Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                          Dated:29th September,2019

Hepatitis C and chronic kidney disease: KDIGO recommendations

  All patients should be screen for HCV infection at the time of initial evaluation of CKD.

  Use an immunoassay followed by nucleic acid testing (NAT) if immunoassay is positive.

  All CKD patients infected with HCV be evaluated for antiviral therapy.

  An interferon-free regimen is recommended. The choice of specific regimen be based on HCV genotype (and subtype), viral load, prior treatment history, drug–drug interactions, glomerular filtration rate (GFR), stage of hepatic fibrosis, kidney and liver transplant candidacy, and comorbidities.

  Patients with GFR =30 mL/min/1.73 m2 (CKD G1–G3b) be treated with any licensed direct-acting antiviral (DAA)-based regimen (1A).

  Patients with GFR < 30 mL/min/1.73 m2 (CKD G4–G5D) should be treated with a ribavirin-free DAA-based regimen.

  (Source: Annals of Internal Medicine, Sept. 25, 2019)

#BecauseHeartMatters: HCFI & Medlife come together to train people in hands-only CPR on World Heart Day

Today is World Heart Day…to mark this day, Heart Care Foundation of India (HCFI) and Medlife have joined hands to train over 2000 people in the life-saving technique of hands-only CPR 10. Medlife is India’s largest e-health platform.

As a part of the #BecauseHeartMatters campaign, over 40 physical trainings were conducted in more than 30 offices across 5 cities in a span of two weeks. ....read more

Do not postpone things in life: Do it now
There is a well-known doha (couplet) from Sant Kabir, which goes as follows:

“Kaal Kare So Aaj Kar, Aaj Kare So Ub
Pal Mein Pralaya Hoyegi, Bahuri Karoge Kub”

This translates as:

Tomorrow’s work do today, today's work now
If the moment is lost, the work be done how ....read more

Debts in Mythology
It is said that there are three debts, which everybody has to pay in his or her lifetime. In Vedic language, they are called Dev Rin, Pitra Rin and Rishi Rin.

In medical language, the body consists of soul, physical body, mind, intellect and ego. The soul is given to us by God or Devtas (Dev Rin), the physical body by our parents (Pitra Rin) and the mind, intellect and ego by our Gurus (Rishi Rin). ....read more

Healthcare News Monitor

Govt considering to let US companies make medical devices in India
ET Bureau-Dipanjan Roy Chaudhury

NEW DELHI: The government is weighing a proposal to ask American companies to produce medical devices in India that will reduce the prices. This has been one of the major issues holding back a trade deal. India’s price control on medical devices became a sticky issue with the US stressing on lifting the mechanism for coronary stents and knee implants. “We can treat them as ‘special products’ with a condition to produce in India in future and pay the price difference directly to American companies – only for those patients who will avail them under Ayushman Bharat,” according to Bipul Chatterjee, executive director of CUTS International, a global public policy research and advocacy group with presence in capital cities like Washington DC. India’s medical device imports jumped 24% to Rs 38,837 crore in FY19, according to the latest export import data. The US is the largest exporter of medical devices to India, constituting one-fifth of the pie, followed by Germany, China, Singapore and the Netherlands.
India slashed prices by 85% and capped the trade margins for coronary stents in 2017 and followed it up with a round of price control on knee implants. The government said the move aims to prevent unethical practices and rein in trade distortion prevalent in the industry.

Centre approves 10 new medical colleges for Rajasthan
ET Healthworld

Giving a major boost to medical education in the state, the Centre on Friday approved 10 new medical colleges for Rajasthan. The 10 medical colleges will come up in Jaisalmer, Karauli, Banswara, Alwar, Nagaur, Bundi, Sirohi, Baran, Chittorgarh and Sriganganagar districts. “We had sent a proposal to the Centre, which has accepted it. This will go a long way in improving the quality of healthcare in Rajasthan and bridge the gap in availability of human resource,” Rohit Kumar Singh, additional chief secretary (health), told TOI. “We had quickly prepared quality proposals and therefore succeeded,” he said.
The medical college in Jaisalmer will have 300 beds. “The Centre has approved Rs 325 crore for the Jaisalmer medical college,” said Sudhansh Pant, joint secretary with the health ministry and district in-charge. Jaisalmer collector Namit Mehta said that the Urban Improvement Trust (UIT) has issued 55 bighas of land on the Ramgarh Road for the new medical college.

State DCs plan action on DCGI directive to verify product safety of widely used ranitidine
Pharmabiz India – Shardul Nautiyal

State drug controllers across the country are contemplating action on the recent Drugs Controller General of India (DCGI) directive to verify product safety of widely consumed acidity drug ranitidine following US FDA alert for carcinogenic impurity. Drug controllers have raised serious concern about N-nitrosodimethylamine (NDMA) impurity detected by USFDA recently. More so as it does not find mention in the major pharmacopoeias like Indian Pharmacopoeia (IP), British Pharmacopoeia (BP) and US Pharmacopoeia. A Central Drugs Standard Control Organisation (CDSCO) official, on condition of anonymity, said that it is high time now that ranitidine, which is the cheapest antacid available to the masses today, should be tested for impurities like NDMA which is carcinogenic in nature. NDMA has been classified by International Agency For Research On Cancer (IARC) as carcinogenic to humans. The point of contention raised is also about the fact that the side effects of ranitidine has never been reported through pharmacovigilance and hence it becomes the collective responsibility of manufacturers, regulators and consumers to report adverse events due to ranitidine. The US FDA on September 13 detected low level of cancer causing impurity NDMA in samples of acidity medicine ranitidine. There are two major API manufacturers of ranitidine in the country based out of Telangana and Gujarat- Saraca Laboratories and Orchev Pharma Pvt Ltd. Following US FDA alert, Orchev Pharma got its samples of ranitidine tested for impurity in a US FDA certified lab in Mumbai. No impurity was detected in the test results.

Strides Pharma halts sales of heartburn drug Ranitidine in US market
Business Today

India's Strides Pharma Science Ltd said on Friday it has halted sales of its heartburn drug Ranitidine in the US market as it conducts tests to identify possible cancer-causing impurities in the tablets. The move comes after the US Food and Drug Administration (FDA) asked the company to test the drug for indications of N-nitrosodimethylamine (NDMA) impurity, which the regulator says is a "probable human carcinogen". Earlier this week, Dr. Reddy's Laboratories Ltd and GlaxoSmithKline Pharmaceuticals Ltd halted Ranitidine distribution, while global companies such as Novartis AG have stopped the supply of their versions of the drug. The FDA flagged the presence of NDMA in Ranitidine samples two weeks ago, while European regulators were assessing its presence in the drug.

UP doctor jailed for death of 60 kids cleared of all charges, demands apology
The Asian Age - ANI

Dr Kafeel Khan, who was suspended from Gorakhpur's BRD Medical College two years ago, has been cleared of charges of medical negligence, corruption and not performing his duty in the 2017 Gorakhpur children death case. More than 60 children admitted at the hospital had lost their lives due to oxygen shortage in 2017. The departmental enquiry report was handed over to Dr Kafeel by the medical college administration on Thursday. "The allegations against the accused are insufficient... Therefore it is submitted that the accused officer is not guilty," the report stated. Khan, who was then posted with paediatrics department, was suspended from service on August 22, 2017, following the deaths of about 60 infants in the hospital due to lack of oxygen, after oxygen suppliers cut off supply due to non-payment of dues by the hospital. He was later booked and arrested on charges of negligent in his duties resulting in a shortage of medical oxygen, culpable homicide, criminal breach of trust and not performing his duty in 2017. The doctor spent nine months in jail. He later secured bail from a court but continues to be suspended from the medical college.