Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 29th June, 2019

NIH launches large TB prevention trial for people exposed to multidrug-resistant TB

(NIH): A large phase 3 clinical trial called PHOENIx MDR-TB (Protecting Households on Exposure to Newly Diagnosed Index Multidrug-Resistant Tuberculosis Patients) to assess treatments for preventing people at high risk from developing multidrug-resistant tuberculosis (MDR-TB) has begun.

The study is comparing the safety and efficacy of a new MDR-TB drug, delamanid, with isoniazid, the standard anti-TB drug for preventing active MDR-TB disease in children, adolescents and adults at high risk who are exposed to adult household members with MDR-TB. Study participants are at high risk for MDR-TB because they either have latent TB infection, immune systems suppressed by HIV or other factors, or are younger than age 5 years and therefore have a weak immune system. The study investigators hypothesize that prophylactic treatment with delamanid will prove better than isoniazid at reducing the likelihood that at-risk household members of individuals with MDR-TB will develop active TB disease.

“It is important to perform randomized, controlled clinical trials on how best to provide preventive care for people who come in close contact with individuals with MDR-TB, since this is a major gap in global public health policy,” said Anthony S. Fauci, M.D. Director of the National Institute of Allergy and Infectious Diseases (NIAID), which is co-funding the study and is part of the National Institutes of Health.

Left hand fractured, plaster cast on right: Is it a never event or gross negligence?

Earlier this week, a case of gross medical error from Darbhanga Medical College Hospital was reported where an orthopedic doctor plastered the wrong hand of the boy who fell from a mango tree. The 7-year-old boy had fractured his left hand, but the plaster cast was put on his right hand.

When I read this story, few questions arose in my mind.

  • Is this an error?

  • Is it gross error or a never event?.....read more

Should ivermectin-based mass drug administration for scabies be combined with albendazole in affected areas?

When I was a student at MGIMS, scabies was rampant in the society. It was among the most prevalent condition in OPDs. Ascabiol ointment was our standard treatment.

Scabies is an infestation of the skin caused by the itch mite Sarcoptes scabiei var. hominis.

In 2017, the World Health Organization (WHO) added scabies to its list of neglected tropical disease

Today Scabies is amenable to mass drug administration, as shown by the Skin Health Intervention Fiji Trial (SHIFT). The trial demonstrated that the mass administration of an ivermectin-based regimen decreased the prevalence of scabies 24 months after ivermectin-based mass drug administration, with an additional effect on impetigo......read more

Spiritual Prescription – Controlling the Inner Noise

Yoga Sutras of Patanjali define yoga as restraint of the mental states (Chapter 1.2). In the state of total restraint, the mind is devoid of any external object and is in its true self or the consciousness. Many Vedic scholars have given their own formulae to control the mind. Being in touch with one’s own consciousness requires restraining of the mind, intellect and ego on one hand and the triad of rajas, tamas and satwa on the other hand. Every action leads to a memory, which in turn leads to a desire and with this a vicious cycle starts.......read more

Healthcare News Monitor

Will AYUSH Doctors Be Permitted to Perform Abortions At PHCs?

News Click- Rashme Sehgal

One of the first decisions the Modi government has taken in this second term is to give a major push to the AYUSH streams of medicine. AYUSH Minister Shripad Naik has announced that every primary health centre (PHC) would now have a doctor from an alternative medicine stream to treat patients, apart from a regular allopathic doctor. The AYUSH doctors are from the Ayurveda, Homeopathy, Unani and Siddha traditions of medicine. Naik has also announced ambitious plans to set up 1.12 lakh AYUSH clinics and 150 AYUSH hospitals. However, the kinds of medicine the AYUSH doctors will have the freedom to practice is still an open issue. The million-dollar question is whether they will be allowed to do surgeries. Specifically, will they be permitted to perform abortions on pregnant women who visit these PHCs? A large number of doctors believe it is only a matter of time before they receive permission to do so. The demand for abortions is huge and there are simply not enough gynaecologists in the country who can meet it. There had been pressure on the previous Minister of Health and Family Welfare, JP Nadda, to get amendments to the existing Medical Termination of Pregnancy Act (MTPA), 1971 passed by Parliament. A draft Bill had proposed several changes in the MTPA. A significant amendment proposed that the abortion limit be extended from 20 to 24 weeks, since with medical advancements it has become safe to terminate pregnancies at that stage. Dr KK Aggarwal, former president of the Indian Medical Association, feels the main problem with this proposal has been that though surgeries will be performed by the AYUSH team, the responsibility for any mishap would rest on the shoulders of the Chief Medical Officer who belongs to the allopathic stream of medicine.

DPCC issues closure notices to 12 hospitals for violating norms

The Times of India

Representative image NEW DELHI: Delhi Pollution Control Committee (DPCC) has issued closure notices to 12 hospitals, directing them to shut down operations in seven days for violating biomedical waste norms. DPCC said action against defaulters was initiated on June 15 with special care being undertaken against hospitals that have patients in a critical stage. Biomedical waste, if left untreated, presents a major health hazard. Under the Bio-medical Waste Management Rules, 2016, all health care facilities (HCFs) operating in the capital, irrespective of the method of treatment and the quantity of waste generated, have to seek authorisation from the DPCC. “Health care facilities that generate biomedical waste are also required to enter into an agreement with either one of the two biomedical waste treatment facilities in the city,” said the DPCC official. “Since February, DPCC has been trying to create an inventory of all the health care facilities in Delhi. A survey was undertaken by the two biomedical waste treatment facilities in their respective areas”. The list of the facilities registered with the directorate of health services was compared with the data available and then notices were issued to 3,354 such facilities.

India’s first medical SEZ awaits liquidation

The Asian Age- Sangeetha G

The country’s first medical Special Economic Zone and first Basic Medical Science Park capable of putting India on the global map of medical research and biotechnology will soon die even before becoming fully operational, thanks to the apathy of the banking system and their inability to understand the requirements of gestational scientific research projects. The project envisaged by Padma Sri Dr. K. M. Cherian, the veteran cardio-thoracic surgeon credited with the country’s first bypass surgery, is staring at impending liquidation. Most activities, including breakthrough researches, have come to a halt as the banks declined to accept the one-time settlement offered by Tamil Nadu government to salvage the project. Without considering a proposal to lease labs and plots to biotech companies for revenue generation, banks have gone ahead with the insolvency process. The Frontier Mediville project spread across 356 acres, 45 km off Chennai, was initially planned to be a Rs 1,000-crore project that will have a Basic Medical Science Park for research activities, a Bio-Hospital, a Sterile Bio-medical Corridor for producing medical consumables, disposables and pharmaceutical products and a 1,000-bed Medical University and Research and Training Centre among other related facilities. Out of this, a 41-acre area was granted the Special Economic Zone status to conduct research in basic and applied sciences, tissue based products, pre-clinical animal studies and clinical studies apart from medical and biotechnology courses in 2010.

Why acute encephalitis patients are flocking to only one hospital in Muzaffarpur

Mint- Neetu Chandra Sharma

In Muzaffarpur, the ground zero of the encephalitis epidemic in Bihar, patients flock to state-run Sri Krishna Medical College and Hospital (SKMCH) for treatment, though 27 other facilities in the district offer free hospitalization under the government’s Ayushman Bharat health insurance scheme. Till Thursday, the state recorded at least 185 encephalitis deaths, with 132 in Muzaffarpur alone. This is followed by 20 in Vaishali, 12 in Motihari, eight in Begusarai, nine in Samastipur, and one each in Arrah, Sheohar, Purnia, and Siwan. Out of the 28 medical facilities in Muzaffarpur empanelled under Ayushman Bharat—Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), 18 are state-run and the remaining 10 private. Of the 18 public health institutions, five are community health centres (CHCs), 10 are primary health centres (PHCs), one is a single-specialty hospital, while two are multi-specialty hospitals, including SKMCH and a referral hospital. Out of the 10 private hospitals, six provide tertiary care but do not have patients exhibiting symptoms of acute encephalitis syndrome (AES). This is because many patients are under the impression that only SKMCH provides free treatment, said Shailesh Kaushik of the Bihar state health department. “We have issued more than one lakh Ayushman Bharat cards to people in Muzaffarpur. We are trying to spread awareness about the scheme so that patients can also go to private hospitals. People have this preconceived notion that only SKMCH is providing free treatment. The treatment is completely free in all the CHCs, PHCs, private hospitals and the referral hospital. They all are also trying to help the patients, provided they go there for treatment," said Kaushik.

NPPA fixes retail prices of 17 formulations under DPCO 2013


The national drug pricing regulator National Pharmaceutical Pricing Authority (NPPA) has fixed retail prices of 17 formulations under Drugs Prices Control Order (DPCO)- 2013 in related notification dated June 26, 2019. Name of the formulations are tacrolimus ointment (Mylimus 0.1% 10gm), tacrolimus ointment (Mylimus 0.1% 20gm), amoxycillin +potassium clavulanate suspension, atorvastatin +clopidogrel capsule, atorvastatin +vitamin d3 tablet, olmesartan medoxomil +amlodipine +chlorthalidone tablet, rosuvastatin + aspirin + clopidogrel capsule, paracetamol + mefenamic acid suspension, clopidogrel +aspirin tablet, tetanus toxoid, ibuprofen, etc. All manufacturers of scheduled formulations, selling the branded or generic or both the versions of scheduled formulations at a price higher than the ceiling price (plus goods and services taxes applicable) so fixed and notified by the Government, shall revise the prices of all such formulations downward not exceeding the ceiling price as specified plus goods and services taxes applicable, if any. All the existing manufacturers of above mentioned scheduled formulations having MRP lower than the ceiling price as specified plus goods and services taxes applicable, if any, shall continue to maintain the existing MRP in accordance with paragraph 13 (2) of the DPCO, 2013.The manufacturers may add goods and services tax only if they have paid actually or if it is payable to the Government on the ceiling price specified.