Editor in Chief Dr KK Aggarwal, Padma Shri Awardee


Dated: 30th May, 2019

New tick-borne Alongshan virus in China

Researchers in northeastern China has discovered a new segmented RNA virus associated with febrile illness in dozens of patients, and they suspect that the virus is transmitted by ticks, according to a study published in The New England Journal of Medicine.

They named the previously unknown pathogen the Alongshan virus (ALSV).

It should be differentiated from other tick-borne diseases, such as severe fever with thrombocytopenia syndrome, tick-borne encephalitis, anaplasmosis, rickettsiosis and babesiosis. Here is the NEJM Abstract

BACKGROUND: In 2017, surveillance for tickborne diseases in China led to the identification of a patient who presented to a hospital in Inner Mongolia with a febrile illness that had an unknown cause. The clinical manifestation of the illness was similar to that of tickborne encephalitis virus (TBEV) infection, but neither TBEV RNA nor antibodies against the virus were detected.

METHODS: We obtained a blood specimen from the index patient and attempted to isolate and identify a causative pathogen, using genome sequence analysis and electron microscopy. We also initiated a heightened surveillance program in the same hospital to screen for other patients who presented with fever, headache, and a history of tick bites. We used reverse-transcriptase–polymerase-chain-reaction (RT-PCR) and cell-culture assays to detect the pathogen and immunofluorescence and neutralization assays to determine the levels of virus-specific antibodies in serum specimens from the patients.

RESULTS: We found that the index patient was infected with a previously unknown segmented RNA virus, which we designated Alongshan virus (ALSV) and which belongs to the jingmenvirus group of the family Flaviviridae. ALSV infection was confirmed by RT-PCR assay in 86 patients from Inner Mongolia and Heilongjiang who presented with fever, headache, and a history of tick bites. Serologic assays showed that seroconversion had occurred in all 19 patients for whom specimens were available from the acute phase and the convalescent phase of the illness.

CONCLUSIONS: A newly discovered segmented virus was found to be associated with a febrile illness in northeastern China. (Funded by the National Key Research and Development Program of China and the National Natural Science Foundation of China.)


Added versus natural sugars

Natural sugars are in foods such as fruit, vegetables, and dairy

Added sugars are added to foods and beverages during manufacturing, processing, or preparation.

Sugary beverages are the greatest source of added sugar in the diet, followed by sweets and grains such as ready-to-eat cereals. Intake of added sugar, particularly from beverages, has been associated with weight gain, and higher risk of type 2 diabetes and cardiovascular disease.

Natural and added sugars are metabolized the same way in our bodies. But for most people, consuming natural sugars in foods such as fruit is not linked to negative health effects, since the amount of sugar tends to be modest and is “packaged” with fiber and other healthful nutrients.

Our bodies do not need, or benefit from, eating added sugar.

The 2015–2020 Dietary Guidelines for Americans and the World Health Organization both recommend that added sugar be limited to no more than 10% of daily calories.

The updated Nutrition Facts Panel, expected to be rolled out in 2020 or 2021, will prominently feature a line disclosing added sugar along with the corresponding 10% daily value, to help consumers gauge their added sugar intake. [Harvard]


Healthcare News Monitor

Pharma News

Modi govt’s 100 day healthcare plan: Cheaper medicines, online pharmacy norms and compensation for patients

Financial Express- Swapna Raghu Sanand

Patients, doctors and pharmacists, pay attention! Gear up for some significant changes in the healthcare sector anytime soon. The changes may include cheaper medicines, a proposal whereby patients can claim compensation for death caused by faulty medical devices and a significant boost to e-pharmacies in the country. Now that the Narendra Modi-led NDA government is set to take charge for its second 5-year term, a report in IE has indicated that the country’s health services industry may have to soon gear up for some regulatory changes such as more price control on medicines to make it cheaper for patients.

Cadila Healthcare arm recalls hypertension drug in US

Daily News & Analysis

Zydus Pharmaceuticals USA Inc has initiated a nationwide voluntary recall of acyclovir and carvedilol tablets in the US for labelling mix-up. The US arm of the Gujarat-based pharmaceutical company Cadila Healthcare has recalled 3,900 bottles of hypertension drug carvedilol tablets, 6.25 mg, in 500 count bottles, after a report was received of one bottle labelled as acyclovir tablets, 400 mg, actually contained carvedilol tablets 6.25 mg. The recall is included in a recent US Food and Drug Administration (FDA) Enforcement Report. Acyclovir is a prescription antiviral used to treat cold sores, shingles, chickenpox and other herpes infections. Carvedilol is a prescription beta-blocker used to treat high blood pressure and heart failure.

Five ways pharmaceutical and healthcare sectors can be ‘Modified’

The Economic Times- Kiran Kabtta Somvanshi

The Lok Sabha election results did not affect the pharma stocks but the Modi government can impact the pharma and healthcare sectors in several ways.
GDP spend on healthcare: Increasing the expenditure on healthcare can be the most impactful measure that the government can undertake. The additional funds would be required for spending on strengthening the primary healthcare infrastructure NSE -0.62 % and building upon the secondary and tertiary public healthcare setup. India spends 1.15 per cent of its GDP on healthcare and the government has targeted to increase it to 2.5 per cent by 2025.
Ayushman Bharat: The ambitious insurance scheme slated to provide secondary and tertiary care to the poor (constituting nearly 40 per cent of the country’s population) was Modi government’s first step towards aiming universal healthcare for India. However, economic sustainability of the scheme and provision of quality healthcare services to the poor in remote areas are challenges that must be overcome. The scheme requires sustained funding, proactive participation from the private sector and diligent execution to succeed.

How ethical dilemmas tailed Sun Pharma’s rise

Mint-Soma Das

No single form of growth-driving pharma marketing in India’s generic drug space of the 1990s could be totally free from controversy. Marketing strategies, including that of Sun Pharmaceutical Industries Ltd, which promoted a long-term relationship with doctors, polarized professionals. But was there a choice? Most large companies, which stuck to what they perceived as “ethical marketing" were slipping into a slow-growth zone.

Alert on affordable medicines

The Telegraph

Sections of Indian health groups and drug industry have expressed concern over what they view as a push by the department of pharmaceuticals (DoP) for an information dissemination mechanism that they say could subvert efforts by Indian manufacturers to release generic drugs. The All India Drug Action Network, a consortium of physicians and patients’ rights advocates, on Wednesday urged the government to probe “recent actions” by the DoP that AIDAN said could undermine access to affordable medicines in India. The concerns relate to a proposal by the Organisation of Pharmaceutical Producers of India (OPPI), a body representing foreign drug-makers, to the apex drug regulatory authority to make public through an information portal all pending applications for drugs.

Maharashtra FDA concludes training of officers to implement new Medical Device Rules 2017

Pharmabiz- Shardul Nautiyal

In order to effectively implement new Medical Device (MD) Rules 2017, the Maharashtra Food and Drug Administration (FDA) has successfully concluded training of officers from Maharashtra along with officers of Western region of India including Madhya Pradesh, Chhattisgarh, Goa and Central Drugs Standard Control Organisation (CDSCO), West Zone. As per the provisions of the MD Rules 2017, training of all the officers has been done and all drugs inspectors of FDA, Maharashtra are notified as medical devices officers under MD Rules, 2017, according to Maharashtra FDA Commissioner Dr Pallavi Darade. Government of Maharashtra through a notification designated all the appointed drug inspectors under sub-section (1) of section 21 of the Drugs and Cosmetics (D&C) Act, 1940 as the medical device officers for implementing MD rules 2017.

ASEAN emerging as new market as countries woo investors with tax incentives, lower labour costs & govt support: GG Gurudatta

Pharmabiz- Nandita Vijay

The Association of Southeast Asian Nations (ASEAN), which consists of 10 countries-- Indonesia, Thailand, Singapore, Malaysia, Philippines, Vietnam, Brunei, Cambodia, Myanmar, and Laos-- is the new emerging market as these countries woo investors with tax incentives, lower labour costs and government support, said GG Gurudatta, chief executive officer, Estima Pharma Solutions. These are the untapped markets. The imminent trends in this region are opportunities for contract manufacturing and high demand for life style disorder drugs along with medicines for chronic conditions and infectious diseases, he added.

Pharmacists not eligible for 6-month bridge course in community health for appointing as MLSP: NHM

Pharmabiz

The National Health Mission (NHM) in Assam has clarified that according to the guidelines of the Union health ministry, the pharmacists working in the central and state controlled healthcare institutions are not eligible to be considered for the six-month bridge course (certificate) in community health for appointing as Mid-Level Service Providers (MLSP). The clarification from the NHM elucidates one fact that the demand of the graduate pharmacists with the government seeking inclusion into the certificate course will not be considered by the national health mission anywhere in the country. The pharmacists' associations have been pushing the government to permit them to do the short-term course in the wake of recommendations by the National Health Policy 2017.

BIS's draft QCO for 6 categories of medical devices to raise cost without covering all aspects of patient safety: MTaI

Pharmabiz

The Medical Technology Association of India (MTaI), which represents leading research-based medical technology companies having a large footprint in manufacturing, R&D and training in India, has said that Quality Control Orders (QCO) for medical device regulation do not fit in government’s broader plan to ensure patient safety or lower cost of healthcare. Bureau of Indian Standards (BIS) through Department of Pharmaceuticals (DoP) is in the process of finalising a quality control mechanism for medical devices. It had issued a draft QCO for six categories of devices including blood glucose monitoring system, surgical blades, gloves, and clinical electric thermometer, seeking stakeholder views

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

Pharmabiz

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.

Here’s the new frontier in beating cancer — immunotherapy

The Print- Atul Khire & Pooja Panwalkar

The word “cancer” itself is enough to evoke terror, with global incidence of the often-fatal disease on the rise: From 14.1 million in 2012, the number of cases had risen 20.6 per cent to 17 million in 2018. But the disease is no longer the death sentence it once used to be. According to the American Cancer Society, the five-year survival rate of breast cancer patients in 1975-77 was 75 per cent, but this had risen to 91 per cent between 2006 and 2012, a trend also seen in many other types of cancer. At the heart of this progress is greater public awareness, and advancement in early detection and therapeutic approaches. Traditionally, most cancers are treated with radiation therapy, chemotherapy and surgery, or some combination of the three.

Healthcare News

Tribal doctor’s suicide could have a caste factor

The Times of India

The failure of mahagathbandhan, the alliance of casteist political parties, to wrest Uttar Pradesh from the BJP in the 2019 parliamentary elections, demonstrated that caste as an instrument of politics, at least at national level, is on the decline. Even as it is a refreshing change, the scourge of casteism prevails across societies in India. A day before the election results were announced a young female doctor committed suicide allegedly for being ragged and humiliated by colleagues for her lower caste and tribal identity. It is not surprising that caste discrimination and casteist attitudes are rampant among conservative sections of Indian society. However, when highly literate and white collar professionals give vent to their prejudices verbally or by their actions, it is shocking and despicable.

Pune doctor: Delhi incident not trivial, could’ve been harmed

The Times of India- Rujuta Parekh

Social worker and gynaecologist from the city Arun Gadre (61) is yet to get over the shock of being accosted by a group of youngsters who, he claimed, made him chant “Jai Shri Ram” during his recent visit to Delhi. The doctor on Wednesday said he realized only later that the incident was not trivial in nature and the youngsters could have harmed him if he had resisted. Gadre, a member of the Alliance of Doctors for Ethical Healthcare, was in Delhi on Sunday and was supposed to visit Bijnor the same day to deliver a lecture at an event organized by the Indian Medical Association. In Delhi, he was staying at the Young Men’s Christian Association (YMCA) near Jantar Mantar and had stepped out for a morning walk on Sunday. He said, “When I was returning from Connaught Place to YMCA, a group of about four to six youngsters obstructed me on the way near a Hanuman temple and told me to chant “Jai Shri Ram”. I was shocked and confused. Instead of arguing with them, I chose to repeat what they told me to say. They then directed me to say the words loudly. But this time, I started walking away from the spot.”

Ayurvedic doctor accuses job portal of cheating

The Times of India

An Ayurvedic doctor from Saragur has complained to Cybercrime, Economic Offences and Narcotics (CEN) wing of state police that she was cheated by a career portal management company under the guise of finding her a job. The police have registered a case under various provisions of the cybercrime act. However, since the web portal has assured of refunding the money, the police are waiting for the next course of action. Speaking to TOI, inspector, CEN wing, T D Nagaraj said the doctor is working in a private hospital in Saragur. A few months ago, executives of a web portal approached her, assuring her a job. She paid Rs 12,340, Rs 19,941, Rs 27,730, and Rs 43,423 to find her a job. But as the company didn't find her a good job, she suspects that it may be a fraudulent company. Hence she approached police.

Govt hospitals out of anti-rabies vaccines, pvt stores sell them at inflated cost

The Times of India- Ishita Mishra

Dehradun is reeling under a shortage of anti-rabies vaccines. While government hospitals seem to have completely run out of the injections, its stock is limited in private hospitals too. The CMO said the government had been notified of the shortage. The crisis has been there in Doon for months. Vinay Kumar, whose 13-year-old son Sumit was bit by a dog on Wednesday, said “I took my son to Doon Hospital, Coronation Hospital and even to a nearby community health centre (CHC), but there was no anti-rabies vaccine available in any of the government hospitals. Private medical stores, where the vaccine was available in limited stock, were selling at an inflated price.”

Civic surgeon held for ‘molesting’ 25-year-old medical student

The Times of India- George Mendonca

The Vashi police have arrested a 32-year-old surgeon posted at NMMC hospital in Vashi after a 25-year-old intern at the civic hospital lodged a police complaint alleging that the surgeon had tried to outrage her modesty by touching her inappropriately. The surgeon is a resident of Koparkhairane and is posted as a senior resident doctor at the NMMC hospital in Vashi. The intern resides in Mumbai and is a medical student at Terna medical college, Nerul.

Mumbai doctor suicide: Post-mortem report reveals ligature mark on neck

Business Standard- ANI

The post-mortem report of postgraduate medical student doctor Payal Tadavi, who was found dead in her hostel room recently, has revealed evidence of a ligature mark on her neck. Under 'provisional cause of death', the post-mortem report stated 'evidence of ligature mark over neck.' A Mumbai court on Wednesday sent all the three accused in the case to two-day police custody as her family sought directions for the crime to be treated as a murder. The lawyer representing Tadvi's family told the court that said that circumstances of the medical post-graduate student's death suggested it was a murder case.

Centenarian cured of Urosepsis at Kalinga Hospital

The New Indian Express

Doctors at BR Life Kalinga Hospital successfully treated a 106-year-old woman who was suffering from Urosepsis, a condition that occurs when a urinary tract infection spreads into the blood stream causing multiple infections. Parbati Behera from Balasore was admitted to the hospital with complaints of high fever, burning sensation during urinating, difficulty in breathing and severely swollen legs. Though the centenarian had visited several hospitals in the City earlier, she was denied treatment owing to her old age.

BR Life Group of Hospitals Announces Association with Art of Living Foundation

ET Healthworld

BR Life SSNMC Hospital, founded by philanthropist billionaire, Dr BR Shetty, announced its association with Art of Living Foundation with an aim to provide holistic wellness and medical care to its patients. Through this partnership, an amalgamation of Allopathy with Ayurveda with Yoga and Meditation for chronic lifestyle diseases such as Diabetes, Hypertension, Obesity, Migraine, Gastric problems, Cardiac ailments etc., will be offered to patients at BR Life SSNMC Hospital and Art of Living Foundation. A MoU has been signed between both the entities in the presence of his holiness Gurudev Sri Sri Ravi Shankar Ji and Colonel Hemraj Singh Parmar, Group CEO, BR Life Group of Hospitals.

Violence grips Pakistan after doctor accused of blasphemy

Deccan Chronicle- PTI

Mobs set ablaze shops belonging to Hindus after a veterinary doctor from the community allegedly tore pages of a holy book and wrapped medicines in them in Pakistan’s Sindh province, according to a media report. The Hindu veterinary doctor, identified as Ramesh Kumar, was arrested on Monday under the country’s strict blasphemy laws after a local cleric filed a police complaint accusing him of committing blasphemy. Under Pakistan’s blasphemy laws, anyone accused of insulting Islam can be sentenced to death. The doctor was taken into custody while angry protesters set fire to shops owned by Hindus and burnt tyres on road in Phuladyon town in Mirpurkhas district in the province, The Express Tribune reported. Protesters set ablaze a doctor’s clinic, a medical store, and two shops belonging to Hindus. They also blocked roads by burning tyres, the report said.

Medical apathy: Pregnant woman loses child after painfully waiting for four hours in hospital

Times Now

In a shameful incident emerging from Karnataka, a 22-year-old pregnant woman was made to wait for hours and was not admitted to a hospital even as she writhed in labour pain. The incident has been reported from KGF Government Hospital in Kolar. In a video that has now gone viral, the woman could be seen lying on the hospital floor and tossing around in pain. Even after she was made to wait for hours, she was neither attended to by any doctor nor admitted to the hospital. Finally, the woman was taken to a private hospital for delivery. However, her child did not survive. According to a report in The News Minute, the victim named Sameena, who is a resident of Kolar, was taken to KGF Government Hospital when she suffered labour pain. The woman was accompanied by her husband and two other women relatives. Due to extreme medical negligence by the doctors at the hospital, the woman almost escaped death. The woman's husband was forced to take her to RL Jalappa private hospital after no medical staff came out to attend to her.


Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 29 May to 0830 hrs IST of 30 May, 2019)

Heat Wave:

Yesterday, heat wave conditions were in most parts with Severe Heat wave in isolated pockets over Vidarbha; heat wave in many parts with severe heat wave in isolated pockets over West Rajasthan; Heat Wave to Severe Heat Wave in isolated pockets over East Uttar Pradesh; Heat wave conditions in some parts over Marathwada, Telangana and Madhya Pradesh and in isolated pockets over northern pats of North Interior Karnataka, Madhya Maharashtra, East Rajasthan and Haryana, Chandigarh & Delhi.(Annexure 1 & 2).

MAXIMUM TEMPERATURES

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

Maximum temperature departures as on 29-05-2019: Maximum temperatures were appreciably above normal (3.1°C to 5.0°C) at most places over Vidarbha, Marathawada and North Interior Karnataka; at many places over West Rajasthan, Rayalseema and Jharkhand; at a few places over Himachal Pradesh, Punjab, West Madhya Pradesh, Madhya Maharashtra, Telangana, Nagaland, Manipur, Mizoram & Tripura and at isolated places over Jammu & Kashmir, Bihar, Uttar Pradesh, East Rajasthan, East Madhya Pradesh, Gangetic West Bengal, Assam & Meghalaya and Tamilnadu & Puducherry; above normal (1.6°C to 3.0°C) at most places over Kerala; at a few places over Gujarat Region, Odisha, Coastal Andhra Pradesh and Lakshadweep and at isolated places over Sub-Himalayan West Bengal & Sikkim, Chhattisgarh and 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 48°C was recorded at Chandrapur (Vidarbha).

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 30 May to 0830 hrs IST of 31 May 2019):-

Heat Wave to severe heat wave conditions in isolated pockets very likely over East Uttar Pradesh; heat wave conditions in most parts with severe heat wave in some parts over Vidarbha; heat wave conditions in many parts with severe heat wave in isolated pockets over West Rajasthan and East Madhya Pradesh; in some parts over West Madhya Pradesh, East Rajasthan & Marathwada and at isolated pockets over Telangana, Rayalaseema, Tamilnadu, Madhya Maharashtra, Haryana, West Uttar Pradesh, Bihar and Jharkhand.


Pharm D degree holders can use 'Dr' prefix

The Pharmacy Council of India (PCI) has said that the candidates getting the Doctor of Pharmacy degree (Pharm D) from recognized universities will be authorized to use the 'Dr' prefix reports TOI.
In a letter issued to director of board of examination and evaluation of Sant Gadge Baba Amravati University, the registrar-cum-secretary of PCI Archana Mudgal has informed that the university should use the prefix 'Dr' before the names of the candidates while awarding the degree certificates to those who clear Pharm D course.....read more


E coli from flour and crypto from recreational pools

USA: The Centers for Disease Control and Prevention (CDC) has said that 17 people in eight states have been sickened with a strain of E. coli. The reports of the illness started on December 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 Shiga toxin-producing E. coli (STEC) infection may get a type of kidney failure called hemolytic uremic syndrome....read more


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