Lucknow for specialised treatment. His parents said they had approached the hospital for an ambulance to ferry Afroz to the state capital, but the authorities did not agree to their request. Afroz's mother said they had given him some medicines for fever but his condition worsened, and they got him admitted at the Shahjahanpur district hospital.

Soaring mercury, ill-equipped government hospitals give nightmares to patients in Telangana

The New Indian Express

Long queues at the free drinking water distribution stalls, scores of people crowding under one fan and some of them carrying their own portable table fans is a common site at the Osmania General Hospital this summer. With the mercury soaring as never before and heatwave conditions continuing to prevail in the State, the patients and their kin at the government hospitals seem to be having nightmares. Speaking to Express, superintendent of Osmania General Hospital, Dr B Nagender said, “The old building is constructed in such a way that there is no requirement for extra cooling. However, patients and their attendants in the three wards in the hospital’s old building are carrying their own table fans to get some relief from the scorching heat.”

Unique hospital in Rajasthan merges medical and astrological diagnoses to treat patients

Times Now

At a time when medical advancements have ushered mankind into a new era, a hospital in the state of Rajasthan has adopted a unique method to treat its patients by combining medical science and astrology. The 'Unique Sangeeta Memorial Hospital' in Rajasthan's state capital has introduced a new approach towards curing ailments which have perhaps never been tried anywhere in the world. A doctor employed with the Jaipur-based hospital said that a new patient is first subjected to astrological evaluation and astrological diagnosis. Astrological assessments are used primarily for diagnosis and not treatment, he added. Once the medical and astrological diagnoses are compared, doctors get a clear picture of the disease which is affecting the patient. The doctor adds that this process satisfies the patients.

No HC relief to hospital over demolition of 4-8 floors

Deccan Chronicle- J Stalin

The Madras high court has declined to defer the demolition of the fourth to eighth floors of Billroth hospital, constructed unauthorizedly at Shenoy Nagar in the city, till a final decision is taken by authorities on the application made by the hospital for regularisation. A division bench comprising Justices RMT Teeka Raman and P.D. Audikesavalu dismissed the petitions filed by Billroth Hospital, which sought to vacate the interim directions given by the court on May 9 and to direct the authorities not to take any coercive steps against the hospital pursuant to that order.

Sanitary napkin vending machine installed at govt hospital in Chennai

Asian News International

On the occasion of the Menstrual Hygiene Day 2019, a sanitary napkin vending machine was installed at the Tamil Government Multi Super Specialty Hospital here on Tuesday. Women can take a sanitary pad from the machine at Rs 5 per piece. Present on the occasion were state Social Welfare minister V Saroja and Health Minister C Vijaya Baskar. "The state government is spending almost Rs 60 crore every year to provide sanitary napkins free of cost. The awareness of menstrual hygiene is good across the state, still we are pushing hard to make more people aware," Vijayabaskar told ANI here.

17 doctors at VS General Hospital turn TB patients

Ahmedabad Mirror- Nikunj Soni

In what has, quite shockingly, not raised the red flag yet, as many as 17 PG resident doctors who worked with VS General Hospital and are now with SVP Hospital, have been infected with tuberculosis in the past one and-a-half years. Four of those were infected with the deadlier drug resistant TB, also known as ‘Ebola with wings’, and are under medication; four others were infected as recently as March, sources told Mirror. The fact that there is no separate ward for TB in the old hospital is seen as one of the major reasons behind rise in cases among doctors. Most of the doctors infected are from the 2017 batch of post-graduate residents while half a dozen are studying surgery, orthopaedics and anaesthesia. Besides, long work hours, filthy staff quarters and lack of good food are the other reasons, complain the doctors. Tuberculosis, a chronic infection that affects the lungs and spreads, is one of the most contagious air-borne diseases. Overcrowded conditions and poor ventilation provide TB bacteria with ideal conditions to spread. "As many as 17 of my colleagues have been diagnosed with tuberculosis in the past one-and-a-half years. Four of them are still under treatment as they were diagnosed with the disease recently. Some of the other patients are still under medication," said a second-year resident requesting anonymity.

Frequent power cuts in hospital force patients to take rest under tree

OdishaTV- Subadh Kumar Nayak

As the entire State is reeling under intense hot and humid conditions for the last several days, frequent power cuts have made life miserable for the patients undergoing treatment at Nilagiri Sub-Divisional Hospital in Balasore district. Health services have been massively hit due to the scorching heat and frequent power cuts at the hospital where hundreds of patients come for treatment everyday. Most of the admitted patients are seen walking out of their beds to rest under trees outside the hospital following frequent power cuts. Patients allege that the hospital staff do not use the inverter and DG set.

Can estrogen help treat women with schizophrenia?

Findings of a systematic literature review conducted at the University of Maryland in Baltimore show that addition of estrogen reduced schizophrenia symptoms in women with schizophrenia in a dose-dependent, and statistically significant, manner compared with stand-alone antipsychotic treatment.
According to the findings presented at the 2019 annual meeting of the American Psychiatric Association (APA), young women typically develop symptoms 3 to 4 years later than their male counterparts. Also, symptoms in women can develop at times of hormonal change, including during the postpartum or postmenopausal periods.....read more

Diet for high uric acid: Focus shifts to healthy diets

Patients with high uric acid levels were earlier advised by their doctors to avoid eating foods high in purine. By itself, it has not been shown to be very helpful; hence, this approach is changing. The focus is shifting to following a healthy diet instead of making a list of foods to be avoided along with maintaining a healthy body weight. Losing weight can lower uric acid levels.

  • Drink plenty of fluids but limit intake of sweetened drinks and alcohol, which can increase uric acid levels.
  • A healthy diet emphasizes plant-based foods, such as vegetables, fruits and legumes. Whole grains are preferred over processed grains. Reduce intake of fat, especially saturated fat (found in red meat). Lean sources of protein, including chicken, turkey, fish and tofu, are better choices than beef or pork....read more

The lips of truth shall be recognized forever