Download DTMT March 2014

RNI No. DELBIL/2012/45560
DL(E)-20/5415/2012-14
March 1 st - 31 st, 2014 • ` 10/- • New Delhi
Monthly Newspaper Vol - 2, Issue - 9
DRUG TODAY
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Medical Times
Medical Institutions
P3
Medical pharmacy
MCI raids will now catch
colleges by surprise
B R A I N Y Q U O T E S
“The more you like yourself, the
less you are like anyone else,
which makes you unique.”
— Walt Disney
DCGI revokes
registration
of Novartis
In an unprecedented move against
the European pharmaceutical giant Novartis, the Drug Controller
General of India (DCGI), Dr GN
Singh cancelled the Registration
Certificate (RC) for import of Tiamulin hydrogen Fumarate manufactured by M/S Sandoz, Austria.
Drug controller cited rule 21 of the
Drugs and Cosmetic Act 1945 for
the move.
The stringent move is followed
by submission of a fake document
from M/s Novartis India Limited,
Animal Health Business Unit, Sandoz House, Mumbai.
Details on P4
P4
Pharmacist may become
mandatory for drug stores
Medical Review
Campaign for direct blood
transfusion takes steam
Spurious drugs make
it to hospital shelves
Uttarakhand, Chandigarh come clean, other states shy away
BS RAWAT
DEHRADUN/ChandiGARH
T
here is lot of concern in
the country over lack of
proper healthcare system. But if we see what
is going on in the name of public
healthcare, we would prefer not
to have any public healthcare
system at all. Irregularities in the
drug deals have been a matter of
speculation for quite some time
but the depth of malaise was not
known. The recent revelations
that 54 drug formulations in Uttarakhandand and 20 in Chandigarh hospitals and chemist shops
across have been declared “substandard” by their respective
Drug Control authorities gives an
insight into the business.
Uttarakhand had analysed 830
samples and the Union territory
administration of Chandigarh
430 drawn by drug inspectors
from different locations in the
state and Union territory in the
last five years in connection with
the supply of spurious drugs in
government-run hospitals/institutions.
Even this expose could be just
a tip of the iceberg as many other
states have not made up their
mind to part any information
about the underhand dealings in
drugs or simply rejected the request to do so.
Through RTI replies officials
of the Drug Controller Department of the two governments
disclosed that their respective
departments have taken prompt
action after the report came in
about the spurious and seized the
tainted drugs, even as the inquiry
is still on.
“We have seized certain medicines from after the report by
Continued on P3
No vehicle, no raid on quacks: DGHS to HC
BS RAWAT
NEW DELHI
When the Delhi High Court asked
the Additional Director, Directorate of Health Services of Delhi,
Dr VK Aggarwal, about the reason for inaction in the case of
quacks active in West and North
West District of Delhi, the reply
he gave is enough to send anybody into peals of laughter.
Quack on bail to arrange Rs 7 lakh damages
Riyazuddin, a quack, has been
sentenced to three-year jail term
for a series of wrong diagnoses
that led to the death of a female
patient. His bail plea was initially
rejected by the court. But when
he came in appeal before Delhi
High Court and offered to pay Rs
7 lakh to the complainant he was
released on bail.
The court granted him twomonth bail on the condition that
he should deposit the stipulated
Rs 7 lakh in the name of 10-yearold Anjali, daughter of the deceased.
In 2013, Riyazuddin was found
“guilty of intentionally compromising the health of a woman
Continued on P2
P6
The bizarre excuse that he offered was that there was no
government vehicle made available to anti-quackery cell of the
Delhi Medical Council (DMC).
As was expected, the court was
shocked at such a reckless reply
from a senior bureaucrat that if
anything reflects the insensitivity of the department entrusted
with the responsibility of public
Continued on P2
Pharma PSUs to
ensure medicine
at affordable price
DTMT NETWORK
In a move to provide medicine at a minimal cost
to the masses that otherwise don’t have the accessibility to the expensive drugs, the Department of Pharmaceuticals has decided to procure
the same from the drug manufacturing companies owned and controlled by state governments.
The move in the offing is followed by a fiveyear pharmaceutical purchase policy adopted
by the Union Government last year. Apart from
providing drugs at a reasonable cost, it also
intends to boost the sick Public Sector Units
(PSUs) dealing with medicine. In this direction,
the Government has already initiated a revival
project.
A person close to the development told DTMT
that the five-year policy of the Government is
applicable only to 103 drugs. It has been unanimously decided that these drugs will be sold by
the PSUs and autonomous bodies at an affordable price. The discount in the price of the drugs
will be decided by the National Pharmaceutical
Pricing Authority (NPPA).
Indian Drug and Pharmaceutical Ltd (IDPL),
Hindustan Antibiotic Ltd (HAL), Bengal Chemicals and Pharmaceuticals Ltd (BCPL), Karnataka
Antibiotics and Pharmaceuticals Ltd (KAPL), Rajasthan Drugs and Pharmaceuticals Ltd (RDPL)
are the state owned PSUs. If the new policy is
implemented, fate of these PSUs will be revived.
The move will benefit needy patients and prove
instrumental in saving many a life as life-saving
drugs happen to be too expensive to afford for a
majority of the patients in the country.
The important thing that should need emphasis is that apart from providing medicine at reasonable price, there must be some mechanism
to reach out to the needy patient with the medicine.
The Union Government has already sanctioned Rs 145 crore for revival and meeting Good
Manufacturing Practices (GMP) compliances for
the BCPL plant which has four factories, two in
Kolkata, and one each in Mumbai and Kanpur.
DTMT Exclusive
P14
Despite being curable TB
on a killing spree in India
Medical City
2
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Rs 1.5L compensation for medical negligence 15 years on, AIIMS to get new blocks
Swami Dayanand Hospital-EDMC to pay labourer for death of minor son
BS RAWAT
NEW DELHI
The National Human Right Commission (NHRC) awarded a
whopping Rs 1, 50,000 as compensation to be paid by Swami
Dayanand Hospital and East
Delhi Municipal Corporation
(EDMC) to a labourer for the
death of his minor son on September 3, 2012 caused by medical
negligence.
On the plea of RTI activist RH
Bansal, the NHRC enhanced the
amount of the compensation and
asked the hospital and the EDMC
to pay the amount to the father
of the deceased child and submit
proof of payment to the commission within six weeks.
The commission observed that
Rs 50,000 paid to the bereaved
father by a guard convicted in the
case by the court is inadequate
and EDMC is required to pay
some additional amount to compensate the loss of an innocent
life. Consequently, the commission ordered the hospital and the
EDMC to pay up Rs 1,50,000.
An FIR, No 190/12 u/s 304A
IPC, was lodged by the deceased’s
father at GTB Enclave police station.
Consequently, a thorough investigation was carried out in
which a guard of the hospital was
found guilty and was prosecuted.
After his conviction, the court ordered the guard to pay a sum of
Rs 50,000 to the father of the deceased, which he obliged during
the court proceedings.
The commission found the
amount too inadequate for an innocent life and hence asked the
Swami Dayanand Hospital and
the EDMC to pay the entire compensation Rs 1,50,000 (which included Rs 50, 000 levied from the
guard) to the deceased’s father.
It also asked them to file a com-
pliance report so that the same
could be placed before it.
NHRC had fixed the compensation amount on a RTI quarry
referring to deceased father’s
appeal to it while holding the
contractor of the guard and the
hospital culpable of civil liability for negligence. An RTI activist, RH Bansal, in his plea before
NHRC had demanded a sum of
Rs 1,50,000 compensation on
the ground that both the hospital
and the EDMC indulged in gross
negligence leading to the child’s
death.
Two-year-old
diseased,
Pradeep, had come to the hospi-
tal escorted by his parents, who
were working there as labourers
for the construction of a block in
the hospital, in September 2012.
At the hospital, he came in contact with a live wire and died of an
electric shock.
After the RTI query, the commission studied EDMC report on
the case and came to the conclusion that there was negligence on
the part of the hospital as it was
the responsibility of the hospital
to monitor the work. The report
of the Deputy Commissioner
clearly said that the Electrical
Department of the EDMC failed
in its duty in this case.
Hence, it is clearly made out
that the EDMC was responsible
to monitor and supervise the
work done by the contractor and
they failed in this duty, which resulted in the unfortunate death of
a minor.
Hence a show-cause notice was
ordered to be issued to the hospital, Delhi government and the
EDMC. The notice has been responded by the EDMC and found
the contractor guilty and was
prosecuted.
Earlier, the police had absolved
the hospitals and the EDMC of
criminal liability for negligence.
Contractual paramedical staff raise banner of revolt
JIVIKA MITTAL
Paramedical staff is considered backbone of our
health system. But unfortunately when it comes to
giving their due, the very
system which never tires
of singing paeans in their
praise develops cold feet.
Take the case of Delhi’s
paramedical
workers.
They have been struggling
for their rights for more
than a decade. But the administration always gives
assurances which have
turned into void.
Around 2,500 contractual paramedical workers
are working in various
government
hospitals
in Delhi. These workers
are hired by Delhi Subordinate Selection Services Board (DSSSB) after
proper selection process.
Many of these workers
have been working on
contractual basis for more
than a decade. However,
they have not been made
regular or permanent em-
Contractual paramedical staff holding a demonstration outside Delhi Secretariat
ployees for reasons best
known to the administration.
These hapless workers have been protesting
from time to time but the
Government has adopted
lackadaisical attitude towards them and shown
scant interest in their genuine demand.
“The Aam Aadmi Party
AAP, despite including
the promise to regularise all the contractual
staff working for more
than five years in their
manifesto, failed to keep
its promise,” said Niyaz
Ahmed, general secretary
of the Delhi Rajya Health
Services Contractual Employees Union.
“Recently,
reacting
to our strike held from
February 10 to 14, which
threw state’s healthcare
machinery out of gear,
the principle secretary of
Health, said that the policy for your regularisation
is already prepared and
will be implemented in
next two-three months,”
added Niyaz.
What is all the more intriguing is that DSSSB has
been inviting from time
to time fresh applications
for permanent posts of
paramedical staff. And if
these posts are filled by
the fresh candidates, what
will come of these trained
and experienced workers.
“I am worried about my
future as I can lose my job
any moment,” a contractual OT lab technician of
Ambedkar Hospital expressed his worst fears.
Furthermore, in November 2012, the Delhi
Government passed an
order for same-pay for
same-work, but these
contractual workers have
yet to get the salary that
their permanent counterparts are drawing.
No vehicle, no raid...
Continued from page 1
health and safety.
“It was very shocking state of affairs of the anti-quackery cell,” the court order observed and
called for an emergency meeting of the officials
of state Government, Delhi Police and Medical
Council of India, Medical Council of Delhi, Central
Council of Indian Medicine and other stakeholders to look into all aspects of quackery, the court
asked the administration to ensure that no quacks
are allowed to practice as it affects the very fundamental right to life of citizens under Article 21
of the Constitution.
The DTMT in its February edition carried an exclusive report on DMC’s action against 38 quacks.
But the action turned out to be a farce as all the
so-called doctors were let off without any stringent and deterrent punishment.
The anti-quackery cells of the Indian Medical Association (IMA)/Delhi Medical Association
(DMC) have become redundant. All these years
they have done precious little in curbing the menace. While DMC is competent to take suo moto action against quacks under Rule 32 of DMC Rules,
2003, it has never done so. There is no reason
why the DMC, state Medical Councils and Medical
Council of India should have anti-quackery cells
at all when they hardly act against quacks.
Proof of medical negligence, expert opinion, and
legal action by medical council and involvement
of the IMA can ensure that quacks are booked
and punished quickly. After all, it is the duty of the
medical system to fight against quackery.
Quack to pay Rs 7 lakh
Continued from page 1
patient” by the Delhi Court. Riyazuddin, who is
an AYUSH practitioner, was allegedly dabbling
in allopathy. “He wrongly diagnosed the patient
and used the wrong treatments,” the court added.
The court is convinced that the patient died as
a result of wrong treatment at the hands of the
convict. This may be the first case where a ‘doctor’ has been sent to jail for medical negligence.
The case of Riyazuddin, which is still pending
in the court, set a good precedent. It shows if an
individual complainant/sufferer is determined,
he can still nail those who indulge in quackery.
Finally, the court has found it necessary to impale medical councils as parties. – DTMT
BS RAWAT
NEW DELHI
After a delay almost long
15 years, foundation stone
for the proposed Mother
and Child (MCH) block and
surgical block in the Masjid
Moth area of All India Institute of Medical Sciences
(AIIMS) was finally laid by
Health Minister Ghulam
Nabi Azad on February 3.
The projects will add 600
more beds and 24 operation
theatres at a total cost of Rs
255 crores.
“Together these initiatives constitute a major
breakthrough in the development of AIIMS infrastructure which has come
under the severe strain due
to increasing pressure of
teaching, research and patient care activities,” Azad
said, adding that the Plan
and non-Plan budget for
the current year was Rs
1,340 crore.
The surgical block will
be spread over an area of
17,000 sq meter and will
have three basements and
nine floors. It will have 200
beds, 12 operation theatres,
a national endoscopy centre, a high dependency unit
and transplant facilities.
The facilities would be
constructed at an estimated cost of Rs 55 Crores
approximately and is expected to be ready by April
2015, Azad said. Further,
the state-of-the art Mother and Child block will be
built over an area of about
45,000 sq meters and will
also have three basements
and nine floors.
The medical college and
research university was established in 1956 and operates autonomously under
the Ministry of Health and
Family Welfare.
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Medical Institutions
COLLEGES BEWARE!
No more cheating! MCI to carry out surprise inspections
JIVIKA MITTAL
No private or government
medical hospital will be
able to hoodwink the inspection team of the Medical Council of India (MCI)
any more by simply borrowing the infrastructure
from some other hospital
to get the approval of the
MCI.
Recently, the Executive
Committee of MCI, on the
basis of the judgment of
the High Court of Delhi in
the case of Raipur Institute of Medical Sciences
Vs Union of India, has
decided to conduct surprise inspections in all the
medical colleges, seeking
MCI approval for Under
Graduation as well as Post
Graduation courses.
Earlier, the MCI used to
inform the college about
the inspection dates in advance. Owing to it, many
medical colleges used to
borrow faculty, laboratory
equipment, library books
and other infrastructural
needs from neighboring
institutions and present
them before the MCI’s inspecting teams as their
own to get MCI’s approval
for their colleges.
“This initiative of the
apex body will help in
keeping a check on the
frauds which will ultimately help in maintaining the standard of the
medical education in India,” said the MCI sources.
MCI also decided
to keep the video recordings of all the
Inaugurated,
maternity
hospital still
awaits opening
A full one week
has passed since
its inauguration by
a rickshaw-puller
Bijay Baba, 60,
amid much fanfare, but the newlyconstructed New
Delhi
Municipal
Council’s upgraded
Palika Maternity
Hospital in Lodhi
Colony, has yet to
become fully functional.
Patients
continue to visit another hospital for
biological
tests
and operation. If
the hospital functions fully, it will
be a great relief for
all of them besides
it would ease the
burden on Charak
Palika Hospital.
When this correspondent visited
the hospital, he
found that people
are getting only
OPD services here.
They were referred
to another hospital
for other facilities.
Despite 65 beds,
no ward service is
available till date.
Sources said that
renovated maternity hospital will
also offer laboratory services and
immunisation and
distribute
drugs
free of cost. DTMT
Spurious drugs
Continued from page 1
two laboratories reached us and we have also sent
show-cause notices to various manufacturing companies in this regard. We are duty-bound to act
against spurious drugs,” SC Sharma Drug Controller, Uttarakhand said in the reply.
In its reply to RTI activist, RH Bansal, Uttarakhand Drug Control have listed 54 medicines as
sub-standard. The drug inspectors found the samples of Paracetamol tablets, Diclofenac Sodium, Vitamin B Complex, Prazolam 0.25 tablets, Prazolam
0.25 tablet, Rem-CC tablets and E-PAR (paracetamol Oral Suspension) taken from CMSD stores and
manufactured by a vadodara, Bangalore, Dehradun,
Kashipurand Haridwar based companies as substandard and having the presence of particulate
matters, the report said.
The samples of the drug CZPAM 0.5 (Clonezpam
Dispersible tablets) taken from the Forest Hospital
Trust and Medical College, Haldwani also turned
out to be sub-standard, the report mentions.
Similarly, analysis of other drug from various institutes namely Aekil tablets, Azizen drops,
Integesic-MR, Norfloxacin & Tinisazole tablets
showed no clarity of the solution and presence of
particulate matter, it said.
The drug controllers also found that spurious
drugs were being sold in chemist shops across the
state, as many samples, taken from such shops
in Bageshwar, Almora, Roorkee, Rudraprayag,
Dehradun,
Rudrapur,Pithoragarh,
Haridwar,
Srinagar,Chamoli, Pauri and Kashipur were found
to be sub-standard.
Similarly, the Drug Control officer, Chandigarh
Administration has listed 20 medicines as substandard. It said that total sample collected during
the last five year are 430 including 37 from the Central Drug Store, GMSH Sector-18, 30 from PGIMER,
Sector 12, nine from GMCH Sector-32, 17 from ESI
Dispensary, Sector-29, four from District Family
Welfare Officer, Sector-22 and seven from Homeopathic Dispensary, Sector -34.
The RTI activist RH Bansal is not happy with other
state agencies. They failed to reply to his queries for
some excuse or the other. The Government of Rajasthan which is pioneering free generic drug distribution, said refused to answer his query. Many other states including Uttar Pradesh, Punjab, Haryana,
West Bengal and Bihar preferred to remain silent
over the matter.
He said he is planning to move high courts of the
respective states if they do not send factsheets.
inspections so that no
one can claim the falsification in any means at
the later stage. Recently,
in the Raipur Institute of
Medical Sciences Vs Government of India case,
Justice VK Jain said surprise inspections must be
conducted so that there
is no scope for (i) arranging or admitting patients
and (ii) arranging/hiring/
borrowing equipment or
employing teachers, on a
temporary basis.
3
Medical Pharmacy
4
PCI mulls making
pharmacist mandatory
for chemist shops
MK SINGH
The Pharmacy Council of India
(PCI) is considering issuing a directive to all the state drug controllers and pharmacist councils
to ensure that every chemist
shop has at least one pharmacist.
The move in the offing is aimed at
implementation of the Pharmacy
Act on the lines of Drugs and
Cosmetics Act.
Dr B Suresh, president of the
PCI, told DTMT that the primary
objective of the move is to ensure
that patients get right medicine
in the right dose and at the right
time under the supervision of
a competent person who could
advise them on the safe use of
medicines. For this, it is crucial
to implement the Act in letter and
spirit.
The Pharmacist Act has a provision that each medical store
should have at least one pharmacist. Moreover, section 42 of the
Act provides for appointment of
inspectors for ensuring implementation of the Act.
"If the new directive is implemented, patients will be assured
of quality medicine and expert
guidance. This will also help
avoid self-medication," added Dr
Suresh.
A lot of chemist shops in the
country are managed by people
who don’t know the basics about
medicine. Quite often lure of the
lucre draws people, even those
who do not have proper degree
or diploma in pharmacy, to the
businesses of medicine. How can
Dr B Suresh, president PCI
“The primary objective of the
move is to ensure that patients
get right medicine in the right
dose and at the right time
under the supervision of a
competent person who could
advise them on the safe use of
medicines. For this, it is crucial
to implement the Act
in letter and spirit”
they do justice to a profession
that requires sensitivity and precision?
Despite the fact that the Act
makes it mandatory for all medical stores to hire the services of
a bonafide pharmacist, very few
comply with the rule.
The council has set aside funds
to conduct the Continuing Education Programme (CEP) for
pharmacists and directed that
the pharmacists should complete two CEPs before registration. With more than one million pharmacists registered with
the council and 700 institutes
producing 40,000 pharmacy diploma holders annually there is
no dearth of pharmacists. Hence,
the challenge is not the nonavailability of pharmacists but
the will to appoint them.
Keeping in mind the safety of
the patients with new drugs coming in the market it becomes imperative to know the useful and
harmful effects of the drugs. The
council has been constantly in
touch with the Central and state
governments and the councils
to implement the same as soon
as possible. It is doing so with
renewed vigor to ensure patient
welfare and safety, added Dr
Suresh.
For the betterment of pharmacists, the council has introduces
a six-year D Pharma programme
right after completing class 12th
class .
This programme will nurture
them in their genre and will
make them clinically competent pharmacists who can use
their knowledge and skill in
various Government and private hospitals and will be able
to support patients along with
the physician with unbiased information of medicines, said
Dr Suresh.
ICMR issues fresh
guidelines for
stem cell research
DTMT NETWORK
NEW DELHI
The Indian Council of Medical Research (ICMR) has come up with
fresh guidelines for stem cell research in India. The revised guidelines are aimed at restraining some
clinics from exploiting patients by offering unproven stem cell treatment
prematurely.
Such a fraudulent practice needs to
be stopped forthwith to ensure that
significantly designed and responsible research on stem cell is not hindered, the ICMR contended in the
guidelines.
The field of stem cell research is
still in its nascent stage in India. However, some significant advances have
been made towards understanding
the basic biology of stems and their
differentiation into different cell lineage. However, harnessing of their
promised potential to usher in the
era of regenerative medicine is still a
long way to go.
In the guidelines, it has been decided to omit the word therapy. This
has been done to emphasise the fact
that the stem cells are still not a part
of standard of care; hence, there can
be no guidelines for therapy until efficacy is proven.
“Any stem cell use in a patient must
only be done within the purview of
an approved and monitored clinical
trial with the intent to advance science and medicine, and not offering it
as a therapy. In accordance with this
stringent definition, every use of stem
cells in patient outside an approved
clinical trial shall be considered as
malpractice,” said the guidelines.
These guidelines apply to all stakeholders including individual researchers, organizations, sponsors,
oversight/regulatory
committees
and anybody associated with stem
cell research.
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Legal Column
Can a doctor run
a pharmacy shop
in his premises?
Query: “Can a doctor who has a private
practice have a pharmacy shop in the
premises where he practices as per the
Drugs and Cosmetics Act? If not, what
is the penalty for doing so?”
(Anonymous)
According to Drugs & Cosmetics Act
1940 and Drugs & Cosmetics Rules
1945, no person shall himself or by
any other person on his behalf can
sell, stock, exhibit or offer for sale, or
distribute any drug except under and
in accordance with the condition of a
licence issued for such purpose under
the Act.
No person has the right to purchase
and sell drugs from his premises
without a licence. The purchase of
drugs for sale and possession without a valid licence would be illegal.
The doctors/registered practitioners of
modern scientific system of medicines
can only stock or dispense Allopathic
drugs/medicine to their own patients
provided a doctor/registered medical
practitioner is not keeping an open
shop or selling across the counter or
engaged in the importation, manufacturer, distribution or sale of the drugs.
The doctors/registered medical practitioners shall purchase the drugs
only from a dealer or manufacturer licensed under the rules and records of
such purchase showing the names and
quantities of such drugs, together with
their batch numbers and names and
addresses of the manufacturers.
The doctor/registered medical practi-
For any legal query you can write us at:
[email protected]
Dharamshila claims successful launch of
Haploidentical bone marrow transplant
The Dharamshila Cancer
Foundation and Research
Centre has started the
Blood and Marrow Transplantation (BMT) through
a procedure called “Half
Matched or Haploidentical BMT”. The procedure
is expected to be the last
resort to 80 per cent of
Leukemia,
Lymphoma,
Myeloma,
Thalasemia,
Aplastic Anemia and Sickle cell anemia patients in
the country.
Pointing out that 25,000
people require transplant in India annually,
Dr S Khanna, president of
the research centre, told
DTMT that of these, only
10,000 could get the procedure done till a couple
of months ago.
The reasons for this lacuna are non-availability
of matched donor and the
cost of importing the stem
cell from abroad, say for
example the UK, the US, is
too high i.e. Rs 25 lakh.
Moreover, lack of awareness about BMT with half
matched donor is one of
the factors that used to
UNDERSTANDING BMT
n BMT is a
procedure to
replace the
damaged
bone marrow, a soft,
fatty tissue
inside your
bones, with
healthy bone
m a r r o w
Dr Sandeep Chatrath (CEO, stem cells
Dharamshila Hospital
nStem cells
are immature cells in the bone marrow that gives rise to all blood cells
There are three types of BMT:
Autologous BMT: Stem cells are
removed from the body before receiving high dose of chemotherapy
or radiation treatment. The stem
cells are stored in a freezer (cryopreservation). After high dose of
chemotherapy your stem cells are
put back into your body to make
normal blood cells.
Allogenic BMT: Stem cells are recome in the way of carrying out the procedure.
Now, with the launch of
BMT indigenously people
RAMESH CHAND, ADVOCATE
Nationally acclaimed expert on
Drugs and Cosmetics Act (1940)
[email protected]
Mob-09810129898
(The views expressed in this column are those of
the author and do not necessarily represent the
views of, and should not be attributed to, Drug
Today Medical Times.)
RAY OF HOPE FOR CANCER PATIENTS
DTMT NETWORK
tioner should also maintain a record of
the names of patients to whom he has
dispense or administered the drugs
in a register open to inspection by an
inspector under the Act. A doctor/registered medical practitioner can purchase the drugs only according to requirements of his patients.
Hence, doctor/registered medical
practitioner has no right to establish a
pharmacy shop in his clinic for sale of
drugs to the general public/outer patients. He has to dispense the medicine
to his patients by himself or through
a qualified compounder or registered
pharmacist.
If a doctor/registered medical practitioner sells drugs from his shop
situated in his clinic without a valid
licence, he is liable to be prosecuted
under section 18(a)(i) punishable under section 27(b)(ii) and liable to be
punishable with imprisonment for a
term which shall not be less than three
years but which may be extended to
five years and with fine which shall be
not less than one lakh rupees or three
times of the value of the drugs confiscated whichever is more and if the
drugs found adulterated or spurious
than he also liable for a imprisonment
mentioned under section 27(a), 27(b)(i),
27(c) and 27(d) as the case may be.
moved from a donor. The donor
genes need to be partly matched
with the genes of the receiver.
Special blood tests are done to
ensure that the donor is a good
match for the receiver. Parents and
siblings are most likely are good
choice. If the donor genes do not
match with the patient, one can go
for registration for national or international bone marrow.
Umbilical Cord Blood Transplant:
This is a type of allogenic transplant. Stem cells are removed from
a newborn’s umbilical cord right after birth.
The stem cells are frozen and
stored till they are needed for a
transplant. Umbilical cord blood
cells are very immature so there
is less of a need of matching. But
blood counts takes longer to recover in the procedure.
A BMT is essential in cancers such
as leukemia, lymphoma or both
which is called myeloma.
won’t have to look to other countries for stem cells.
Apart from carrying out
the procedure successful-
ly we have been focusing
on prevention of infection
since infections have been
major cause of casualties
in the case of BMT in the
past. For the same, we
have created a state-ofthe-art infrastructure.
We have built four
rooms at a cost Rs 8 crore
endowed with the best facility available nowhere
in India, added Dr Khanna.
“BMT is a very delicate
procedure in which patients have to go through
Immuno
suppression
where chances of infection are enormous. To
overcome this, we have
laid emphasis on the air
catering unit, air pressure
in the room. Beside, we
have created vinyl cladding joint less-wall, stainless steel door among
many, Happa filters of .3
microns to sanitise the
BMT room of all infections.
The BMT treatment is
also quite affordable. The
cost of the procedure
ranges between Rs 6 to
15 lakh which otherwise
would cost almost Rs 30
to 40 lakh if you go for
imported stem cell, said
Dr Sandeep Chatrath,
CEO of the hospital.
DBT research project to
curb pre-term births
DTMT NETWORK
The Department of Biotechnology decided to undertake
a multi-disciplinary research
project to predict and diagnose Pre-Term Birth (PTB)
by enhancing knowledge
about the underlying pathophysiological mechanism. It
has been decided that as an
initial step the department
will establish a hospital of a
cohort of pregnant woman.
Screening of pregnant
women will start from the
first trimester and each of
them will be followed till
delivery. Applying a crossdisciplinary approach, it has
been proposed that possible
mechanisms and outline the
etiology of PTB should be
elucidated. Whole genome
screens, study of genomics,
epigenomics and proteomics
in different time frames will
be done to access the biological risk factors and dynamic
nature of PTB.
Beside, the objective of the
research is to achieve appropriate risk stratification of
women in early pregnancy,
identify simple and better
prediction tools that will
recognize the optimal time
of prediction and clinical intervention.
Globally, PTB is the single
largest cause of neonatal
deaths. In India, of 27 million
birth cohorts born annually,
3.6 million are pre term and
over 300,000 of them die
each year.
Directive against
import of drugs with
less than 60 pc
residual shelf life
DTMT NETWORK
NEW DELHI
The Drug Controller General
of India (DCGI) has issued a
directive restraining the import of drugs having less than
60 per cent residual shelf life
unless the drug licensing authority relaxes the norm in the
case of certain drugs which it
may deem fit.
The directive reads: “No
drugs shall be imported unless
it complies with the standard
of strength, quality and purity
if any. The licensing authority
shall not allow the import of
any drug having less than 60
per cent residual shelf life period as on the date of import.”
As per the directive, the
DCGI office can consider special conditions/circumstances
under which the permission
for import with less than 60
per cent found an edge especially for charity, national
health schemes, when no substitutes are available and if the
drugs required for treatment
of disease which are specific
to be of India origin, drugs
meant for only testing and
analysis purpose, orphanage
drug for rare disease and to
control the sudden outbreak
of a disease.
DCGI cancels Novartis
registration certificate
MK SINGH
In an unprecedented move against the European
pharmaceutical giant Novartis, the Drug Controller
General of India (DCGI), Dr GN Singh cancelled the
Registration Certificate (RC) for import of Tiamulin
hydrogen Fumarate manufactured by M/S Sandoz,
Austria. Drug controller cited rule 21 of the Drugs and
Cosmetic Act 1945 for the move.
The RC number BD-394 & Import Licenses issued
under the said certificate has also been cancelled and
in this regard direction from the drug regulatory authority has been issued asking that the stocks of the
imported drugs available in the market, under the
said certificate shall be recalled with immediate effect.
The stringent move is followed by submission of a
fake document from M/s Novartis India Limited, Animal Health Business Unit, Sandoz House, Mumbai.
Along with the application, the firm has submitted
Certificate of Suitability (CEP) R1-CEP 2004-176-Rev
01 dated 25/2/2013 for the drug THF, covering a different manufacturing site namely M/S Sandoz Industrial Products SPA, Italy.
While evaluating the document, the Indian drug
authority found that the firm has submitted the same
CEP number of Austria and Italy. The matter was verified with European Directorate for the Quality Medicine (EDQM) and after an enquiry it came to light
that the documents supporting M/S Sandoz, Austria
is fake.
Draft of a very confidential order available with
DTMT says with respect to submitting fake document
with a fraudulent motive and notarization of the fake
document are concerned, the matter would be required to be investigated as per applicable law of the
land. For this purpose the matter would be referred
to the Ministry of Health and Family Welfare for their
considered opinion for taking further legal action in
the matter.
ICMR norms for medical researchers
DTMT NETWORK
Indian Council of Medical Research (ICMR), the apex research
body of the country, has issued
guidelines on code of conduct for
research scientists of life sciences.
The move is aimed at ensuring that
all research activities including
into microbial, biological agents
or toxins, irrespective of their
origin and method of production,
are meant for protective or other
peaceful purpose.
Since laboratory services are an
integral part of disease diagnosis,
treatment, response monitoring,
surveillance programme and research, it is mandatory for the personnel working in the clinical or
research laboratories to be aware
of their ethical responsibilities.
Taking cognizance of instances
where scientific discoveries across
the globe are being used for both
peaceful and destructive purposes,
the research council has stipulated
checks and balances through the
guidelines.
It is of the view that modern
technologies can be wittingly or
unwittingly used to create organisms that are more virulent, anti
biotic resistant and have greater
stability in the environment.
This advance genetic modifica-
tion can be used to facilitate the
immune response system of the
host population with an intention
to modify susceptibility to a pathogen or disrupt the normal host response.
The guidelines said that in order
to prevent the use of scientific research for purpose of bio-terrorism or bio-warfare, all persons and
institutions engaged in all aspects
of scientific research should strictly abide by this code governed by
the principle of non- maleficence,
principle of beneficence, principle of confidentiality, principle of
compliance among many.
The code of conduct lays emphasis on ethical considerations,
which is binding on all the laboratories scientists involved in scientific research concerning dangerous organisms and toxic weapons against any living being or
environment.
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Medical Paramedical
INC relaxes rules for Tibetan
nurses practicing in India
DTMT NETWORK
In a move that comes as a much
needed relief for Tibetan nurses
studying and practicing nursing in
India, the Indian Nursing Council
(INC), which had earlier issued a circular barring Tibetan nurses from
practicing in the country, has reversed its decision.
The INC has clarified that Tibetan
nurses born in India (before July 1,
1987), being citizens of the country,
can be registered to enable them to
practice their profession. The Council will verify their birth certificates
before registering them.
Earlier, in July, 2013 the council
said that Tibetans born and residing in India, being foreigners, cannot work as nurses in hospitals in
the country. It also sent a letter to
all universities and State Nursing
Councils in the country, stating Tibetans, being foreigners, cannot
work as nurses in India.
“The issue of citizenship of Tibet-
an refugees born in India has been
clarified by the Hon’ble High Court
of Delhi which has held that Tibetan
nurses born in India have to be taken
as Indian citizens,” the council explained.
INC also stated that the issue of
admission and taking up the profession of nursing for livelihood by
Tibetan refugees in the country has
engaged the attention of the council
for quite some time, keeping in view
the provisions of the Indian Nursing
Council Act 1947. There are several
Tibetans, mostly women, studying in
nursing colleges or working in various hospitals all over India.
The Government of India requires
all Tibetans born in India to be registered as foreigners even though the
country’s citizenship law states that
all persons born in the country before July 1, 1987 are citizens. In 2009,
the Delhi High Court ruled for judicial enforcement of this statutory
provision in the case of a Tibetan petitioner. It directed the Government
to issue passport to her as she was
born in India during the relevant period even though it was contended
by the state that she was already
registered as a foreigner.
However, most Tibetans born before July 1, 1987 do not possess birth
certificates and continue to be registered as foreigners with temporary,
renewable permits to remain in the
country. Hence, those seeking to
register as nurses have to follow a
cumbersome process to prove their
birth in the country to obtain the
relevant certificate.
Cough syrup as liquor sets new trend
JIVIKA MITTAL
During raids on the wholesalers and retailers of the
drugs in Ghaziabad we
checked the sale and purchase records of. On the
basis of investigation, the
license of three wholesale
pharmacists got cancelled
in the city.
Recently, a drug inspector conducted some raids
in different parts of Ghaziabad on the directions of
Food and Drugs Depart-
Draft rule on cosmetics Interview for pharmacists:
Defending the indefensible
test ban on animals
DTMT NETWORK
NEW DELHI
Union Health Ministry of
India adopted a draft rule
to prohibit the testing of
cosmetics on animals nationwide. A leading animal
welfare group, Humane
Society
International
(HSI), welcomed the draft
rule, which is the last legislative step to end this practice in India.
Be Cruelty-Free India
campaign of HSI played
a vital role in forcing the
Government to come up
with this legislation. The
campaign is now focusing
on obtaining a ban on the
import and sale of cosmetics tested on animals in
other parts of the world including India.
HSI India managing director NG Jayasimha said,
“Last year, our Be CrueltyFree India campaign was
instrumental in obtaining
a ban on animal test for
cosmetics. The Government revised the Bureau
of Indian Standards’ test
guidelines to ensure that
such tests are not carried
out in the country. But to
ensure that this test ban is
executed within the existing regulatory framework
amendment to the Drug
and Cosmetics Rules is vital.”
Pointing out that companies are still free to outsource their animal testing
to other countries and to
import their newly animaltested cosmetics and ingredients back into India,
Jayasimha said this double
standards must stop. Israel
and the 28 countries of the
European Union have already introduced an import and sales ban, India
should follow their example to be truly cruelty-free.
The Drug Technical Advisory Board has also spoken
out in favour a ban on import and sales of cosmetic
products tested on animals. The Board noted that
the Ministry of Health and
Family Welfare is already
in the process of prohibiting the use of animals in
testing of cosmetics manufactured in the country. India should therefore take a
lead in prohibiting the import of cosmetics testing in
animals also.
JIVIKA MITTAL
Even as state drug authorities keep justifying interviews for approval of manufacturing chemists there
are certain pertinent questions left unanswered on the
interview process in vogue.
DTMT had carried an article under the title: “Mfg
chemists kept on the tenterhooks” in its February issue.
In the article, the state pharma councils vehemently
defended the interview criterion saying they are crucial
in judging the efficiency of the chemists in manufacturing drugs glossing over the fact that it has no mention
in the Drugs and Cosmetics Act 1940.
As per the aforementioned Act, any graduate in
pharmacy with the stipulated 18-month experience in
manufacturing is entitled to be a manufacturing chemist and get its approval from the state drug authority
under rule 76 of the Act. In the light of the Act, are not
these drug authorities acting in an extra-constitutional
manner?
We have found that these interviews are just eyewash. If they conduct these interviews to judge the
efficiency of the person as they claim, are we to understand that all those manufacturing chemists in the
trade approved by the authorities competent enough
to carry on with the business of drug manufacturing?
Is their record without blemish?
The tradition of conducting interviews for manufacturing chemist is quite old. State drug authorities are
routinely carrying out them for long. Why the fake
drugs are occupying space on the shelves of the chemist shops? Who do they blame for this? They may argue
that those who indulge in illegal practices do so not due
of incompetence but for the lure of easy money. Is it not
the duty of the drug control authorities to see that such
unprofessional elements should not enter the field?
Can’t they eliminate them through interview process?
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ment, UP.
Deepak Sharma, Drug
Inspector,
Ghaziabad
told that during raids,
we checked the sale and
purchase records of the
wholesalers and retailers
of the drugs. On the basis
of investigation, the licence of three whole sale
pharmacists got cancelled
in the city.
In January, in Lucknow
the drug department of
UP seized the Phesyndyl Cough Syrup bottles
which was worth of rupees
20-25 lakhs. The syrup was
seized as there were no
record of sales and purchases.
“The syrup if used in
higher dose than the prescribed dose can cause the
alcoholic effect, told Sharma. According to sources,
these drugs were meant to
be supplied in the foreign
countries where the consumption of the alcohol
is banned. As legally any
drug cannot be exported
exceeding to a particular
limit. Therefore, the syrup
was kept for illegal supply.
After this, the UP FDA
ordered all the drug departments of the state
to investigate the matter
thoroughly.
Consequently,
raids
were conducted and the
license of Balaji Medical
Store, Mittal and Mittal
pharmacy and Raj Medicos were suspended for
failure to produce the sale
and purchase records.
Medical Review
6
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
ALLOW DIRECT BLOOD TRANSFUSION, SAVE RURAL LIVES
Campaign by surgeons gains momentum
MK SINGH
M
any patients in rural India
die for want of blood. These
causalities can be averted if only
blood is provided to them at an
instant at the time of emergency.
Association of Rural Surgeons
of India (ARSI) spearheaded a
campaign to save the lives of the
people living in villages across
the country.
ARSI called for legalising the
unbanked direct blood transfusion (UDBT) through an amendment in the Schedule K of the
Drugs and Cosmetics Act. This,
the association argues will
give village folks easy access
to blood and thereby help save
millions of lives in the country.
In this context, Dr Rajesh
Tongaonkar, chairman of ARSI,
wrote to the Union Health Minister, Chairman, National Human Right Commission emphasising the need for the UDBT.
In his letter, Dr Tongaonkar
pointed out that 70 per cent of
the Indian population lives in
rural areas which does not have
access to the blood banks. As per
estimation, 30 per cent of maternal mortalities occur due to
haemorrhages (bleeding) while
19 per cent deaths are due to
anaemia. Both these conditions
need immediate blood transfusion to prevent death.
Dr Tongaonkar said if the Government amends Act, it won’t be
doing so for the first time. There
is a precedence of amending the
Act to save the lives of a soldier
as the Government of India had
amended the rule in schedule
K way back in 2001 and had allowed Armed Forces Medical
Services to do what is akin to
UDBT in emergency situation.
“Is the life of rural women
or men is less precious than a
jawan?” he argued.
To buttress its argument, the
association said in certain areas
of the country there are no blood
banks. Hence, it becomes imperative on the part of the Government to legalise the UDBT in line
with the amendment it made in
the case of armed forces.
It further said that the UDBT
can be included in the healthcare facilities in rural areas or
small towns where blood banks
are not available so that blood
transfusion can be carried out in
emergency situations and surgeries. Such facility will have a
designated qualified physician
n India has only 2545 licensed blood banks most of which are in cities
n At present the D & C Act author-
izes collection of blood only by
licensed blood banks making the so called UDBT illegal
n According to WHO a country needs Dr R Tongoankar From ARSI a minimum stocks of blood equal to
1% of its population. As per WHO estimates India needs 12
million units of blood a year, but only 9 million are collected
n Earlier UDBT were allowed till 1998, but Govt amends the D & C Act to curb the HIV transfussion
and adequately trained medical
laboratory technician and will
be licensed for five years by the
state Food and Drug Administration.
UDBT is done by the designated physician himself. In this
procedure blood of a voluntary
donor is taken and after conducting all the mandatory tests,
immediate transfusion of blood
is done without storing or banking.
The mandatory tests include
blood test, cross matching, test
for HIV, hepatitis B, VDRL and
malarial parasites. These tests
can be conducted by using rapid
test kits as recommended by the
WHO.
However, despite all the efforts
of the association, UDBT has yet
to be legalised as the Government has not taken any decision
for the requisite amendment.
Moreover, the NHRC rejected
the proposal outright saying
blood transfusion in such a way
cannot be carried out as it will
dilute the investigation of HIV/
AIDS.
Beside, the National Aida Control Organisation (NACO) is also
opposed to the idea. It argued
that the move is fraught with
dangerous consequences as it
will dilute the prevailing system
which stresses the need to avoid
HIV/AIDS infection.
However, speaking to DTMT,
Dr Tongaonkar clarified that
UDBT is absolutely safe as no
HIV risks are associated with
it as we did it with all the mandatory tests. Moreover, when
it is allowed to save the Army
personnel, why then the government is not considering it
to save millions of countrymen.
Why the rural folks are left at the
mercy of the blood banks which
of which they have no access.
Claiming that Union Additional Health Secretary and Executive Director are of the view
that the UDBT will save lives in
the rural areas especially that of
the expecting mothers so also
the victims of road accidents, Dr
Tongaonkar asked why then the
NACO and Blood Transfusion
Council is opposed to it.
Dr Tongaonkar started his
campaign for UDBT in 1998 by
collecting blood from crossmatched donors in view of the
scarcity of blood banks in rural areas. After conducting the
mandatory tests, he gave it to
the patients immediately without banking or storing it.
Now, unmarried and
divorced too going for
IVF: Fertility Specialist
BS RAWAT
With Assistant reproductive technology (ART)
techniques are breaking
the social taboo divorced
and unmarried men and
women too are taking advantage of techniques. A
new variation has been
observed that older couples are also coming for
taking advantage of these
techniques. This is the observation of a well-known
fertility specialist, Dr
Anoop Gupta of Delhi IVF
Fertility Research Centre
Director.
Dr Gupta, not the only
in the country but also
abroad, treated more than
seven thousand couples
Success rate of IVF then
was Just 5 per cent. Today the success rate has
reached to 50 per cent
and such clinics have increased in number. But
they suggest that before
adopting this process couples should have a good
heart and experienced
doctor.
A senior fertility specialist of Delhi IVF Fertility Research Centre, Mrs
Alka Gupta, said, “These
days even couples who
have crossed 50-55 years
of age are coming forward
to give these techniques a
try. Earlier, people used to
give up all hope of bearing
a child after a certain age.
Rather it was expected of
Cancer: Awareness and high index Dramatic rise in
of suspicion key to early diagnosis joint replacement
BS RAWAT
NEW DELHI
The number of cancer patients in India is increasing
at an alarming pace. Annually, over 12 lakh people are
diagnosed with different
types of cancer and over
36 lakh patients are being
treated at any given time of
the year in different parts of
the country. By conservative estimates, the numbers
are expected to double in
next two decades.
Main reason for the
spurt in cancer cases is the
change in lifestyles – increasing use of tobacco,
increase in fat and caloric
consumption,
sedentary
habits, overweight, infections and change in dietary
habits. Newer causes such
as insecticides, pesticides,
immunosuppression, and
exposure to electromagnetic waves are under investigation.
Dr R Ranga Rao, senior
consultant and director,
Medical Oncology, BLK Super Speciality Hospital, New
Delhi said common cancers
in men include lung, oral
cavity, stomach and esophageal cancers and in women
cervical breast, gall bladder
cancers.
According to Dr Rao,
some major changes are being observed in the recent
years in the cancer occurrence. Firstly, more young
patients with cancers are
being diagnosed nowadays.
In India, people as young as
40 years, against 30 years
in the West, are diagnosed
with cancer. Secondly, some
types of the disease such as
lymphomas, lung, breast,
ovarian kidney, colon and
prostate cancers are surfacing more often.
Treatment of cancer
too has undergone many
changes with increase in
the rate recovery, survival
of patients with advanced
cancers. One of the important changes in the treatment is the use of person-
alised therapy according to
the type of cancers. Patients
undergoing treatment need
to educate themselves
about various options and
choose the appropriate one
after discussing with their
treating oncology centers.
About 5 per cent patients
have family history of some
cancers. Frequent checkups
and awareness can diagnose their cancers early. A
detailed discussion of the
family members with family
oncologist is encouraged.
Breast Cancer
As lifestyles change in India, an increasing number
of younger women have
become susceptible to the
breast cancer. “We see girls
as young as 18 years with
breast cancer. Due to urbanisation, lifestyle of people
has changed by 180 degrees
and the effect is visible.
While the normal age for
contracting breast cancer
was anywhere between 45
and 55 years a decade ago,
it has plunged to 35-45,”
said Dr NK Pandey, cancer
surgeon of Asian Institute
of Medical Sciences (AIMS).
According to Dr Pandey,
breast cancer today is the
most common cancer in
most Indian cities, and second most common in the
rural areas. The disease accounts for 25 to 32 per cent
of all female cancers. This
implies practically onefourth (or even approaching one thirds) of all female
cancer cases are breast cancers. In India, the average
age of developing a breast
cancer has undergone a significant shift over last few
decades.
“Breast cancer can also
be termed as a lifestyle disease.” Late marriage, fewer
children and declining
trend of breastfeeding are
some causative factors, and
all these are related to urbanisation. Obesity, which
is related to lifestyle, is another cause.” said Dr Anita
Kant, breast cancer expert
at AIIMS.
DTMT NETWORK
NEW DELHI
Osteoarthritis of the
knee and hip are one of
the five leading causes of
disability among elderly
men and women. The
risk of disability from
osteoarthritis is as great
as that from cardiovascular disease. Similar
disabilities develop with
joint degeneration from
rheumatoid, ankylosing
spondylitis and many
other causes of joint degeneration.
Orthopedic surgeons
say some problems may
affect everyday activities
such as walking, bending
and use of stairs. Pain
continues even while
resting, both day of night
and stiffness in joint limits ability to move or lift
leg.
Addressing a press
conference on February 16, Prof Surya Bhan,
Chief Joint Replacement
Surgeon of Primus Super
speciality Hospital, said
in India, over the last
few years, the volume of
joint replacement procedures has increased
dramatically due to increased level of awareness and improvement
of technologies.
Treatments of joint
and knee problems have
improved significantly
with newer therapies
and methodologies including the very exciting
biologic disease modifying drugs and procedures like arthroscopy
and joint replacements
making tremendous impact on ability to treat
various arthritis.
Joint replacement surgery is one of the most
successful procedures
in orthopaedics. Prof
Bhan, said, “a joint replacement can improve
the quality of life tremendously by making
the patient free of pain,
deformity and physical
dependence.
Married for 15 years, the couple were blessed with three girls,
Safa and Marwa and Sofia after IVF treatment.
successfully for infertility and helped them have
babies. About a thousand
of the babies born through
such techniques are twins.
“Childlessness is a major problem in countries
like India. In India growing
number of couples are unable to produce offspring
due to different medical
reasons. But thanks to ART
techniques many are now
enjoying
parenthood,”
says Dr Gupta.
Nearly 20 years ago Delhi IVF Fertility Research
Center was established in
Bengali Market in Delhi.
This technology was fairly
new then. People did not
believe then that a baby
could be born this way.
them. There are many couples who rang the whining
of children in the home
from the ART technique.”
Mrs Gupta says those
couples who fail to achieve
parenthood before 35
years of age should be
treated with this technique
for a meaningful parenthood.
Whether or not the female ovum in fertility they
are not then they are taken
away from a female donor.
Similarly, the male’s sperm
may not be weak or if their
fertility is taken from the
donor. If for medical reasons, women are not able
to conceive of such surrogacy is taken from another
woman.
Doctors say Indian men a KNOW YOUR ENEMY :
neglected lot in healthcare Greying prematurely? Find solution in your lifestyle
altering.
Noting that most national health
programmes focus mostly on comith a population of 1.3 billion, municable diseases and on children
India has just a handful of urol- and women doctors at the conferogists cater to urological needs of ence observed that men’s health
the public and men’s health remains in India has always been neglected
a neglected area even though diseas- though diseases like cancer and
es grip them two to four times more those related to heart and lifestyle
afflict them two to four times more
than women.
To address the above mentioned than women.
Over 1.3 billion Indian men are sufissues and discuss various health
programmes that can be framed in fering from kidney disorders among
this regard on a national scale, the other health issues but are unable
Urological Society of India hosted to get early and effective treatment
five-day 47th annual conference here due to dearth of urologists in India,
from January 29.
said Rajiv Sood,
The
conferhead of the urolence was attendogy department
at Ram Manohar
ed by over 3,000
Lohia hospital
urologists from
here.
across
India,
Speaking at the
SAARC
counConference, he
tries, US, Europe
said: “Till now
(UK,
France,
men’s
health
Germany
and
had no place in
Spain) and Ausnational health
tralia.
During
programmes. We
the conference
numerous im- Use of ring clamp to facilitate vasal fixation. only focused on
child and women
portant issues Courtesy : Brady Urology Foundation
health.”
of national con“We are unacern like organ
donation and urinary genital cancers ware of the fact that the average life
among others came up for discus- span of man is five years less than
sion. A pre-conference live work- women in India.
“There is fast-paced technologishop featuring robotic and laparoscopic surgeries in 3D was the high- cal advancement in urology and
there are a number of options availlight of the meet.
The focus was on the technologi- able for optimal patients’ care but
cal advances like Fusion Biopsy and they are going unnoticed for want
Photodynamic therapy for focal ab- of awareness,” added Sood, calling
lation of prostate cancer and phar- for focus on newer equipments and
macological advances in terms of drugs to cure urological problems of
newer molecules that can be disease Indian men.
DTMT NETWORK
NEW DELHI
W
T
here was a
time when
grey hair was
considered
a
sign of wisdom.
Times
have
changed. Grey
is no longer a
symbol of wisdom
and exMadhuri Shukla
perience. Now,
even youngsters as young as in
their early 20s have a grey hair
here and a grey hair there protruding from their locks. Even as
the problem is becoming more
and more common, the reasons,
causes and possible solutions of
the prematurely greying hair are
still elusive.
What Is The Source Of Hair
Colour ?
Each hair strand has a follicle that
originates under the root and the
skin of the scalp. Within the hair
follicle are cells which determine
the colour of the hair. These cells
produce colour pigment called
melanin. Once melanin cell production slows down, the colour
changes in each hair strand resulting in greying of hair.
What’s Premature Greying?
One reason for hair turning
grey is reduction in the number
of colour-producing melanin
cells. Another reason is the build
of naturally occurring hydrogen
peroxide in the hair which bleaches the colour. With advancing age,
hydrogen peroxide builds up in
large amounts in the hair follicle
and ultimately inhibits the synthesis of melanin.
Hydrogen peroxide, or H2O2,
is a by-product of a process by
which cells burn fuel for energy. Generated in small amounts
throughout the body, the chemical is normally neutralised by an
enzyme which breaks it down into
water and oxygen. With growing
age, levels of the enzyme fall and
hydrogen peroxide builds up in
the follicle.
On an average, white people
start going grey in their mid-30s,
Asians in their late 30s, and African-Americans in their mid-40s.
Around 50 per cent of all people
have a significant amount of grey
hair by the time they turn 50.
White people are considered
prematurely grey if their hair
turns grey by the age of 20, while
grey hair before the age of 30 is
premature for African-Americans.
Greying begins to get visible
when thicker darker hair-fall increases and there is an enhanced
growth of thinner white hairs. This
shedding of hair can last over a
period of few months, or in some
cases can be sudden fallout.
Moreover, greying pattern varies in men and women. In men,
it starts at the beard, then moustache, side locks and over time
spreads to other parts of the head.
For women, grey hair starts from
the temples, and then it spreads to
the sides.
Why It Happens?
Ranging from hormonal im-
balance, thyroid, malnutrition,
pernicious anemia, nutritional
deficiency such as Vitamin-12 deficiency B Vitamins, iron, copper
and iodine in daily diet, stress,
use of electric dryers and concentrated hair dyes, as well as genetic
disorders, all these factors provide causes for going grey.
What Are The Solutions?
Grey hair can be concealed in a
number of ways. Semi-permanent
ammonia-free hair colour is a
good option for those who have
just started to see grey hair. Coloured grey hair blends easily with
natural colors making your mane
look beautiful and natural. Permanent colour is recommended
for those who have 45 to 50 percent grey hair.
While greying is irreversible
in most cases, checking the right
nutrient uptake, maintaining a
proper hair and scalp hygiene and
leading a disciplined stress free
lifestyle is important to prevent
the problem from worsening.
Regular healthy diet, proper hair
and scalp hygiene and de-stressing activities are a must. Applying
bhingraj oil to the scalp, substituting coffee for green tea and eating
vegetables rich in folic acid, iron,
vitamin D and vitamin B complex
have been proven to be beneficial.
The rejuvenating effect of yoga
on the mind and body is well
known, but many are not aware
of the fact that practicing yoga
asanas on a daily basis has wonderful effect on hair, especially if
greying is due to stress. Routine
practice of the inverted postures
of yoga helps increase the blood
circulation to the scalp and reduce greying. Some of these postures are Sirshasana (Headstand),
Sarvangasana (Shoulder Stand),
Halasana (Plough Pose) and Adho
Mukha Vrksasana (Handstand).
However, it is important to not
over do these yoga postures and
practice them within limits.
Breathing exercises such as Pranayam involving alternate breathing from each nostril helps in
maintaining a steady flow of oxygen in the upper part of the body,
hence increasing the amount of
blood flow to the melanin producing cells and taking good care of
your long healthy locks.
Finally follow your granny’s advice, eat lots of Indian gooseberries (amla) as they stimulate hair
growth and quality, maintain a
good hair care regime and flaunt
your healthy, shiny, thick and dark
locks!
nBusting Myths
w Popular belief: If you find a grey hair, do not pluck it as many more greys will grow in its place.
w What science say: Plucking the hair will indeed get rid of the grey hair, but only tempo
rarily. As the hair follicle is still alive and it will produce another hair to replace the one that was pulled out, how
ever, it has no effect on its neighbors.
Medical Voice
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Bronchial asthma – chronic, but complex disease
FROM THE EDITOR’S DESK
Knee-jerk action set a dangerous precedent
Asthma being a complex disease needs to be handled with the utmost sensitivity. Awareness of
patient and involvement of doctor are crucial for treatment, contends Dr Abhishek Kumar
Medicos could have been brought around
The high drama that culminated into a deadlock between medicos
and the Central Government in Delhi held the medical system in
the National Capital to ransom for some breathtaking moments
that lasted for a few days. It all started with the threat of medical students and senior resident doctors of city’s top hospitals to
go on an indefinite strike. The episode ended in an anti-climax
when the medicos called off their agitation after an assurance
from Union Health Minister Ghulam Nabi Azad that there was no
proposal to extend the duration of MBBS Course, a demand that
was agitating medical students for quite some time now.
Earlier, doctors from AIIMS, GTB hospital, Safdarjung hospital, Maulana Azad Medical College (MAMC), Lady Hardinge Medical College, Deen Dayal Upadhyaya and
RML hospital and medical students had demonstrated outside the Health Ministry
headquarters at Nirman Bhavan, demanding revision of the proposed MBBS course
structure. True, the strike had led to the closure of OPDs in many of the hospitals,
causing distress to the patients. But the Government did not even once tried to bring
the agitating medicos around through dialogue and reason.
As always it was the Government to blink first much to the chagrin of the entire nation. The Government, in fact, conceded much more than the agitators had bargained
for, that too, without much ado. There is no point arguing who was right and who was
wrong in the entire episode. But one thing is clear, the Government ended up a loser.
A release issued by the Health Ministry soon after resolution of the issue was drafted
in a way to give an impression that the decision was not taken under any pressure
and was followed by much deliberation but the facts were otherwise. It read: “He
(Azad) listened to all their (the medicos’) concerns patiently and allayed their fears
regarding Medical Council of India (MCI) Notification in respect of one year mandatory rural posting of PHC after completion of MBBS, before they seek admission to
PG Course. The minister has directed concerned officials of the Ministry to keep the
Notification in abeyance.”
As far as the nation’s memory goes, mandatory rural posting for medicos has been a
commitment of the UPA Government led by the Congress. Why this turnaround now?
As a vast majority of people living in villages across the nation are deprived of basic
medical facilities, the Government had taken a decision to reach out to them with
medical services.
Mandatory rural posting of medical graduates was seen as precious first step in this
direction. If the Government had tried it could have succeeded in convincing the defiant medicos. By reversing its own decision, it might have bought peace with them
for now but has lost its core constituency – the villagers – who have missed one last
chance to get access to healthcare. This pusillanimous approach on the part of the
administration is fraught with dangerous consequences. If it is doctors this time, it
will be some other professionals next time around. If it goes on to concede to the
whims of some group or the other holding the system to ransom, it will create a dangerous precedent which our democracy will ill afford.
If people let the government decide what
foods they eat and what medicines they
take, their bodies will soon be in as sorry a
state as the souls who live under tyranny.
“
— Thomas Jefferson
W
hen people talk about
bronchial asthma, what
they really mean is asthma, a
chronic inflammatory disease of
the airways that causes periodic
“attacks” of coughing, wheezing,
shortness of breath, and chest
tightness. Asthma is a common
chronic disease worldwide. It is
one of the most common chronic but noninfectious diseases
that afflict childhood.
The prevalence of the disease
in adult population is 2.5 per
cent or more. In children its
prevalence is higher exceeding
5 per cent. The patho-physiology of asthma is complex as it
involves airway inflammation,
intermittent airflow obstruction,
and bronchial hyper-responsiveness.
Most types of asthma are
linked to allergies. If you have
allergic asthma, learning how to
avoid your allergy triggers is a
big part of staying well. In people
with allergic asthma, the muscles around their airways begin
to tighten. The airways themselves also become inflamed and
flooded with mucus. The symptoms of allergic asthma are generally the same as those of nonallergic asthma.
Allergens you inhale are most
likely to worsen your allergic
asthma. Some common allergens
are pollen from trees and grass,
mold, animal dander (from hair,
skin, or feathers) and saliva, dust
mites and cockroaches. People
may also have allergic reactions
if they touch or eat allergens
but this type of exposure rarely
causes asthma symptoms. Some
irritants can also trigger an
asthma attack, even though they
don’t cause an allergic reaction.
Tobacco smoke, air pollution,
cold air, strong chemical odors
like perfumes or other scented
products, intense emotions may
precipitate asthma attack.
What patients should do?
w Avoid asthma triggers:
When pollen counts are high,
stay inside as much as possible
in order to keep dust mites out,
wrap your pillows, mattress, and
If you have allergic asthma, learning how to avoid your allergy
triggers is a big part of staying well. The airways themselves also
become inflamed and flooded with mucus. The symptoms of allergic
asthma are generally the same as those of non-allergic asthma
box spring in allergen-proof
covers. If your child has allergic asthma, only buy washable
stuffed animals. Remove wallto-wall carpeting, if possible.
If moisture is a problem in
your home, get a dehumidifier
to cut down on mold. Repair any
plumbing leaks. If you have pets,
keep them out of the bedroom.
Keep your kitchen and bathroom very clean to avoid mold
and cockroaches. Change your
work place if possible.
w Recognise asthma attack
The most common symptoms
of an attack include: symptoms
that keep getting worse, even
with treatment like not able to
complete a sentence, tightness
in the chest, flaring your nostrils as you breathe, sucking
in your chest or stomach with
each breath, difficulty walking,
the dose of your daily maintenance therapy to help control
your asthma.
w Self-care and optimal therapy
For optimal asthma relief, it
is important to participate in
your care. With the help of your
healthcare provider, you can get
the best asthma relief by checking your peak flow and developing an asthma action plan. Keeping an asthma diary, avoiding
asthma triggers, and learning
ways to manage stress are important tools for better management.
So, pay attention to your asthma symptoms. You may notice a
pattern that can help guide you.
Knowing your personal signs of
asthma allows you to take action
early, reducing the severity of
your asthma attacks.
What physicians should do?
In a country like India where
health expenditures are not covered by government, we need
to educate the patients about
management of chronic disease
like asthma. Physician should
get involved with the patient to
know his or her lifestyle, work,
socio-economic status and affordability of medications. Only
prescribing medications are not
sufficient. Despite a good advice
patients keep coming with same
symptoms.
A number of medications may
be needed for control of symptoms leading to poor compliance. Minimum medications
should be prescribed, importance and specific use of tablets/
inhalers to be stressed. Patients
should understand importance
of each and every component of
treatment.
Main problem with inhaler is
that the patients do not understand how to use it. It costs a
lot especially latest long acting
drugs. In dedicated clinics, doctors should pay time to demonstrate inhaler technique: individual and group demonstrations
are needed. This avoids wastage
of drugs, ensures better drug delivery leading to better control of
symptoms.
These steps lead to active involvement of patients in their
disease management, stimulate
them to take medications regularly and increase their confidence and, of course, give satisfaction to clinician.
(The author is senior resident doctor
at Lady Hardinge Medical College)
Carlos Juan Finlay
Alexander A. Maximow
Discovered yellow fever. Born on December 3,
1833 in Cuba, Carlos attended the Jefferson Medical College in Philadelphia, Pennsylvania and
later studied in Havana and Paris. He started practicing medicine in Havana and began researching on the cause of yellow fever during the 1870s.
He discovered how yellow fever gets transmitted,
via mosquitoes and not through humans.
The discovery of stem cells is largely credited to Alexander A. Maximow. He was a Russian-American physician, biologist and scientist. Born on January 22, 1874
in Russia, Maximow studied in Germany and America
and obtained an M.D. from the Imperial Military Academy in St. Petersburg. Alexander A. Maximow developed
the theory that all cells come from the same precursor
cell, which he later called as stem cells.
PERSONALITY OF THE MONTH
‘Challenges and changes give me a high‘
It is a contrast that strikes everyone. Dr Suversha
Khanna, who happens to be a qualified paediatrician,
is, in fact, president of the Dharamshila Cancer
Foundation and Research Centre. Her transition
from a paediatrician to a crusader against the cancer
is followed by the sad demise of her father who was
diagnosed with prostate cancer at stage four. Noticing
that there was dearth of treatment for cancer in the
country, she decided to do something to ensure that
in future nobody suffers the way her father did. Dr
Khanna wanted to change the treatment situation in India and has successfully
established the largest cancer hospital in North India.
In the beginning, she faced many impediments; financial crisis being prominent
among them. She took it as a challenge. Through grit and determination she
could be able to make her dream come true. Her family and friends were her
strength stood by her through thick and thin. She went ahead and registered an
NGO with an objective of starting 300 beds with state-of-the-art comprehensive
cancer care and research centre in Delhi.
To live her dream she had to make many sacrifices. She had to give up her
practice of almost 25 year and sell her family assets to fund the project. In an
informal conversation with Maharishi Kant Singh, Dr Khanna spoke about her
achievements and goals in life.
Drug Today Medical Times: Tell us
something about your childhood.
Dr Survesha Khanna: Very happy,
balanced and enjoyable childhood,
except that to fulfill my dream of
becoming a doctor I had to work a lot
to convince my parents to put me in a
medical college.
DTMT: If not a doctor what would you
have been?
DSK: I have been a totally focused
person from my childhood. I set my
goals very clearly and work hard to
achieve those goals. There was no
question of not becoming a doctor.
DTMT: Do you regret leaving practice
as a paediatrician for almost 25 years,
if not why?
DSK: One regrets leaving old work if
he/she is not enjoying new ventures,
or is not able to achieve the set
goals. Accepting challenges and
changes gives me a high, which I
enjoy. Completion of BMT project has
really made me extremely happy and
therefore question of regretting does
not arise.
DTMT: From pediatrician to president
of leading cancer institute, how did
you mange this transition without
technical know-how and managerial
skills?
DSK: “Technical know-how” has to be
learnt every day because technology
keeps on changing very fast. If one is
bluish or grayish tinge to your
lips or fingernails usually in the
background of running or stuffy
nose, sore throat, and other allergic or cold symptoms.
Now, what should you do if
you have any of these asthma
warning signs? Take two puffs
of quick relief inhaler medication; repeat it two to three times
if needed. If your symptoms are
not controlled; consult your
physician immediately. Your
doctor may also need to change
History makers
Quote of the month
“
7
passionate about anything, one has to
pursue every possible tool of learning
with firm commitment and hard work.
That is exactly what I did.
Managerial skills: Since I come
from a business family, I had been
imbibing general managerial skills
from my father, uncles and brothers.
But at hospital one requires special
managerial skills which I kept on
learning every day. In spite of all this,
every day there are new managerial
challenges and one has no choice but
to learn skills for managing crisis by
attending conferences, workshop etc
on managerial skills.
DTMT: Five years down the line
where do you see your cancer
institute?
DSK: In the next five years,
Dharamshila should change the
oncology scene in India by:
nBecoming a national leader in
blood and marrow stem cell transplantation by saving
500-1000 precious lives that are
being lost due to lack to fully
matched HLA donors
n Downgrading cancer staging by early detection and prompt
treatment
n Improving 10 years cancer survival rates by optimum and high quality treatment
n Decreasing morbidity and mortality rates of cancer.
DTMT: North India’s largest cancer
institute: in which parameters,
infrastructure or service to the
patient?
DSK: We have 300 including 21
BMT beds Equipment: we have the
maximum number of state-of-the-art
equipment in each department for
diagnosing cancer, finding out stage of
cancer and treating cancer with world
class technology.
Expertise: we have maximum
number of oncologists and all
the other allied specialists to
manage associated problems of
cancer patients e.g. dental, ENT,
neurological, hypertension , diabetes,
kidney, liver, orthopedic, Gynae,
Psychiatric, Psychoogical, speech and
rehablitaiton.
Systems and standards: Dharamshila
Hospital and Research Centre is
India’s first cancer hospital accredited
by NABH, NABL and ISO TUV
NORD for implementing integrated
quality, safety and environmental
management systems and standards.
Care and service: We have thousands
of satisfied patients who love us for
compassionate care, ethical practices
and transparent billing.
Survival: In cancer five years survival
and 10 years survival after treatment
is the bench mark for different types
of cancers and their stage.
Prevention can be primary, secondary
and tertiary. In primary we organise
almost 15 awareness lecture per
annum in Delhi/NCR, educate people
through our website to make them
know the risk factors, warning signs
of cancer. Beside this we also educate
for healthy lifestyle and fro self
examination for diagnosing cancer
at an early stage. In secondary we
provide subsidized cancer check up,
offering free cancer check up for the
poor. In tertiary care we put all our
efforts to save the patients.
DTMT: Tell us something about the
efforts that your centre puts in to
save the patient at the last stage of the
disease?
DSK: It is not possible to cure patients
of last stages but it is possible to add
quality to their lives by providing
palliative care or symptomatic relief.
Depending on the specific problems
of patients we go out of the way in
providing palliative care by giving
pain relief, e.g., oral morphine, nerve
block: CARM guided, US guided
and by continuous spinal analgesia
inaccute or chronic pain. Besides, we
go for Palliative surgery, Palliative
radiation and Palliative chemotherapy.
DTMT: Three things that make you
smile?
DSK: Achieving my goals
nA thankful patient who has become disease-free
n A successful cancer surgery which was highly challenging
n A smiling, kicking, cooing baby, lush mountains, lakes, sea, rivers and musical dance of pines and wind in hills
DTMT: Your suggestions to the young
oncologists?
DSK: Treat every cancer patient like
your own kith and kin
Avoid unnecessary procedures, drugs
and hospitalisation.
Become patient centric and stop being
self centered.
Be a friend, philosopher and guide for
the teammates in real sense, ensuring
their growth and development.
Become excellent role models for
others with ethical work practices.
RAPID FIRE
BORN ON
16th June, 1945
PLACE OF BIRTH
Lahore
HOBBY
Music and climbing
mountains
FAV DISH
Peas Pulao
FAV HOLIDAY DESTINATION
Kashmir and Europe
ALL-TIME FAV READ
Geeta, Upanishads
Readers are welcome to write to us on any health and
medicine related issue. We will be glad to publish the
same on merit after suitable editing.
You may email us at —
[email protected]
Visit us at drugtodayonline.com
LETTERS TO THE EDITOR
Interview for pharmacists is a dilatory tactic
Sir,
Apropos the news item under the title ‘Mfg chemist kept
on the tenterhooks’ (DTMT, February 2014), I congratulate DTMT for raising a vital issue. There is no reason why
there should be any interview for manufacturing chemist
prior to their approval when the law sanctions none. Those
who insist on it are behaving like extra-constitutional authority.
The contention of the drug control authorities that the interviews are crucial in ensuring merit in the profession is
untenable. The delaying tactics most bureaucrats adopt to
deprive the citizens what is rightfully due to them is guided
by anything but virtuous. And this is also a fact that most
of them use this excuse to hide their ulterior motive.
Inderjeet Singh, Pharmacist, Haryana
Let the Govt come up with alternative to quackery
Sir,
Your editorial ‘Overhaul healthcare system’ (February
2014) was thought-provoking. I congratulate DTMT to
bring such an important issue related to public health out
into the public domain.
Those who are at the helm of the country’s governance
should not behave like dog in the manger. While they have
long abdicated from their responsibility towards the poor
and underprivileged, they seem to have decided not to allow others to do something to serve their interest.
Granted, the quacks who treat the poor are not qualified
enough to take precautions to treat them safely. What better option they have other than this. Does the administration have an alternative for them? Unless it has one, it
should refrain from upsetting the applecart.
Preeti Srivastava, Delhi
Innovation keeps readers’ interest intact
Sir
DTMT is growing rich in both quality and content. Every
month, DTMT comes up with newer and little known facts
about medicine and healthcare. This saves the paper from
becoming monotonous and the reader’s interest secure.
The service you and your team have been rendering on humanity through this noble venture is praiseworthy. I wish
you all the success. Keep it up.
Somesh Kumar, Pune
Medical Nation
8
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Island of poverty and disease amidst opulence of city life
A woman standing in front of her dilapidated house. (Inset) garbage strewn all around
here alongside others. Well
said, misery is great equaliser.
Not a single clinic exists in
the entire area to cater to the
healthcare needs of the poor
inhabitants. There is no water
connection from any source
including corporation water.
Whatever little water is supplied, it is through a mosque
borewell. Only 166 houses
have toilet facility.
Many houses here do not
have power connection. Residents don’t possess ration or
voter ID cards leave alone Aad-
har cards
or
bank
accounts in
their name. Social security scheme
of the Government like widow
pension, old-age pension etc.
does not reach many of the in-
Early test to cut death risk in Oral cancer
JIVKA MITTAL
Cancer is the second leading cause of death worldwide. It is really shocking
that 86 per cent of all oral
cancer cases, reported
worldwide are, take place
in India. Currently over
23 per cent of all recorded
cancer deaths in India are
from oral cancer.
The high mortality rate
from oral cancer is due
to several factors, but undoubtedly, the most significant is delayed diagnosis.
According to experts the
survival and cure rate can
significantly increase if
oral cancer can be detected in its pre-cancerous or
early disease stages.
To salvage the situation,
Virtus Health Services India (VHSI) launched the
O-Test in India, which is
a non-invasive, highly affordable early stage detection test for oral cancer.
The O-Test is supported
by Virtus’ highly advanced
automated screening software.
This software designed
by senior pathologists
and applied to the entire
process right from case
history to medical examination and microscopic
slide viewing, offers higher
accuracy and speed of results generation.
Mr Sunil Ikhe, Opera-
tions Director and Country
Head, VHSI said, “Given
the significant morbidity
and mortality associated
with advance stage oral
cancer, there has been a
compelling need to provide doctors with an accurate and easy access diagnostic technique for early
detection of oral cancer or
even identity those at high
risk. The O Test addresses
this critical requirement
at costs highly affordable
and accessible to all sections of society.”
The O-test has already
been run on a pilot basis
as an internal employee
health benefit with some
prominent corporates in
India such as Edelweiss
and Just Dial. In the roll
out phase, a total of over
600 employees have been
administered the O-Test.
The globally widely accepted O-Test is expected
to significantly reduce the
rate of morbidity and mortality from oral cancer.
The O-Test, a screening
of the oral cavity works on
two principles. The first is
a five minute visual examination of Oral Cavity and
identification of susceptible areas, if any which is
conducted by qualified
dental medical professionals. This is followed by the
brush test, a non-invasive,
painless, bloodless procedure which does not need
local anaesthesia.
The cells acquired on
the brush are transferred
to a microscopic slide for
staining which is further
analysed for cell abnormalities using the technical method. If any legions
found suspicious or the
cells are detected abnormal, the further tests are
advised.
habitants as most of them do
not have any proof of identification whatsoever.
As for educational profile of
the area, of the 272 children in
the age group of 3-6 years,
only 83 go to school
and 189 are either
dropouts
or
have never
been
to
school at
all. Children in
the age
group of
7-18 years
numbering 728 of
whom less
than 50 per
cent i.e. 340 go
to school. There is
not a single graduate
or postgraduate in the entire area. However, 18 children
have completed their Pre-University Course (PUC) and 39
SSLC. Only seven children are
pursuing their religious studies in Madrasas.
There are many factors responsible for backwardness of
this area. What is intriguing is
that the local municipality too
turns a blind eye to the civic
woes of the residents. This is
one of the slums of the city
where unauthorised occupants
are staying since ages.
Politicians are not interested
in improving their lot simply
because they have a state in
their backwardness. They think
as wretched of the society they
serve them better as vote bank
at the time of elections. The
living conditions here are so
dismal that even access to basic amenities is not available
to them. Since the roads are
either so narrow or in such dilapidated condition that no vehicle, not even a two-wheeler,
can enter the locality after a
certain point.
Family keeps Nepalese man in chains
DTMT NETWORK
KANCHANPUR
It may sound strange, but
it’s true. An apparently
mentally ill man is kept
in chains for the past 48
years in Malka Badayat of
Shreepur VDC-6, southern
part of the district. Kept in
a solitary confinement, the
man in his seventies has
been deprived of treatment
and is forced to live a hellish life due to poverty and
lack of awareness.
Badayat’s family decided to put him in chains
in 1966 when he started
behaving abnormally. For
the purpose, they built a
small hut (which itself is
an incomplete structure)
for him near the house. The
hut cannot protect Badayat
from rain and cold as it is
open on all four sides and
even mosquito bites.
Badayat was taken to a
local health institute and
even to a hospital in India
for treatment in the initial
stages of the illness, according to his nephew Rajaram. He was brought back
home following some improvement after one-anda-half month treatment.
“But the problem persisted and we could not take
him to hospital for further
treatment. Rs 48,000 was
spent on uncle´s treatment
at that time,” he added.
While some times Badayat expresses pain and sor-
row by crying, at others he
digs the earth with the help
his nails. Once he even attempted to break the chain.
Although married early,
he has no children and his
spouse, who was caring for
her helpless husband since
he was put in chains, died
around
one-and-a-half
year back. Since then his
nephew Rajaram is looking
after him.
Of late, he has lost his
appetite, according to his
neighbour Ganesh Rana.
He complained that Badayat’s family visited local shamans for the treatment of
ailing their member rather
than a doctor which led
to the deterioration of his
health.
DTMT NETWORK
CHENNAI
The Indian Institute of Technology-Madras (IIT-M) has announced setting up of a cancer
tissue bio-bank, a first-of-its-kind
community-based venture. At a
press briefing here, IIT-M director
Bhaskar Ramamurthi said the tissue bio-bank was a collaborative
effort between the Department
of Science and Technology (DST)
of the Government of India, and
IIT-M.
The DST had awarded 27.81 crore
towards the establishment of the
facility in IIT-M and the project
would be spearheaded by Professor S Mahalingam of the Department of Biotechnology.
According to Bhaskar, the project
was aimed at attracting voluntary
contribution of cancer tissues by
individual patients and doctors/
institutions.
Such type of indigenous research
was mandatory for progress in advancement of cancer therapeutics
for the community. The community-based venture would help to
reflect on cancer incidence, diagnostics and treatment outcomes,
he said.
The director also added that
Research institutions/organisations with appropriate regulatory
approval may have an access to the stored tissue samples with an aim
to identify suitable drug targets and biomarkers
IIT-M initiated the biobanking
process with Cancer Research and
Relief Trust (CRRT), Chennai, and
aimed to collaborate with various institutions/organisations to
encourage voluntary donation of
cancer tissues by patients.
“Measures will be put in place for
appropriate collection, transport
and storage of such tissues in the
centralised tissue bank, which will
be located within the IIT-M premises,” he said.
Research institutions/organisa-
tions with appropriate regulatory
approval may have an access to
the stored tissue samples with an
aim to identify suitable drug targets and biomarkers.
“This is aimed at discovering
‘personalised treatment’ with less
side-effects, early detection and
prevention of cancer,” Bhaskar
said.
Besides a complementary funding of 3.9 crore, IIT-M will also provide 10,000 sq ft of space for the
biobank with required storage and
security facilities. It will have infrastructure to accommodate 25,000
cancer tissue samples initially over
a period of five years.
Super-resolution imaging system, cell sorting facility and next
generation sequencing facilities would also be housed in the
biobank.
Further, IIT-M would be involved
in training, education and research
of the next-generation biobanking
process, said Bhaskar. Upon standardising the system and process
within the central facility at Chennai, the process would be duplicated at nodal stations in peripheral
areas, he added.
The director also said that an ‘International Conference on Cancer
Biology: Molecular Mechanisms
and Novel Therapeutics’ - Cancercon 2014 - would be held at IITMadras from January 30 to February 1.
The three-day meet is being organised jointly by the Biotechnology Department of IIT-Madras and
the Cancer Research and Relief
Trust (CRRT), Chennai. Around
500 delegates from across the
globe, including the US, UK, Belgium, Sweden, Germany, Australia
and Singapore, are expected to attend the meet.
medical test nears ends
DTMT NETWORK
MUMBAI
A four-year legal battle for gender-sensitive
examination protocols
in sexual assault cases
is at the final stage. A
judgment is awaited after the Nagpur Bench of
the Bombay High Court
concluded hearing into
a PIL and an accompanying intervention application.
Sangeeta Rege of the
Mumbai-based Cehat,
who had intervened in
the original public interest litigation filed by
Dr Ranjana Pradhi in
2010, said that on January 29, when the matter
last came up and closed
for judgment, the court
asked the state to implement the protocols.
The Centre for Enquiry into Health and
Allied Themes (Cehat)
had argued that the
protocols and the pro
forma for forensic ex-
amination of a rape
survivor have certain
lacunae. It intervened
in the PIL through the
Lawyers
Collective,
seeking gender-sensitive protocols for rape
examination and right
to healthcare to survivors.
Cehat objected to the
focus on the height and
weight of a survivor, the
past status of her hymen and commenting
on the elasticity of the
vagina and the anus.
“These points are biased against women,
irrelevant and unscientific,” it said.
The NGO argued that
the definition of “rape”
itself had been changed
by the Criminal Law
(Amendment) Act, 2013,
and now covers nonpenile sexual assault
that may not result in
injuries. Often there
are no injuries found
in rape cases too, the
court was told.
H IN
D IA
IIT-Madras sets up bank for cancer tissues Battle for sensitive rape
T
National Centre for Research
and Development (NCRD), an
NGO, zeroes in on the most
backward areas in a select
city, district or block consisting of around 500-600 houses
to carry on with its social activities. Recently, the NGO has
chosen Devara Jeevanahalli as
focus of its activities among
several backward areas of the
city.
Given the pathetic infrastructure, subhuman living
conditions and the civic mess
the locality present, DJ Halli
seems to be the right choice
for NCRD’s activities. Most of
the residents in DJ Halli are
underprivileged and hence
lead a life of penury with meagre resources, barely enough
to make both ends meet. The
irony is that the locality is surrounded by up-market Banga-
lore suburbs which are home
to rich and the elite of the city
– truly an island of poverty and
destitution amidst opulence of
urban life.
NCRD classified DJ Halli
into 12 parts, each consisting
of 50,000-60,000 households
for its activities. The major
problems the residents of this
area are facing include chronic
illness and physical handicap.
Oldage, widowhood, damaged
houses etc.
With a population of just
2,683, the locality has a large
chunk of people suffering
from heart diseases, TB, cancer, asthma, diabetes, hyper
tension, skin diseases, leprosy,
deafness, kidney, abdominal
ailments and other health related problems. The positive
aspect of this locality is that
even people affected by leprosy, generally made to live
in segregation due to age-old
myths against the disease, live
SO U
S AFSHAN AZHAR
BANGALORE
“An
analysis of case records
of 100 rape survivors brought to three
Mumbai-based public
hospitals showed that
50 per cent survivors
reaching the hospitals
were children and they
did not exhibit injuries.
This was also seen with
adult women survivors who have reached
hospitals within 24 to
48 hours,” said Rege,
adding that the World
Health Organisation,
too, had noted that only
a third of sexual assault
cases display any injuries.
“It is, therefore, critical that damaging indicators such as height
and weight, and status
of hymen (of survivors)
be replaced with a gender-sensitive protocol
for sexual assault examination at the level
of hospitals,” a Cehat
statement said.
Now, quit-line for addicts to rub Vani Vilas – a boon for the underprivileged
off the habit of tobacco
DTMT NETWORK
VISAKHAPATNAM
A group of dentists and patients have joined hands
under Tobacco Intervention
Initiative (TII) in collaboration with the Indian Dental
Association (IDA) to launch
a toll-free helpline called
quit-line for counselling tobacco users on phone.
Dentists are now increasingly donning the role of anti-tobacco counsellors while
treating patients addicted to
cigarette and other tobacco
products. Apart from six TII
centres in Hyderabad, IDA is
planning to train more dentists and open more centres
across the state, including
the coastal region.
The tobacco-user can call
the quit-line number for
free personal counselling in
any regional language. Call-
ers receive counselling from
trained tobacco cessation
experts, who also give advice on medication to help
fight withdrawal symptoms.
The Tobacco Intervention
Initiative (TII) is a professionally-led ‘call to action’
programme to eradicate tobacco addiction while striving for a tobacco free India
and thus improving the oral
health of Indians by the year
2020.
Tobacco causes significant changes in a person’s
mouth and counseling is
the first step on the road to
quitting. Counseling reveals
the deleterious effects of
continued tobacco use. The
dental community is the
first line of defense in early
detection of the disease and
risk factors associated with
oral cancer. Oral health
awareness and tobacco ad-
diction prevention should
be promoted more and
more.
Patients with tooth problems are identified with
the tobacco-related cases,
which are usually marked
by blackened teeth, nicotine
patches, loosening of teeth
and gum problems.
Doctors prescribe medicines and also counsel the
patients based on their tobacco smoking or chewing habits, age, profession,
whether they are social
smokers or addicted to tobacco.
However, the government
needs to be more proactive
in dealing with tobacco addiction and not give in to
the lobbying of tobacco
companies. More TII centres should be set up in
other parts of the country
as well.
S AFSHAN AZHAR
BANGALORE
Located at the center of
the Garden City of India, Vani Vilas Hospital
is part of its rich heritage. Founded in the year
1935, the hospital, meant
for women and children,
is run by the state Government. This hospital
has two departments viz.
Obstetrics and Gynecology and Pediatrics.
The Central and state
governments have provided various schemes
for the convenience of
the patients. Under the
Central
Government,
the
‘Pradhanamantri
Swastya surakhsha Yojana’ scheme was launched
which aims at correcting the imbalances in the
availability of affordable
healthcare facilities.
On the other hand
the state Government
provides Janani Shishu
Suraksha Yojane, under
which all the deliveries
including under Cesarean Section are conducted free of cost. Yeshaswini Yojane provides free
gaynaecological advice
and treatment till delivery.
Speaking to DTMT, the
Medical Superintendent
of the hospital, Dr Some
Gowda, MD, DGO, said
that the hospital is one of
its kind, where deliveries
and neonatal care is free
of charge to all patients.
Of the 536 beds 420 belong to the maternity
section, 80 to the pediatrics and the remaining 36
to the pediatric surgery.
Forty to fifty deliveries
take place here on a daily
basis.
Majority of the patients here belong to ei-
ther middle class or poor
families. There is a facility for special ward at a
reasonable fee. However,
deliveries and medicines
are provided free of
charge. All the neonates
born in the hospital are
given free treatment up
to one year.
Dr Gowda brought
about positive changes
in the hospital such as
a musical centre which
provides music therapy
to the pregnant ladies.
The hospital introduced
a special ward for children suffering with Marasmus, a first in the state.
“Now, use of Yeshaswini and BPL cards has
come down because
we are providing free
service to all would be
mothers. There is another scheme, the Vajpayee
scheme, under which
cancer patients and other surgeries like babies
born with abnormalities,
heart, brain, abdominal
problems which may require higher surgery are
also done free of cost. In
all cases, laparoscopic
method of surgery is
used,” said Dr Gowda.
“We are the first in Karnataka to introduce removal of uterus through
laparoscope. Advanced
surgeries like urogynaechology are also being
done here instead of referring them to higher
centres. ‘Malignant’-cancer cases are also operated upon, here,” he added.
DTMT caught up with
Dr Sudha, a gynaecologist at the hospital, for
her views. She felt there
was a scope for more facilities from the government because the flow of
patients is large. Airing
similar view, one of her
colleagues, Dr Rashmi
said, “We are doing our
best to serve the patients.
But, there is still much
more to be improved
due to shortage of man
power.”
The common refrain
among the patients is
that the doctors here are
found to be quite caring.
While they feel there is
much to be desired by
way of facilities, the nononsense and diligent
service of doctors make
up for this deficiency.
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Medical Nation
9
Watch out on your alcohol intake AORTIC COARCTATION
The heart disease that
to keep up the festive spirit
comes without warning
I
t’s that time of the year when
people generally lower their
guard to enjoy the season of festival. You too must be looking
forward to have a rollicking time
gulping as much of alcoholic beverages as you can. But you need to
take a look at your levels of alcohol intake this Holi to minimise
the effects it could have on your
health.
Of course, you can enjoy the
pleasure of drinks with friends.
But it’s best to reduce your alcohol intake if you want to fend
off its deleterious effects on the
body.
Apart from partying, you may
look at the times you consume
alcoholic beverages such as
your weekly ‘happy hour’ or just
taking a couple drinks at home to
reduce stress.
It’s said that moderate drinking
may be healthy, but that doesn’t
apply for everyone. For women, it
is up to one drink per day; for men,
up to two drinks per day. However, each person must weigh the
benefits and risks of consuming
alcohol.
So, even if you go to an event,
with beverages that are on the
house or part of what you pay for
at an all-inclusive party, you must
make a decision to arrive home
alive by drinking responsibly, especially if you are driving.
Alcohol creates health problems
for irresponsible drinkers. This
is why it is important to drink responsibly to prevent the problem
of alcoholic addiction, which can
harm relationships.
The long time effects range from
possible health benefits for low
levels of alcohol consumption to
severe effects in cases of chronic
alcohol abuse
Psychiatric disorders associated with alcoholism include major depression, mania, phobias, suicide
and panic disorders.
Teen drinking: Adolescents
who tend to drink excessively
at parties and nightclubs may
place themselves at risk for
slower brain development
and increased risk of alcohol
abuse.
Some experts argue that the
benefits of moderate alcohol
consumption may be outweighed by other increased
risks, including injuries and
acts of violence. Excessive
consumption of alcohol is
one of the leading
preventable
causes of death.
According to the
British Medical Journal,
The Lancet, one in 25 deaths
around the world is caused by
alcohol consumption. Alcohol
is now as damaging to global
health as tobacco was a decade ago.
Beware of unfamiliar drinks.
Such drinks as zombies and
other fruit and rum drinks can
be deceiving, as the alcohol is
not always detectable, and it
is difficult to space them out.
Remember that alcohol is
still the No. 1 date-rape substance. When you drink that,
you are out of control, putting yourself at risk of
DTMT NETWORK
KOLKATA
Researchers from Netaji
Subhash Chandra Bose
Cancer Research Institute
(NCRI), Kolkata, have found
sojne danta (moringa oliefera), popularly known
as drumsticks, has the potential to cure breast and
ovarian cancer. They have
discovered that there are
certain compounds in the
vegetable that can inhibit
cancer cells and cause their
programmed death.
“We were experimenting
with various plants when
we came across the moringa
root. It has two interesting
compounds – glucosinolate
and bengyl isothiosyonate
– that kill breast cancer
cell lines. It works under a
mechanism that is called
apoptosis and results in
programmed cell death. It is
effective in case of ovarian
cancer as well,” said clinical scientist Chinmay Bose,
head of the research.
Ovarian and breast cancer are caused by the hyper
functioning of estrogen hormone. The moringa compounds have been found to
inhibit estrogen biochemically.
“These compounds while
“Glucosinolate and
bengyl isothiosyonate in
drumstick work under a
mechanism that is called
apoptosis and results
in programmed cell
death in breast as well
as ovarian cancer”
on the one hand control estrogen, kill cancer cells on
the other. The moringa root
has got more compounds
that have yet to be identified which might have more
properties that could help
treat the disease more effectively,” said Bose.
“The next step for researchers will be to identify
the cell lines that are being
blocked by the compounds.
Cancer cells will have to be
cultured for that. It has to be
done in a particular laboratory environment that we
don’t have yet. We will have
to imports certain instruments from other cities and
develop the laboratory. It
won’t be easy but we are
confidant of success,” added
Bose.
Ashish
Mukhopadhyay,
director NCRI said once the
rest of the compounds are
identified, the scientists will
prepare for phase one clinical trial. The signs are encouraging and the research
has the promise to be a path
breaking one.
The West Bengal has
around 21,000 ovarian cancer patients, 60 per cent of
whom turn drug resistant in
two years. Of 48,000 breast
cancer patient in the state,
30 per cent are resistant to
drugs. This figure underlines
the necessity for the development of the biological
agents as a replacement for
conventional chemotherapy.
Around 20 per cent of the
breast and ovarian cancer
patient died every year, added Dr Mukhopadhyay.
The research was started
in 2012 jointly by the Indian
Council of Medical Research
and NCRI.
Exotic imported
foods bug bites
small towns too
Cancer is growing in all the
north eastern states by leaps
and bounds. Of late there has
been a spurt in the number of
cancer cases. While 2011 accounted for 36354 cases, the figure for 2012 and 2013 was 36814
and 37294 respectively. The data
is presented by the cancer registries under the aegis of the Indian Council of Medical Research
(ICMR).
The North Eastern Indira Gandhi Regional Institute of Health
and Medical Sciences (NEIGRIHMS) geared up for the challenge. It created a state-of-theart infrastructure to combat the
disease. The institute developed
separate oncology wards with
16 indoor beds with a provision
With state-of-the-art
infrastructure two N-E
institutes geared up for the
challenge posed by cancer
of further expansion up to 30
beds. Pain relief, palliative care
facilities, regular screening programme are also conducted in
the hospital.
Beside, Dr B Borooah Cancer
Institute, Guwahati has also
come out to meet the Cancer
challenge. It is has 209 beds, radiotherapy equipments like Linear Accelerator Machines with
IMRT, IGRT, SRS/SRT and major
equipments for radio diagnosis
like CT scan and MRI, five fully
equipped state of the art opera-
JIVIKA MITTAL
A
dvocate Govind Sharma, 52, had been suffering from a life-threatening congenital condition
called Aortic Coarctation.
He came to know about
this disease only recently
when he stricken by a heart
attack. Sharma was advised
immediate open heart surgery to carry out a bypass
for blocked coronary arteries and the repair of coarctation.
Coarctation of aorta is
among the most common
congenital heart abnormalities. Coarctation means
blockage or narrowing of
aorta, largest artery which
distributes
oxygenated
blood to all parts of our
body.
This disease is often
detected in the first few
months of birth when children develop symptoms of
heart failure like breathlessness, poor feeding and
growth. In adults, it is often
discovered in the third decade of the life. Rarely, some
people can walk around
with their condition undetected for years like Govind
Sharma.
“It was really surprising
that the patient survived
for so many years without
any symptom of Aortic
Coarctation, which is very
risky as he could have a
severe heart attack at any
moment. The diagnosis of
coarctation of the aorta
may be missed during early
childhood unless an index
of suspicion is maintained.
DTMT NETWORK
NEW DELHI
Demand for cheese, tortilla chips, pasta,
sauces and olive oil among others has gone
up by 27-28 per cent in small towns recently
against a 15-17 per cent growth in big cities,
according to data from the Forum of Indian
Food Importers.
“The demand is booming in small cities.
Exposure to international fast food chains
through various food shows on TV has
changed the eating habits of people,” observed Amit Lohani, convener of the Forum
of Indian Food Importers.
For instance, olive oil sales are growing by
50 per cent every year while imported pasta
and cheese is seeing a growth of more than
30 per cent. The Indian gourmet food industry, which is growing at 20 per cent annually,
is likely to top $2.8 billion (Rs 17,500 crore)
by 2015, data from consultancy Technopak
Advisors shows.
“Small cities are where the future is,” said
Jehangir Lawyer of Fortune Gourmet Specialities, which imports cheese, processed
meats and seafood from Europe, the US and
Australia.
“The super six cities (Mumbai, Delhi, Kolkata, Chennai, Hyderabad and Bangalore)
were earlier driving growth for imported
food.
Now we have identified 30 additional
towns,” said Sumit Saran of SCS Group,
which represents several US brands including California Prunes and Washington Apples. People from places such as Dhanbad
and Bokaro to shop for imported gourmet
food products, said Saikat Sarkar of retail
chain Spencer’s., four buses to Nepal on
Republic Day.
A large section of the society in the country has no
access to healthcare services. There are social, geological and economical factors that come in the way of
reaching out to them with
healthcare. These factors
act like roadblocks in the
way of achieving healthcare for all.
To address these issues,
Associated Chambers of
Commerce and Industry of
India (ASSOCHAM) recently organised a summit: “Access to Healthcare: Scaling
up Best Practices”.
The event brought policy
makers, industry leaders,
entrepreneurs, R&D professionals, academicians
and students at one platform to raise awareness
about the problem.
This is the second time
Assocham organised the
event since 2011 to inspire
the gathering to work together towards facilitating
excellent healthcare facilities for the citizens of the
country.
The initiative offered a
platform to discuss the
state of Indian healthcare
services and showcase
tion theatres among many.
Modernisation of these institutes and introduction of
newer technologies is an ongoing process in this direction.
As per information provided
by Atomic Energy Regulation
Board (AERB), Mumbai, there
are as many as four institutions
with radiotherapy facility in the
public sector in the North-East
region.
Health being a state subject,
the Centre supplements the efforts of the state governments
here through inter alia, the Central Government health institutions and national programmes.
In assisting the state governments the National Programme
for Prevention and Control
of Cancer, Diabetes, CVD and
Stroke was started in 2010.
Coarctation means
blockage or narrowing
of aorta, largest artery
which distributes
oxygenated blood to all
parts of our body
Generally, the diagnosis
is delayed until the patient
encounters the symptoms
of the disease for long time.
Stroke, brain aneurysm
and early onset coronary
artery disease, are some of
the symptoms of the disease” said Dr Mukesh Goel,
HOD and chief cardiac
surgeon, Asian Institute of
Medical Sciences.
“It is estimated that 1
out of every 10,000 babies
born have coarctation of
the aorta, but diagnosed
at such later stage of life is
very rare,” added Dr Mukesh.
The aorta is the main artery that leaves the left side
of the heart (the left ventricle) and supplies oxygenated (oxygen-rich) blood to
our body. The aorta is the
main artery of the body and
all of the other arteries of
the body derive from it.
In coarctation of the aorta, there is a narrowing in
part of the aorta and thus
blood cannot pass as easily
through the narrowed part
of the aorta. This means
that the blood supply to the
lower half of the body can
be affected (less blood is
able to get through). Also,
because of the narrowing,
the heart works harder to
pump and try to squeeze
blood through the narrowing. Because the heart is
working harder to pump,
this can cause blood pressure to rise which is the
main symptom of coarctation of the aorta. The degree
of narrowing in coarctation
of the aorta can be different
in different people.
During a physical exam,
the doctor may find that a
person with a coarctation
has higher blood pressure
in the arms than in the legs.
The doctor also might hear
a heart murmur or notice
that the pulses felt in the
groin area or on the feet are
weak or even absent.
To judge the exact condition of the heart a cardiologist may perform some
tests such as a echo, ECG,
chest X-ray, a magnetic resonance imaging (MRI) test,
or a computerized tomography (CT) scan.
Call your doctor immediately if you are having high
blood pressure, shortness
of breath, chest pain, or
fainting as it can be a silent knock of coarctation of
the aorta.
Healthcare access: Assocham meet
takes up roadblocks for discussion
DTMT NETWORK
KOLKATA
North-East gears up to meet cancer challenge
DTMT NETWORK
T IN
D IA
Drumsticks – a veggie and
potential antidote to cancer
sexual assault by persons.
Do not leave your drink unattended at any time. This provides
the perfect opportunity for someone to add hard drugs that could
knock you out and place you at
risk of sexual abuse. If you feel
extremely drunk after only a
few drinks, get help because
you may have been drugged.
Two other predator drugs
being used are ‘roofies’ and
GHB. These make you feel
drunk after 20-30 minutes
of consumption. They can
also cause amnesia and
unconsciousness for three
to eight hours.
Because of the physiological and psychological
effects of alcohol consumption, it is important to know
how to administer first aid to
an intoxicated person. The following are some guidelines if a
problem develops.
There is no way to sober up
quickly: a cold shower, black
coffee, oxygen or exercise only result in a wet, wide awake or tired
but intoxicated person.
The amount of alcohol in the
blood is controlled by the metabolic rate of the liver. Quitting alcohol for short periods – even up
to a month – not just brings health
benefits but also changes the person’s mindset about drinking,
which over time could be a bigger
gain.
Abstinence not just reduces
levels of liver fat, cholesterol and
blood glucose but also makes it
easier for people to say no to alcohol or to start an evening off with
low alcohol drinks.
Taking safety steps during festival may save you from accidents
caused by excessive alcohol consumption.
EAS
BS RAWAT
the best available scalable
models.
“In India, public healthcare is much more affordable as compared to the private healthcare; however
the lack of physical reach
and other practices makes
private healthcare system a
better alternative.
Government of India’s
initiatives such as formation of High Level Expert
Group (HLEG) on Universal Healthcare Coverage
(UHC) and Prime Minister’s announcements about
increasing public funded
supply of the free generic
medicines to the less privileged half of the population by 2017 are some of
the steps in right direction,” said Manoj Jhalani,
Joint Secretary, Ministry of
Health and Family Welfare.
“Although
substantial
progress is visible in the
key healthcare indicators,
there are still a set of challenges to work upon for
improving access to common Indian and guarantee
their healthcare needs,”
said Bhaskar V Iyer, chairman of Assocham National Council on Drugs and
Pharmaceuticals.
“At present, socio-economic conditions of Indian healthcare system
is in need of innovative
models of healthcare delivery. Some models have
emerged in the last few
years which aim to address
issues of accessibility, affordability and assurance
on quality of care,” added
Iyer.
The objectives and major
areas of focus of the summit included scaling up
best practices, major policy
gaps and possible solutions, redefining role of private sector in healthcare,
importance of traditional
Indian health practices,
utilisation of ICT in enabling healthcare delivery
and management, pioneering models for increasing
access to healthcare and
value of a comprehensive
health insurance policy to
serve health needs of the
people.
Medical Nation
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Under panic attacks? Don’t panic, beat the blues
ROHIT KUMAR
In today’s hectic lifestyle people
are left with hardly any time for
themselves. In this age of cutthroat competition social interaction and family life which
gives an individual relief from
day-to-day stress have no place
in a person’s scheme of things.
Anxiety and mental stress are
the byproducts of this professional strain which eventually
leads to panic attacks.
nWhat Are Panic Attacks?
Sudden surge of overwhelming anxiety and fear is known as
panic attack. In the state of panic
attack, heart pounds and breathing becomes heavy. One feels
as if he is dying or going crazy.
If left untreated, these panic attacks can lead to panic disorder
and other problems. They are
likely to force us to withdraw
from normal daily routine. Panic
attacks generally give a sense of
unreality or a fear of losing control.
In the struggle for success in
professional life each individual
finds himself or herself alone in
life. This takes a toll on physical
and mental well-being. Those
who have experienced panic
attacks think they are having
heart attacks, losing their control or even may think they will
die. Panic attacks are unpredictable. One can’t anticipate when
and where such attack will occur. They can occur even during
sleep. An attack generally ends
within 10 minutes, but some
symptoms may last longer.
n What Causes Them
There is not a single cause of
panic attacks. However, psychological factors like depression,
drug abuse and alcoholism are
the main reasons for panic disorder. These disorders need to
be treated separately. The main
symptoms of depression are
feelings of sadness or hopelessness, not sleeping adequately,
weakness and difficulty in concentration. Patients with Depression can be treated with anti-de-
New IVF technique holds out a
ray of hope for issueless couples
JIVIKA MITTAL
NEW DELHI
netic abnormalities caused
due to abnormal sperms.
PGS
(pre-implantation
genetic screening) is a revolutionary technique that
uses array CGH (Comparative Genomic Hybridization) which can screen all
the 24 chromosomes for
any genetic abnormality and hence is an accurate
test to increase the ongoing
pregnancy rate. The first of
its kind, Iviomics lab, offers
the international technology for a safer, faster and
more accurate method of
identification and selection of healthy, disease-free
embryos to overcome the
current limits of pre-natal
genetic testing.
Dr Nalini Mahajan, Past
President Indian Fertility
Society (IFS) and Clinical
Director, Nova IVI Fertility Delhi, said, “Using PGS
technology, we selected a
chromosomally normal and
healthy embryo for transfer to Pooja’s uterus and
it resulted in a successful
Limited access to
contraceptives for
Haryana women
DTMT NETWORK
CHANDIGARH
The Punjab and Haryana High Court on Friday
directed the Centre and
Haryana Government to
respond within a month to
a petition alleging that the
state’s health policy and
programmes discriminated against women by limiting information and access
to modern contraceptives.
The directions came
from a division bench
comprising chief justice
Sanjay Kishan Kaul and
justice Arun Palli, while
disposing of a public interest litigation (PIL) filed by
Rohtak based non-government organisation (NGO)
Himmat Mahila Samooh.
The petitioner had accused the Haryana government of providing women
limited access to reproductive healthcare facilities, inadequate and incorrect information about
contraceptives in violation of the National Rural
Health Mission (NRHM)
and Adolescent Reproductive Sexual Health (ARSH)
Strategy. It was submitted
that inadequacy of such
facilities led to mental
and physical anguish with
unwanted pregnancy and
increased the need for unsafe abortion.
The organisation had in
November 2013 submitted
a similar representation
to the Union Ministry of
Health and Family Welfare
and Haryana Government,
but got no response till filing the petition.
The court observed: “The
petitioner has sought to
raise an important issue
of adequate healthcare facilities for family control.”
It directed the Centre and
Haryana Government that
they “must examine the issue on the basis of material
set out in the petition” and
“take a considered decision”, and a speaking order
be communicated to the
petitioner within a month.
Petitioner’s
advocate,
Veena Kumari, submitted that in a Jindal Global
Law School study in 2013
in Haryana, it was revealed
that nearly 86 per cent unmarried women did not
know about modern contraceptive options.
“Inadequate access to
modern contraceptives... is
a human rights violation,
and part of the continuum
of indignities women in
Haryana experience from
birth,” said Colin Gonsalves, founder of Human Rights Law Network,
which helped the NGO in
legal proceedings.
The petition has sought
that public health facilities
be equipped with adequate
stock of contraception,
and counselling sessions
be carried out at anganwadi centres, primary health
centres and community
health centres.
Papaya – one fruit,
five health benefits
DTMT NETWOK
NEW DELHI
Papaya is known as ‘fruits of
angels’. The fruit is liked by
one. But many people are not
aware of medicinal properties
the fruit boasts of. Doctors recommend papaya as it is digestive, has nutritional value and
last but not the least delicious.
The best thing about papaya
is its availability in all the seasons and is affordable for all.
It has immense health advantages and is packed with nutrients.
anxiety medications. Cognitivebehavioral therapy, also known
as CBT, can also be highly effective in the treatment of panic attacks. CBT may be used alone, or
in conjunction with medications.
During CBT, the therapist
helps the client identify thought
patterns that contribute to panic attacks. Once these harmful
thoughts have been identified,
the clients can then focus on altering their destructive thoughts
and learn to engage in more
helpful behaviors.
n Self-Help Tips
Take a break from the monotony and indulge in a hobby, Exercise to work off tension, Relaxation techniques like meditation,
yoga and chanting are beneficial,
Eat a healthy diet, with plenty of
fresh fruits and vegetables, See a
physician and especially if physical complaints persist.
Shri Shekhar Kunte an embodiment
of social service: Sanjeev Pendharkar
DTMT NETWORK
“For an ardent and selfless social worker, his dedicated service to the society
is itself a precious ornament.”
With these words Sanjeev Pendharkar, director of Vicco Laboratories,
introduced Shri Shekhar Kunte at function held recently at Dadar (Mumbai)
by friends, students and well-wishers
of Shri Shekhar Kunte’s Institution.
“This rare dedication to social service,” he said “reflected in the life and
work of Shri Kunte, who he said has
accepted social service as a mission of
his life.”
Sanjeev Pendharkar was chief guest
at the function. On the occasion, he felicitated a number of social workers –
including Mrs Shalaka Mane, coaching
Yoga, Pranayam and Reiky; Dr Pawar
rendering free Ayurvedic diagnosis and
treatment for their selfless service to
humanity.
For more than two decades Shri
Kunte inspired the young generation
through his various social activities.
His efforts were instrumental in trans-
As eradication of polio is
being celebrated in India,
Unicef said there is big
need to make immunisation system for children
stronger, accessible and
tackle the women’s status
if it really wants to address
the problem of mortality
among children.
Unicef pointed out that
routine immunisation for
kids in parts of the country is still very low and
they are facing inequality
within one state.
“Routine immunisation
in some parts of the country is yet very low. I visited
some districts in south UP
where it is below 20 percent. So that’s quite serious,” Louis-Georges Arsenault, Unicef representative to India, said. Though
the national average is
”not very bad”, he added.
He also alerted that there
should be no
quite period in
polio immunisation programme,
which he termed
an “amazing accomplishment”,
as the danger of
polio virus being
spread into India from affected parts of the
world remains.
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transmission has not
been eradicated
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Sanjeev Pendharkar giving away awards
to social workers at the function
forming the youth from pessimism to
optimism and enthusiasm.
“He has also developed a team of
such social workers roping his his numerous pupils. The society will remain
grateful to Shri Kunte and contribute
to his remarkable but tough mission.”
With these words Shri Pendharkar concluded his speech.
Shame of Bihar: Fifth acid
attack in just 14 months
DTMT NETWORK
PATNA
Acid attack on a young
woman in north Bihar
hospital is the fifth recorded case in the state
in the past 14 months. The
attack came just over six
months after the Supreme
Court directed state governments to put in place
stringent measures to curb
such attacks.
The victim of acid attack is fighting for her life
in the Sri Krishna Medical
College Hospital (SKMCH)
in Muzaffarpur. She was
found in a serious condition at a public place at
Mohanpur village under
Piprahi police station of
Sheohar district before
rushed to the hospital.
RK Mandal, Piprahi police station house officer,
confirmed that a woman
was found in a critical
condition at Mohanpur.
“Out of purely humanitar-
“We can’t ignore such
danger. We should be
aware of it and make sure
that the measures that are
put in place are sustained.
The main thing is to ensure that each and every
child continues to be immunized for polio,” the
Unicef representative said.
It is a big challenge for
complete immunisation;
he said a well-planned
system has to be put in
across the country. There
are some districts and
states where immunisation is running well. Some
parts of the country have
99.9 percent. South India
is doing much better, he
said.
India will have to improving the statues of
women and children, particularly child marriage, as
both issues have a larger
impact on a child’s survival and development.
DTMT NETWORK
New Delhi
ian consideration, we have
rushed her to Muzaffarpur
as saving her life was our
top priority. We are in the
process of instituting a
case”, Mandal said.
The SHO claimed that
an attempt had been made
to kill the woman by setting her alight after pouring kerosene on her. “This
was the finding at a medical facility where the police took her for first aid”,
he said. However, SKMCH
superintendent Dr GK
Thakur confirmed the
woman was the victim of
an acid attack.
“She has suffered 65 per
cent burns and is admitted
to the ICU in a critical con-
dition. She was brought
here in an ambulance, has
been registered as an unknown person and does
not have any attendant”,
said.
On January 22, two men
had pinned town a Dalit
youth, Ranjit Sada, 22, who
they accused of being a
thief, and poured acid in
his eyes. The attack took
place in Kishanpur police
station area of Supaul in
north eastern Bihar.
Earlier, in October last
year, failing in their attempt to molest a woman
sleeping on a Samastipur
railway station platform,
some miscreants threw
acid on her as retribution.
She was badly injured in
the attack.
Also last October, acid
was poured on the private parts of a minor boy
accused of theft by the
owner of kabadi shop in
Sohrai locality of Nalanda
in south central Bihar.
78,000 infants die
of congenital heart
disease every year
TH IN
D IA
When
Pooja
(name
changed), 33, a financial analyst and her husband Purav
(name changed), a IT professional decided to start a
family, they discovered to
their chagrin that she could
not conceive as Purav had
fertility issues. He was suffering from azoospermia, a
severe male factor problem
where no sperms are produced in the semen.
They explored the option of having their own
baby through IVF. After two
failed IVF cycles and recurrent miscarriages, they
gave up the hope of ever
having a baby. However, a
third and final attempt using PGS screening technology helped in choosing the
healthiest embryo for implantation and today she is
successfully 6 month pregnant.
Like Pooja and Purav
many couples these days
face repeated miscarriages
or problems in conception.
They should consider getting a sperm analysis done
before any other test as
chances are that an abnormal sperm could be the culprit. Infertility experts say
that a new test can successfully screen embryos for ge-
A new test can successfully
screen embryos for genetic
abnormalities caused due
to abnormal sperms
— Experts
pregnancy. It has saved the
couple’s precious time, effort and money from undergoing repeated IVF cycles
while also assuring them
of a healthy and safe pregnancy.”
Sharing her story, Pooja
said, “We wanted a healthy
child and didn’t want to
take too many chances so
we explored the option of
undertaking the new test
during IVF (In vitro fertilization). Finally we can look
forward to our family being
complete. ”
Severe Male Factor is a
very crucial element that
plays a huge role in defining
an IVF success rate. About
50% of the infertility cases
either alone or in combination with other factors that
are evaluated and under
treatment are because of
the same. It includes not just
the abnormal (low) sperm
count but also abnormal
motility, appearance and
volume.
Men with a severe male
factor problem can produce defective sperms having abnormal DNA. If such
a sperm is used for embryo
formation, it can form chromosomally abnormal embryos, which if transferred
in the mother can lead to
failure of implantation and
abortion. pression medicines, meditations
and physchoterapy.
n Signs & Symptoms
Some symptoms of panic disorder are: fast heartbeat, chest
pains, stomach upset, dizziness,
sickness, difficulty breathing, a
sense of feeling smothered, tingling or numbness in the hands,
dreamlike sensations or perceptual distortions, a need to escape, fear of losing control and
doing something embarrassing,
fear of dying, terror- a sense that
something unimaginably horrible is about to occur and one is
powerless to prevent it.
n Treatable
Medications are often used to
treat panic disorders and have
been shown to be both safe and
effective. The pharmacological
treatments that are prescribed
by doctors and psychiatrists include antidepressants and anti-
Unicef: Vaccination
programme for polio
needs to be robust
NOR
10
DTMT NETWORK
AGRA
Nearly 78,000 infants suffering from congenital
heart disease die in India every year due lack of
healthcare facilities, say experts. Congenital heart
disease is a problem with the heart’s structure and
function that is present at birth.
“Every year 1.5 lakh infants are born in India with
congenital heart disease,” Dr Murtaza Chisti, chief
cardiac surgeon of the Mahatma Gandhi Cardiac
and Critical Care Centre said after conducting a
medical camp.
Due to lack of knowledge among people, cases
of congenital heart disease are growing in the
country. Work-related stress coupled with lifestyle
changes of youngsters and those who belong to 30
to 40 years age group make them susceptible to
heart attacks,” he said.
“A balanced diet with minimum fatty and nonvegetarian food, non-consumption of sweets,
could decrease the growing cases of cardiac related problems, he said, adding that diabetes, high
blood pressure, depression, increase in cholesterol
were causes of cardiac attacks.
Dr ML Swarankar chairman of the India Education Trust, asserted that India had the dubious
place of having the largest number of deaths in
Asia from heart attack. A new research shows that
sharing your anxiety with people who may be feeling the same way, can be an effective coping mechanism to deal with stress.
At long last, neonatal screening facility for ESI beneficiaries
JIVIKA MITTAL
GHAZIABAD
Some of the benefits of this
tasty fruit are:
1. Some researches in the past
have suggested that it is an
amazing option of food for diabetic patients as it helps lower
blood-sugar levels.
2. It helps in losing weight as
they are packed of vitamins,
minerals content and does
have low calories.
3. Papaya highly advised in
constipation,
indigestion,
heart burn and irritable bowel
syndrome as it contains antiamoebic and anti-parasitic
traits thereby easing bowel activities.
4. It is also used for skin, pimples and spots.
5. Taking a papaya daily can increase the immunity a lot as it
contains Vitamin A and C.
ESI hospital, Sahibabad, is soon
going to start Gestational diabetes mellitus screening (diabetes screening test for neonates)
and the cervical cancer screening for female patients.
Dr Vinod Kumar, Medical
Superintendent, ESI hospital,
Sahibabad, says that they were
planning to start these screening tests with the starting of the
New Year. But, there are many
doctors in the hospital who are
on contract basis, and the renewal of the contract was pending. So, due to shortage of doctors in the hospital, they were
unable to start these services in
the January.
“Now, as the contract of these
doctors has got renewed we
can now concentrate on the
initiation of these services,” he
added.
The machines which are required for the testing and the
screening are already available
in the hospital. They just need
the authorities go ahead so that
they can start the diabetes and
cancer screening tests in the
hospital.
Owing to the high costs of
these tests, the poor people
could not afford these tests.
But as these tests will be free of
cost here, the most vulnerable
people would be able to get the
benefit of the service.
Good blood sugar control
is important before becoming pregnant, because many
women do not even know they
are pregnant until the baby has
been growing for two to four
weeks. High blood sugar levels
early in the pregnancy (before
13 weeks) can cause birth defects. They also can increase the
risks of miscarriage and diabetes-related complications.
High blood sugar levels early in
the pregnancy can cause birth
defects and also can increase
the risks of miscarriage
A common problem among
the babies of pregnant women
with diabetes is a condition
called “macrosomia,” which
means “large body.” In other
words, babies of diabetic women are apt to be considerably
larger than others.
Sometimes, the baby becomes
too large to be delivered vaginally, and a cesarean delivery
becomes necessary which leads
to many complications.
The complications associated
with Gestational diabetes can
be prevented by early recognition, intense monitoring and
proper treatment.
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Medical Nation
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
A familiar episode in tallest woman’s saga
BS RAWAT
The plight of Siddika Parveen,
26, who was brought to the All
India Institute of Medical Sciences (AIIMS) recently for removal of a “giant” brain tumour,
reflects India’s embarrassing reality of healthcare in rural areas
where many patients do not receive timely treatment because
of either poor diagnosis or inadequate access to appropriate
treatment.
The giant brain tumour responsible for secretion of growth hormones up to 16-18 times above
the normal level could have
been fixed had she got timely
treatment. In the absence of any
medical aid the tumour went unchecked and by the time she was
15, she was already six feet tall.
“She may not have grown so
much if the surgery had been
done earlier,” Dr Ashish Suri,
professor of neurosurgery and
who led the surgical team at
AIIMS told DTMT. Tests at AIIMS,
where she was brought in November 2013, revealed that Siddika’s levels of growth hormone
were nearly 16 times higher than
the normal range. Suri has per-
TALL ORDER: Siddika Parveen with her father Asafuddin Ahmed in her hometown in West Bengal
formed nearly 9,000 brain surgeries over the past 20 years and
routinely trains young surgeons
in endoscopic neurosurgery, a
procedure that helps surgeons
avoid making large incisions
on the skull. “But the surgery
on Siddika was among the most
challenging I’ve encountered,” he
said.
The team removed 90 per cent
of the 4cm tumour, leaving behind a tiny portion that Suri said
could not be extracted because it
was too close to important blood
vessels. The residual tumour
could be removed through radiotherapy or medication.
Siddika Parveen is a resident
of Buniadpur, about 60km from
Balurghat in South Dinajpur, in
West Bengal. Her sight was also
weak and she was bed-ridden
due to fractures in her vertebrae
from the last 15 years. Her illiterate parents didn’t know how to
help her, so she was forced to live
a life of isolation, with no friends
and no hope of a future.
For Siddika, her height, which
earned her the distinction of being the tallest woman on earth,
was cause for more pain than
joy. AT 26, she measures 7 feet 8
inches and weighs about 130 kilograms, with a shoe size of 15-16.
The pituitary adenoma had
begun growing when Siddika
was in her early teens. Her family recalled that she began grow-
ing unusually fast after she had
turned 10.
Siddika was admitted to AIIMS
with a condition where her serum growth hormone level was
significantly elevated as a consequence of over secretion of
the hormone by the pituitary
tumour. Siddika also had a vertebral spine fracture and could not
walk properly.
Now the tumour is almost
gone, but she won’t lose her title of one of the world’s tallest
women. First, she spoke no language other than Bengali and we
needed an interpretor to create
a rapport with her and convince
her for the operation, explained
a professor who was in the team.
Siddika had received pre-operative medical management at
the AIIMS endocrinology department and doctors say she will
need to continue taking medicines after surgery.
“She’ll require lifelong medical therapy to address certain
hormone deficiencies caused by
the destruction of the normal pituitary gland by the tumour.Siddika’s father Asafuddin Ahmed
said she was looking forward to
going home.
Govt helpless as tobacco goes on a killing spree
The rising death toll due
to tobacco-related diseases is a matter of grave
concern. A World Lung
Foundation report has
claimed that more than
one million people die in
India due to use of tobacco products.
There are approximately 120 million smokers in India. According
to the World Health Organization (WHO), India
is home to 12 per cent of
the world’s smokers.
Tobacco in India is the
primary cause of cancer
while chewing tobacco
Tobacco in India is
the primary cause of
cancer while chewing
tobacco is directly
related to oral cancer
that affects any part of
the oral cavity
is directly related to oral
cancer that affects any
part of the oral cavity, including the lips, upper or
lower jaw, tongue, gums,
cheeks, and throat.
“It is estimated that our
oral cancer wards point
to 80 to 90 per cent of
preventable cancers of
the neck, head and throat
are tobacco related. The
burden of oral cancers
caused by chewing tobacco, as well as lung
and other cancers caused
by smoking tobacco in
‘bidis’ and cigarettes, is
Prenatal Sex Determination
DTMT NETWORK
JAIPUR
With a view to curb sex
determination and female
feticide in the society the
preconceptions,
prenatal diagnostic technique
(PCPNDT) cell of the health
department here has come
up with a novel initiative.
Now, pregnant women will
assist in decoy operations
to nab doctors and their
agents involved in prenatal
sex selection activities.
In this context the department even gave a proposal
to the Government on rewarding the pregnant women who volunteer to play
decoy to the doctors with
a cash prize as incentive.
In fact, the health department is already carrying
out such operations to nab
the culprits but
is finding it
difficult to
take
the
help
of
pregnant
women in
the absence of a
cash incentive which could
encourage.
Under the Mukhbir Yojna,
the state Government gives
Rs 1 lakh as reward to any
person who gives information to the PCPNDT cell and
helps in decoy operation to
nab the persons involved in
sex selection activities.
Help of a pregnant woman is always needed in decoy operation. The Health
Department and the mukhbir (whistle blower) send
a pregnant woman as a
decoy to the doctor suspected to be involved in
prenatal sex determination
activities. In most cases the
mukhbir persuades a pregnant woman for the operation and it is his responsibility to reward her. After
successful decoy operation, the mukhbir gets Rs 1
lakh in instalments, which
depends on the case filed in
the court against the doctor too.
So far the Department
has not taken an initiative
to reward the pregnant
women directly as mukhbir rewards her from the
Rs 1 lakh that he gets from
the department. It depends
on the mukhbir how much
money he parts with as a
reward for her.
A Health Department official said that they have
now impressed upon
the state Government
on the need to reward
pregnant women under Mukhbir Yojna.
PCPNDT cell has
proposed that
the
amount
should be increased
to
Rs 2 lakh so
that it can
be shared
between
the mukhbir and the
pregnant
women.
Timely innovative surgery
averts stroke successfully
DTMTNETWORK
NAGPUR
A special surgical intervention and welltimed treatment at the
Orange City Hospital
and Research Institute
prevented a dangerous
situation like stroke in a
65-year-old man. Hospital authority claimed
that this is the first time
a procedure of this kind
was carried in Nagpur.
The patient came
to the hospital with
slurred speech and
some problem in the
right eye vision, which if
picked in time can avert
brain stroke and save a
man’s life.
“The patient had typical indications of the
danger ahead and fortunately for him the
doppler picked up the
70 per cent block in the
carotid artery, the artery in neck which supplies blood to the brain.
Had it been not cleared
in time, the block would
have caused to a brain
stroke,” said Dr Anup
Marar, medical director
of OCHRI.
“There are many ways
of clearing the block in
carotid artery. One of
the common methods is
angioplasty (an operation to repair a damaged
blood vessel or unblock
a coronary artery) in the
block area. But there are
many disadvantages of
the process, including
the cost. In the modern
era carotid artery stenting, still carotid endarterectomy ( a method of
cleaning the block surgically) or CE remains
the gold standard. So,
we decided to use this
technique against angioplasty,” said Dr Rohit
Gupta a vascular surgeon who performed
the surgery.
I
ST N
D IA
Pregnant women to be
rewarded for catching
doctors red-handed
enormous,” said Pankaj
Chaturvedi of Tata Memorial Hospital, Mumbai.
Earlier, a report by the
International
Tobacco
Control Project has stated that despite having
signed a global treaty
on tobacco control and
having numerous antitobacco and smoke-free
laws, India has failed to
implement them completely.
“Health experts are
surprised at the rising incidence of cancer caused
by lifestyle factors, particularly tobacco use.
Governments must implement policies on an
urgent basis to prevent
the access of unhealthy
products and enforcement of ban their advertisements and promotion,” said Nandita Murukutla, India director of
World Lung Foundation.
WE
DTMT NETWORK
The blockage in the
carotid artery was originally leading to discharge of some of the
deposited cholesterol
moving randomly once
in awhile upwards in
the brain. Depending on
the area of brain where
these pieces were moving, the patient was responding accordingly.
Therefore the person’s
speech and vision were
affected.
The patient responded extremely well and
regained his speech and
vision after the surgery.
Otherwise also, the slurring of speech and loss
of vision in such case is
a temporary phenomenon. But if the patient
is aware and sees the
he can be diagnosed
and a brain stroke can
be prevented. Whether
this patient had knowledge of the symptoms is
unclear but he came to
the doctors in time and
therefore was saved of
the stroke.
Health issues plague auto drivers
DTMT NETWORK
NAVI MUMBAI
Years of auto driving
tells on health of the
drivers in the city. This
was disclosed in a free
health camp organised by a city hospital.
Poor vision, back pain
and painful mobility of
wrists were the major
problems found among
them.
Out of 130 auto drivers in the age group of
20-40 who attended the
health camp at Sneh
Saideep (SSD) hospital,
Koparkhairane, a significant 81 or 62.3 per cent
reported
ophthalmic
and orthopedic prob-
Health problems were
high among auto
drivers in their 40s,
who had begun
driving when they
were in their 20s
lems. Eight of them even
have high levels of blood
sugar.
“We had anticipated
more bone problems,
but eye tests showed
auto drivers have major
vision issue and they
had no knowledge of
it. Thirty-five relatives
of the auto drivers who
went through a checkup also suffered from
eye problems and joint
pain,“ said Dr Sandeep Thadani who heads
the operations department at the hospital.
He said, “Health problems were high among
auto drivers in their 40s,
who had begun driving when they were in
their 20s. This was the
first health check-up
camp for auto drivers as they serve as
in reaching hospital
during
emergencies.”
“Two auto drivers have
undergone eye operation and those who suffered from bone problems have been advised
regular exercise,” said Dr
Thadani.
11
‘High-caffeine’ drinks
may lead teens to drugs
Mandatory eye
tests mooted
for diabetics
DTMT NETWORK
AGRA
The government must make eye
tests mandatory for diabetic patients to prevent increasing blindness in India, a leading doctor
recommended an ophthalmology
convention that ended here on
Sunday.
Quresh Masketi, president of
the All India Ophthalmologiacal
Society, made the suggestion at
the four-day meet, a conference
spokesman said.
Due to lack of awareness, many
diabetic patients are losing eye
sight and making their lives difficult as their eyes were not
checked regularly.
A total of 6,000 delegates from
different parts of the country participated in the convention, the
world’s largest gathering of eye
surgeons and eye care specialists.
The conference discussed new
techniques, evaluated the performance of latest gadgets and
shared useful professional experiences. More than 220 scientific papers were discussed, the
spokesperson said. HP Singh, a
important of the organising committee said, “ Both for the country and Agra, this has been a truly
landmark conference.
Rohit Kumar
Children who consume
high-caffeine
energy
drinks may indulge in using alcohol, cigarette, or
drug, a new study has
claimed in US. The same
characteristics that attract youngsters to consume energy drinks such
as being different or riskoriented may make them
more likely to use other
substances as well, suggests the new search by
Yvonne M. Terry-McElrath, MSA, and colleagues
of the Institute for Social
Research, University of
Michigan, Ann Arbor.
This research was done
on nearly 22,000 US secondary school students.
Responding to questions
about 30 per cent children
said they use caffeinecontaining energy drinks.
More than 40 per cent
said they take regular soft
drinks every day, while 20
per cent drank soft drinks
daily.
It was revealed that boys
were more likely to use
energy drinks than girls
and teens were in large
numbers using it without
parents at home and those
whose parents were less
educated.
Surprisingly, the children whose ages were 11 to
13 were most likely to use
energy drinks. Students
who used such energy
drink or caffeine related
items were more in possibilities in using alcohol,
cigarette or illicit drugs.
Women may be at higher risk of
stroke than men, warn scientists
Rohit Kumar
US scientists have warned
for the first time that women may face a higher risk of
stroke then men due to high
blood pressure, disorders in
pregnancy and other hormonal changes.
American Heart Association issues guidelines for
preventing stroke in women tells factors such pregnancy, birth control pills,
and migraine headaches
with aura and menopause
that put women at particular risk for stroke.
“If you are a woman, you
share many of the same
risk factors for stroke with
men, but your risk is also
influenced by hormones,
reproductive health, pregnancy, childbirth and other
sex-related factors,” said
Cheryl Bushnell, author
of the new scientific state-
ment. The guidelines said
that high blood pressure,
migraine with aura, artial
fibrillate, diabetes, depression and emotional stress
factors that are likely to be
stronger or more common
in women than in men.
According to new guidelines, Women have basically a history of high blood
pressure before pregnancy
should be considered for
low-dose aspirin and cal-
cium supplement therapy
to decrease preeclampsia
( abnormal condition of
pregnancy
characterized
by hypertension and fluid
retention,
albuminuria)
risks.
Women who have preeclampsia have twice the risk
of stroke and a four-fold
risk of high blood pressure
later in life.
That’s why, preeclampsia
should be known as a risk
factor too after pregnancy,
and other risk factors like
high cholesterol, obesity,
smoking in such type of
women should be treated
early, the association said.
Pregnant women with
slightly high blood pressure may be considered for
blood pressure pills, whereas expectant mothers with
extremely high blood pressure should given proper
treatment.
Medical Latest
12
Premature birth can have Common cold:
long-term health effects Drug promises
DTMT NETWORK
NORTH CAROLINA
A new study published
journal PLoS One indicates that a major cause
of premature birth - where
waters break too soon,
triggering labour may be
caused by specific bacteria.
This research could lead
to screening and possible treatment for women
at risk of early labour and
help and protect the newborn from further difficulties. The condition wherein
the water breaks prematurely in a pregnant woman is termed as preterm
premature rupture of the
membranes (PPROM).
It is estimated that nearly
one-third of all premature
births are caused due to
early rupture of membranes. The membranes
that make up the sac that
holds the baby usually
break at the start of labour.
The study was conducted
by the researchers at the
Duke University School of
Medicine and has found
that high numbers of bacteria are present at the site
This discovery will help
prevent premature
births by detecting
bacteria associated with
premature rupturing
of the membranes
where membranes rupture
which are linked with the
thinning of membranes.
It is important to understand that if the bacteria
are the major cause of early membrane rupture, then
this study may lead to new
treatments or screen for
women at risk.
This discovery will help
prevent premature births
as certain bacteria associated with premature rupturing of the membranes
can be detected by screening early in pregnancy and
treated affected with antibiotics and thereby reduce
risk for PPROM.
Still following the research more opportunities are required to explore
potential targeted therapeutic interventions in the
field.
surefire cure
DTMT NETWORK
LONDON
UK scientists have found
a new drug compound
which can prevent people from catching the
cold virus by blocking its
transmission to others.
The very same compound
can also be useful against
potentially dangerous illnesses as polio, hand, foot
and mouth disease, which
have caused thousands of
deaths globally.
The work of this compound is to bind itself to
the virus, paralyzes it and
prevents it from releasing
the genetic material that
causes the infection.
Presently, there are
number of effective drugs
against the flue, but drugs
which can ward off diseases like common, cold polio
and hand, foot and mouth
disease are not available,
said Dave Stuart, lead researcher from the University of Oxford.
He said this compound
can also help improve polio vaccines.
Medicine alone can’t beat cancer;
prevention is vital, says WHO
DTMT NETWORK
On World Cancer Day
on February 4th, World
Health Organization asserted that drugs alone
can’t cure or protect from
cancer but using of better
vaccines and preventive
public health policies are
required to fight against
the fatal disease.
Noting that the dreaded
disease is growing “at an
alarming pace”, WHO’s
International
Agency
for Research on Cancer
(IARC) stressed on the
need for new measures to
curb the menace.
Scientists from more
than 40 countries take
part in producing IARC
report roughly once in
five years. They said that
more commitment and
dedication is needed to
fight cancer. They said
relatively effective and
inexpensive drugs would
significantly drastically
cut death tolls even in
places where healthcare
services are less developed because a large
number of patients can’t
afford the treatment.
According IARC report,
in 2012, the number of
cancer cases were 14 million which is expected to
rise to 22 million.
Over the same period
cancer deaths are likely
to rise from 8.2 million a
year to 13 million per year
and that would be hard to
overcome if it continues
with this pace.
The data also suggests
that at the present rate
one in five men and one
in six women will develop
cancer before they attain
the age of 75 years and
one in eight men and one
in twelve women will die
from disease.
In 2012, the most common causes of cancer
deaths were liver, lung
and stomach cancer. Increasing and aging population in developing countries will be affected the
most by cancer cases.
60 per cent of cases
take place in Africa, Asia,
Central and South America. This regions account
for 70 per cent of cancer
deaths and the condition
becomes so critical when
such deaths or tragedy
occurs in poorer countries due to lack of health
facilities.
“Governments
must
show political commitment to implement the
high-quality
screening
and early detection programs, which are an investment rather than a
cost,” said Bernard Stewart, another co-editor of
the report.
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Human lungs grown in
a lab for the first time
DTMT NETWORK
Researchers at the University of Taxes Medical
Branch in Galveston of
the US have succeed in
growing human lungs
in the laboratory using
components from the
lungs of deceased children.
Stem cell (undifferentiated biological cells) specialists have been working
on growing lung tissue for
some years, but the lung is a
complex organ of the body,
which gives more troubles
than renewing other organ
tissue, such as human skin.
The University of Texas
Medical Branch first announced their solution for
growing lungs in 2010.
“The lung is probably the
most complex of all organs
– the cells near the entrance
are completely different
from those deep in the
lung,” UTMB researcher Dr
Joaquin Cortiella.
“People question us why
we are doing the lung, because it is so difficult. But
the potential is so great,
and the technology is here.
It’s going to take time, but I
think we’re going to make a
system that works,” he said.
“If we can make a good
lung for people, we can also
make a good model for in-
At long last, effective
HIV vaccine comes
closer to reality
DTMT NETWORK
Washington
to human lungs.
Taking lungs from two
children who were killed in
an accident, the researchers
stripped one of the lungs
down to a bare skeleton of
just collagen and elastin –
the main proteins in connective tissue.
Using this stripped-down
lung as a “scaffold”, they
harvested cells from the
other lung, which were applied to the scaffolding.
This lung structure was
then placed in a chamber filled with a nutritious
liquid.
After four weeks of immersion, the team removed
a human lung from the liquid. It was just softer, pinker
and less dense. The team
then successfully repeated
the process suing a second
set of lungs.
jury. We can make a fibrotic
lung and assess what’s happening with those, what the
cells are doing, how well
stem cell or other therapy
works,” researcher Dr Joan
Nichols said, adding, “We
can see what happens in
pneumonia, or in tuberculosis, or hantavirus - all the
agents that target the lung
and cause damage in the
lung,” he added.
The research conducted
in 2010 involved destroying rat’s cell by repeatedly
freezing and thawing and
then reseeding the lungs
with developing stem cells
from pests.
Following that work up
with similar but more largescale experiments on pig
lungs, the researchers now
applied the same regenerative engineering principles
Scientists have discovered a mechanism that
helps HIV evade antibodies and stabilise key
proteins, a finding that
could pave way for more
effective vaccine for the
deadly virus.
National Institutes of
Health (NIH) scientists
found the mechanism
involved in stabilising
key HIV proteins and
thereby concealing sites
where some of the most
powerful HIV neutralising antibodies bind.
Numerous spikes jut
out of the surface of HIV,
each containing a set of
three identical, bulbshaped proteins called
gp120 that can be closed
together or spread apart
like the petals of a flower,
researchers said.
Some of the most important sites targeted by
HIV neutralising antibodies are hidden when
the three gp120s, or the
trimmer, are closed, and
the gp120 trimer remains
closed until the virus
binds to a cell, they said.
The researchers discovered that certain
amino acids located on
the gp120 protein undergo a process that stabilises the trimer in its
closed position.
In this process, called
sulfation, the amino acids acquire a sulfur atom
surrounded by four oxygen atoms.
By either blocking or
increasing sulfation of
these amino acids, the
researchers changed the
sensitivity of the virus
to different neutralising
antibodies,
indicating
that the trimer was being
either opened or closed.
The scientists suggest
that if the synthesised
gp120 widely used in
HIV research were fully
sulfated during manufacture, the resulting
product would adopt a
more true-to-life structure and more closely
mirror the way the immune system sees unbound HIV.
This might help generate a more effective HIV
vaccine, NIH researchers said.
They added that full
sulfation of gp120 may
enable scientists to
crystallise the molecule
more readily, which also
could advance HIV vaccine design.
Turning down thermostat can help lose weight: Study
DTMT NETWORK
A research suggested
that turning down
thermostat a few
degrees could
help reduce weight
O
verweight people can
be found in all age
groups and sections of
the society. Obesity is not
a disease in itself, but it
gives rise to many a medical condition. In some
cases obesity causes depression among youngsters.
Here is good news
for those who
are
looking
forward
to
cut down that
extra flab in
their bodies.
Dutch research
has claimed that
keeping
temperature a bit cool at home
may help reduce weight
during winters. It burns
calories to keep you warm.
Americans love to crank
up the thermostat particularly in bitterly cold conditions. But a new research
suggested that turning it
down a few degrees could
help to reduce weight.
“Since most of us live in
indoor conditions 90 per
cent of the time, it is worth
Crossword Hints
cal order? (7)
2) Appropriate work in bed (5)
1) Getting back bit in Radio Te- 3) Whip up perfume (7)
lephony for evidence of pay- 4) Conducts tense incomplete ment (7)
search before Tuesday, the 5th of August (9)
5) A legendary musician, he joins us after turning profes
5) Readily available, like piped sional (7)
water (2,3)
9)Watch for order containing 6) Boat for Landseer, perhaps (7)
fifty boxes with arrows (9)
7) Unnecessary oath from ex-
10)Simply missing the point, I priest I’ve allowed in earlier (9)
suggest (5)
8) Statements, perhaps more 11)Former prongs may furnish than one saw (7)
outer coats (7)
14)Famous lover partly emraced 12)The sound of raindrops -- by Maria could knock you last thing in design for a down (9)
model (7)
16)Victor William? (9)
13)Monsieur drowned in unspe-
17) Quietened when learner ci fied French river (5)
bungled around (7)
15)Right after two cop per bits 18)Skill is extremely troulesome for gourds (9)
for a performer (7)
17)Evil, it’s normal, possibly 19)He is not doing it for money; (6,3)
a good friend coming to an-
19)Proficient in algebra, starting cient city (7)
with short division (5)
20) See tidy artful batiks! (3-4)
21)Juliet and I invested in suet-
22)Dismisses dry white wines (5)
like snacks (7)
24)Jetsons dog star? (5)
23)United Nations leads a war,
with Eritrean head caught napping (7)
25)Mendacious storytellers? (5)
26) Confine bear without a trade (9)
27)Merchants could be card players (7)
28)Umpire Southhead
surrounding jumper pro-
vides shelter again (7)
Across
Down
1) Beams in reverse alpha beti-
Solution on page 16
exploring health aspects
of ambient temperatures,”
lead author Wouter Van
Marken Lichtenbelt said.
“What would it mean
if we allow our bodies
to work again to control
body temperature?” Lichtenbelt and his team
has been working on this
for 10 years.
Animals and humans
shiver to stay warm. There
are types of shivering, one
of them called thermo
genesis occurs when the
temperature is cool but
not cold, says research.
That type of shivering is
called ‘brown fat’ that can
burn up to 30 percent energy of the body and help
to reduce weight loss.
Brown adipose tissue (BAT), also known as
brown fat, is one of two
types of fat humans and
other mammals have –
the other type is known as
white or yellow fat.
Human newborns and
hibernating
mammals
have high levels of brown
fat. Brown fat’s main function is to generate body
heat.
However, scientists are
just starting to understand
what brown fat does, and
stress that there is a great
deal about it that we do
not yet know. Brown fat
was discovered in adults
in 2009 which burns calories instead of storing
them like white fat.
Amazing Facts
„„ Most people think of the toilet as the most contaminated part of the house, but in fact the kitchen sink typically contains 100,000 times more
germs than a bathroom or lavatory.
„„ The human body is home to some 1,000 species
of bacteria. There are more germs on your body
than people in the United States.
„„ Trachoma, the leading cause of preventable
blindness worldwide, is related to the lack of facial hygiene.
„„ When you are looking at someone you love, your
pupils dilate, and they do the same when you are
looking at someone you hate.
„„ The human brain cell can hold five times as much
information as the Encyclopedia of Britannica.
„„ Your body gives off enough heat in 30 minutes to
bring half a gallon of water to a boil.
„„ Each year about 2,500 people go to emergency
rooms to be treated because of injuries caused
by using a toothbrush.
„„ On an average, women say 7,000 words per day.
Men speak just over 2,000.
„„ The eye of a human can distinguish between 500
shades of gray.
Sudoku Corner
How to play
Fill in the grid so that every horizontal row every vertical column
and every 3 x 3 box contains the
digits 1 to 9, without repeating
the numbers in the same row,
column or box.
You cant change the digits already
given in the grid. Every puzzle has
one solution.
Medical Globe
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
13
Decoded: How brain creates
sequences in the memory
DTMT NETWORK
LONDON
We would further
study the functional
organization of the basal
ganglia during learning
and execution of action
sequences,” Rui Costa said.
‘A step closer’, according
to Nature article
N
euroscientists have discovered how efficiently the brain
organises memories and actions
by connecting separate small elements to become a unique and
meaningful sequence.
“A specific area of the brain –
the basal ganglia – is involved in
a mechanism called chunking
that signals neurons to connect
individual elements into a behavioural sequence, says a study published in the journal Nature Neuroscience.
“We trained mice to perform
gradually faster sequences of
lever presses – similar to a person who is learning to play a piano piece at an increasingly fast
pace,” narrated Rui Costa from
the Champalimaud Neuroscience
Programme (CNP) in Lisbon, Portugal.
“By recording the neural activity in the basal ganglia during this
task, we found neurons that seem
to treat a whole sequence of actions as a single behaviour,” he
added.
The basal ganglia encompass
two major pathways, the direct
and the indirect.
The authors found that although
activity in these pathways was
similar during the initiation of
movement, it was rather different
during the execution of a behavioural sequence.
“The basal ganglia and these
pathways are absolutely crucial
for the execution of actions. These
circuits are affected in neural
disorders, such as Parkinson or
Huntington’s disease, in which
learning of action sequences is
impaired,” added Xin Jin, an investigator at the Salk Institute in
San Diego, US.
“We would further study the
functional organization of the
basal ganglia during learning and
execution of action sequences,”
Rui Costa said. ‘A step closer’, according to Nature article.
Scientists have found a way to
turn animal cells back to a youthful, neutral state, a feat hailed as a
“game-changer’’ in growing transplant tissue.
The research, reported in the
journal Nature, could be the third
great advance in stem cells - a futuristic field that aims to reverse
Alzheimer’s, cancer and other
crippling or lethal diseases.
The latest breakthrough comes
from Japan, as did its predecessor
which earned its inventor a Nobel
Prize.
The new approach - provided it
overcomes safety hurdles - could
smash cost and technical barriers
in stem-cell research, said independent commentators.
“If it works in man, this could be
the game-changer that ultimately
makes a wide range of cell therapies available using the patient’s
own cells as starting material,’’
said Chris Mason, a professor of
regenerative medicine at University College London.
“The age of personalised medicine will have arrived.’’
Stem cells are primitive cells
that, as they grow, differentiate
into the various specialised cells
that make up the different organs
- the brain, the heart, kidney and
so on.
The goal is to create stem cells
in the lab and nudge them to grow
into these differentiated cells, thus
replenishing organs damaged by
disease or accident.
One of the obstacles, though, is
ensuring that these transplanted
cells are not attacked as alien by
the body’s immune system.
To achieve that, the stem cells
would have to carry the patient’s
own genetic code, to identify them
as friendly.
Sunanda latest victim of drug
overdose among rich & mighty
DTMT NETWORK
NEW YORK
Socialite Sunanda Pushkar
Tharoor was found dead
after a heated exchange
on Twitter where she alleged that her husband
was having an affair with
a Pakistani journalist. Her
body was discovered by
husband Shashi and the
autopsy report suggested
that she died of a drug
overdose – most probably
a combination of sedatives
and strong medicines.
Sunananda is not the
lone celebrity to have
died of substance abuse.
In fact, there seems to
be a causal link between
fame and substance abuse
which more often than
not ends on a tragic note.
Here is a list of rich and famous whose deaths under
mysterious circumstances caused flutter in the
society.
nPhilip Seymour Hoffman
Philip Seymour Hoffman recently died of an
alleged heroin overdose.
He’s not the first celebrity
whose death is linked to
substance abuse.
n Cory Monteith
The Glee star was found
dead in his Vancouver
hotel room after taking a
lethal cocktail of heroin
and alcohol. He was alone
when he died.
n Anna Nicole Smith
The former Playboy
model and reality TV star
was found unresponsive
in a hotel in Hollywood
and when she was rushed
to a hospital she was declared dead. Her death
was caused due to a combination of drugs but the
major culprit was chloral
hydrate – a sleep drug.
n Marilyn Monroe
Hollywood’s
ultimate
sex symbol was discovered dead in her bedroom
by her psychiatrist and it
was believed she committed suicide by consuming
too many anti-depressants. Her cause of death
was believed to be ‘acute
barbiturate
poisoning’
though many still consider the circumstances
suspicious.
n Heath Ledger
Heath Ledger will forever be remembered for
his immortal portrayal
of The Joker in The Dark
Knight and he even received a posthumous Os-
R
O
F
G
N
I
K
O
LO
car for that performance.
Many believed that his
preparation for the role of
a joker might have driven
him over the edge and he
was found dead a few days
after shooting. Autopsy
reports revealed that he
died of acute intoxication
caused due to the effect of
six different prescription
drugs.
n Janis Joplin
The legendary musician’s manager found her
dead at her house in Hollywood. She too died of a
heroin overdose and was
found dead with a cigarette in her hand.
n Elvis Presley
The King of Rock and
Roll died of cardiac arrhythmia (irregular heartbeats) and it was believed
that it was caused by an
overdose of prescription
drugs including codeine,
valium, morphine, and
Demerol.
n Jimi Hendrix
Arguably the greatest
guitarist of them all had a
history of drug abuse and
was even arrested for possession of heroin in 1969.
He was acquitted after
convincing the authorities that the drugs were
planted in his belongings
and he died of a heroin
overdose in 1970.
n Jim Morrison
Drugs have claimed
some of music’s greatest talents including the
Doors frontman who was
just 27 when he was found
dead in a Paris apartment
bathtub. While there’s no
autopsy report to back up
this claim, most believed
he died of an a heroin
overdose, having accidentally injected it believing it
to be cocaine.
n Kurt Cobain
Like Morrison, Cobain
too was just 27 when he
was found dead. He left
behind a suicide note
and the autopsy revealed
a high concentration of
heroin and traces of diazepam (Valium) in his body.
n Sid Vicious
The bassist from the
punk rock band The Sex
Pistols died in his sleep
after a party. He consumed a lot of heroin on
the night after his release
from prison and the drug
was provided to him by
his mother! But it doesn’t
always end badly, here
are 10 celebs who beat
addiction!
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India gifts 17
ambulances
to Nepal
DTMT NETWORK
KATHMANDU
India’s ambassador to Nepal Ranjit Rae presented
17 ambulances and four
buses to various social
and educational organisations during a function to
mark the Republic Day in
the Indian Embassy premises.
The remaining three
ambulances were gifted
by the Consulate-General
of India, Birgunj to various organisations based
in southern Nepal.
Rae presented books to
50 educational organisations, libraries and training institutions.
He hoisted the national
flag and read out the address of the President
of India, which stressed
among other things “India’s support for peace,
stability and development
in its neighbourhood”.
Nepali Congress president Sushil Koirala, general secretary Prakash Man
Singh and former prime
minister Baburam Bhattarai among others were
present on the occasion.
Rare Diseases
Mermaid Syndrome
A young victim of the genetic disorder Sirenomeila (Mermaid Syndrome)
S
irenomelia is a rarely found disease
which affects the development of kidney, urinary bladder, genitourinary abnormalities, gastrointestinal abnormalities and anomalies of the lumbar sacral
spine at the initial stage of birth.
The disease is a result of failure of
normal vascular supply from the lower
aorta in utero. In this particular disease
most of the infants die. The exact cause
of sirenomelia is still not known, most
cases take place randomly for no apparent reason.
In Sirenomelia, also called as Mermaid
Syndrome, legs of the newborn are fused
together and look like tail of a mermaid,
a half woman and half fish that lives in
the sea. This condition is found in nearly one out of 100,000 infants as rare as
conjoined twins.
Affected infants may have one foot, no
feet or both feet, which may be rotated
externally. The tailbone is usually absent
and the sacrum is partially or completely
absent as well. More than fifty percent of
such disease results in stillbirth and this
may happen to identical twins than in
single birth or dissimilar twins.
Cases where infants have survived the
disease:
nA girl from Peru, known as the ‘Little
Mermaid”, has taken her first steps after
undergoing a second round of surgery to
separate her fused legs. Milagros Cerron,
now two years old, is learnt to be one of
the world’s few surviving ‘Mermaid syndrome’ babies.
nTiffany Yorks of the United States
underwent successful surgery in order
to separate her legs before she was one
year old. She is the longest-surviving sirenomelia patient.
nShiloh Pepin who has been named as
an extraordinary person in the US didn’t
have bladder, uterus, rectu, vegina, rectum. She had only six inches of large colon and with only one quarter of a kidney
and one ovary survived for ten years.
First Indian WHO regional
director for southeast Asia
BS RAWAT
NEW DELHI
Taking charge as regional director of WHO for
South-East Asia Dr Poonam Khetrapal Singh is the
first the first Indian national in particular and the
first woman in general to
hold the coveted post. She
retired as advisor, International Health in the Ministry of Health and Family
Welfare.
Dr Poonam was elected
by the 11 member states of
the region in September
2013 and subsequently appointed by the WHO’s executive board at its 134th
session in January 2014.
The South-East Asia Region is expected to be certified polio free by WHO in
March 2014.
Dr Poonam Khetrapal
Dr Poonam Khetrapal Singh
Singh served for over two
decades as a civil servant
in India as a member of
the Indian Administrative
Services.
She was the Secretary
to Health, Family Welfare
and Medical Education in
the State of Punjab, with
a population of 22 million
and a health budget of US$
350 million.
In 1987, Dr Singh moved
to the Health, Population
and Nutrition Department of the World Bank.
In 1998 she joined WHO
headquarters as executive director, Sustainable
Development and Healthy
Environments,
and
a
member of the Cabinet of
then director-general Dr
Gro Harlem Brundtland.
From 2000 to 2013, Dr
Khetrapal Singh served as
WHO deputy regional director for the South-East
Asia Region.
In February 2013, she
joined the Ministry of
Health and Family Welfare of the Government
of India as Advisor for International Health, where
her principal task was to
strengthen global health
outcomes and provide
guidance to the Ministry
to take forward the international health agenda.
India, Netherlands sign MoU to boost ties in health sector
DTMT NETWORK
NEW DELHI
Indian and the Netherlands signed an agreement to boost bilateral
cooperation in the areas
of communicable diseases, public health policy,
e-health, and medical
products among others.
Under the agreement,
both countries could
also encourage greater
research collaborations
among their universities,
foundations,
industry
and the health services,
an official statement said.
The Memorandum of
Understanding
(MoU)
was signed by Health and
Family Welfare Minister
Ghulam Nabi Azad and
his Dutch counterpart
Edith I Schippers.
Azad said the strengthening of cooperation between the two countries
would result in mutually
beneficial exchanges.
“This is a very positive
development and a step
forward from the sectoral MoU between respective food regulatory
authorities in the area of
food safety,” he said.
Schippers said the MoU
would strengthen ties between the two countries
in the areas of health.
Azad expressed his
happiness that the United Nations had recognised the importance
of health in the next
generation of global
development goals beyond 2015, suggesting
an illustrative goal of
“ensuring healthy lives”.
DTMT Exclusive
14
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
TB – no more formidable, but facing weak resistance
Don’t ignore bad cough! Go for
a test and make sure it’s not TB
JIVIKA MITTAL
R
With 2-2.5 million cases of tuberculosis reported annually in the
country India has achieved a dubious distinction of being home to
highest number of TB patients in the world. High prevalence of tb in
the country and the casualties at a time when the totally disease is a
sad commentary on the state of our healthcare system. Unless we
take steps to plug the loopholes in the implementation of healthcare
schemes, our victory over TB will remains pyrrhic.
eena had bad cough
for two months. She
was taking cough syrup
regularly taking it for bad
cold. But there was no respite from cough. As gradually she started having
fever with high temperature, losing weight and
was complaining pain in
the chest, omitting blood,
weakness and fatigue she
realised something seriously wrong with her. She
underwent some test and
diagnosed with tuberculosis.
Tuberculosis (TB) is a
highly contagious disease caused by the bacteria that spread through
the air from one person
to another. The TB bacteria spread when a person
with TB of the lungs or
throat coughs, sneezes,
speaks or sings. People
nearby may breathe in
these bacteria and become infected. The TB
bacteria usually attack
the lungs, but can attack
any part of the body such
as the kidney, spine, and
brain.
It is important to note
The TB bacteria spread when a person with TB of
the lungs or throat coughs, sneezes, speaks or sings.
People nearby may breathe in these bacteria and
become infected. Normally, the TB bacteria usually
attack the lungs, but can also attack any part of the
body such as the kidney, spine, and brain
that everyone infected
with TB bacteria does not
fall sick. People who get
infected but are not sick
have latent TB infection.
People who have latent TB infection do not
feel sick, do not have any
symptoms, and cannot
spread TB bacteria to others. But they can be a carrier of the disease.
A positive TB skin test
or TB blood test only tells
that a person has been infected with TB bacteria. It
does not tell whether the
person has latent TB in-
Need to cut down delay India home to most TB patients in the world
in treatment of TB cases
ROHIT KUMAR
BS RAWAT
As theme for World TB Day
2014 – “A TB test, treatment and cure for all” – has
been announced, global
partners will call for an effort to find, treat and cure
all people with TB and accelerate progress towards
the bold goals to see in
Tuberculosis
strategies
post-2015 and a world with
Zero TB deaths, stigma and
infections.
The day is observed all
over the world not only
to create awareness in the
general public about the
disease but also to involve
it in the efforts for total
eradication of the disease.
World TB Day has been
established to commemorate the tuberculosis by
all at one place in order to
get some solution to eradicate it from the world. It
mobilises the political and
social authorities for further progress towards the
disease prevention for the
effective reduction in the
TB cases and death rate in
the coming years.
TB is a completely curable disease at very lowcost through the DOTS
treatment administered by
the government. Its treatments and diagnostic tests
should be accessible by
each and every person affected by the tuberculosis
all over the world. Active
participation is required
by the all group people,
communities and government agencies to work
together as it is continues
to be major public health
threat, with an
estimated 8.7
million new
cases
per
year, and
an
estimated 1.4
million
deaths.
Early case detection and
rapid treatment continues
to remain the cornerstone
of the “Stop TB strategy”.
With the incidence of TB
declining very slowly, it is
now becoming clear that
TB cannot be eliminated
by 2050.
India has the world’s
highest burden of TB
where TB kills one person
every two minutes and 750
people every day. Global
TB control is unattainable
without enhanced control
of TB in India. The emergence of “totally drugresistant” and the DOTS
strategy may not be sufficient for reducing TB incidence in the country.
India’s Revised National
TB Control Programme
(RNCTP) has made great
strides in the last decade,
and free, quality-assured
TB diagnosis and treatment is available to all patients who seek care in the
public sector.
While there are some
positive
developments,
but the TB control in India
is at a critical juncture. The
DOTS program has been
scaled-up and may have
reached its limits because
TB incidence is not declining.
TB case finding has plateau and many cases remain either undiagnosed.
By the time TB cases are
initiated on treatment in
the RTNCP, they likely have
already infected many others in the community. Delays in diagnosis or ineffective treatment lead to
ongoing transmission, facilitating the spread of
the disease.
The government
reluctantly made
TB a notifiable
disease as the
public and private sectors were
not ready to
correct this
anomaly and
have shown
little interest
in implementing the order. If
implemented in
right earnest,
every case detected would
get reported
and the actual extent
of
the
disease
will bec o m e
known.
Of late, there has been a
dramatic rise in cases of tuberculosis cases in India.
According to World Health
Organization (WHO), of a
total number of TB cases in
the world, 2-2.5 million cases are from India alone. This
makes our country the most
TB vulnerable nation in the
world.
Poverty, huge urban settlements and unhygienic living
conditions are some of the
major factors behind this
rise. A rough survey shows
that even one unnoticed TB
patient could affect 10-15
people in one year.
Take the case of Mumbai, in January 2012 the city
had a big TB worry when 12
people were reported to be
suffering from a totally drug
resistant version of tuberculosis, a potential epidemic
likely to occur.
Cases Undetected
One of the important aspects of the report was that
the three million TB cases
are not detected each year
and 33 per cent popula-
tion does not get treatment
when they need it the most.
The WHO believes that if we
want to eradicate this dangerous disease, we need to
reach such patients.
It was estimated that
450,000 people suffered
from a multi-drug resistant
variety of TB with China,
India and Russia accounting for the highest patients.
MDR-TB is a type of tuberculosis that can resist the
first line of anti-TB drugs. It
happens because people do
not take medicine regularly
or stop taking it mid-way in
the course of treatment. It
spreads in the same way as
tuberculosis.
Mdr-Tb Threat
The WHO’s belief that
drug-resistant TB is a big
problem is completely justified as we would be hardpressed to make new drugs
if the millions around the
world were forced with
drug-resistant TB.
“The unmet demand for
a full-scale and quality response to multidrug-resistant tuberculosis is a real
public health crisis,” says
Dr Raviglione, head of the
WHO’s tuberculosis programme.
“It is unacceptable that
increased access to diagnosis is not being matched by
increased access to MDR-TB
care. We have patients diagnosed but not enough drug
supplies or trained people
to treat them. The alert on
antimicrobial
resistance
has been sounded; now is
the time to act to halt drugresistant TB.”
Maintain Funding
The present worldwide
funding to fight TB is nearly
$2 billion per year and it is
particularly crucial for lowincome countries which
heavily depend on international donor funding. To
increase response, we will
require refilling the Global
Fund so that there is decline
in the resources handed out
to vulnerable nations.
The WHO is trying to meet
its Millennium Development Goals but it will need
to maintain the current pace
and to rise in some sectors
to reach its goals.
fection or has progressed
to TB disease. Other tests,
such as a chest x-ray and
a sample of sputum, are
needed to see whether the
person has TB disease.
Not all people need a TB
test. You should get a TB
test if you are at increased
risk. If a person has been
recently infected with TB
bacteria or his immunity
is decreasing day by day,
should undergo the TB
tests.
While anyone can get TB
disease, some people who
are infected with TB bacteria are more likely to get
sick. The person who has
HIV infection can be infected with TB bacteria as
well in the last two years
of his existence because
he will have weak immune
system or consumes alcohol and hence have higher
chances of getting TB.
Active TB disease can
be fatal if left untreated,
therefore, regular monitoring and treatment by a
doctor is crucial as doctor
gives several antibiotics
to treat the infection and
to help prevent resistant
bacteria from emerging in
patient’s body.
Tips for prevention
Early diagnosis: Early diagnosis is key to avert
spread of the disease and infection. Patients
with active lung tuberculosis can go to any
government chest clinic for treatment.
Close contacts: The close contacts of TB patients, generally members of the household,
should be examined. In the examination, skin
test and or chest X-ray examination for teenagers and older children and adults are essential.
Healthy lifestyle: The germs attack the lungs
when a person’s body resistance decreases.
So, try to protect yourself by leading a healthy
lifestyle in order to cut down chances of contracting the disease.
BCG vaccination: The TB & Chest Service provides Bacille Calmette-Guerin (BCG) vaccination to all infants to guard them against tuberculosis. Children residing in Hong Kong below
15 years of age and have never received BCG
before are also advised to receive the vaccine.
Other precautions
Regular exercise
Adequate rest and sleep
Balanced diet
Avoiding alcohol and tobacco
Breathing fresh air
Absolutely curable, yet a killer disease in India
Reason: Delayed diagnosis, lack of public awareness, irregular treatment and inaccurate dosage
MK SINGH
T
uberculosis is an absolutely a
curable disease. Right medicine at right time and the right
course of treatment are key to
treat tuberculosis successfully.
Patient needs to follow the instructions of the physician in letter and spirit. Just persecution of
medicine is not enough.
TB being highly contagious
disease, it is the public health responsibility of the doctor treating a patient has to make sure
that his patient eventually gets
relief. For this, he should ensure
that the patient follows his instructions properly, lest however
efficient the treatment might be
it will not show the desired results.
In fact, it is the responsibility
of both the doctor and the patient to ensure that the treatment
reaches to its logical conclusion.
All the doctors treating TB are
under obligation to choose correct line of treatment and prescribe right medicine. In case
of any lapses, apart from the
patient, the society at large will
have to pay a heavy price.
It is a pity almost 2.5 lakh people have lost their lives due to TB
in India despite all the caution.
On an average two people die
in every three minute. Patients
do not get the medicine in correct dosage as it should be and if
they do they do not take it properly owing to negligence. In most
cases patients do not follow the
prescribed course and give up
medicine mid-way. It doesn’t
mean they don’t have the desire
to live, but they do so due to lack
of awareness.
The need of the hour is to educate people. The Government
is making medicine available
to all, diagnosis too is not a big
deal what is required is that the
patient should avail the benefits.
Only 50 per cent of the TB patients avail the benefits.
Tuberculosis is a sensitive disease, we need to handle it sensitively but unfortunately we do
not as most of the patients tend
to break the duration of medication. They, however, start taking
the medicine again after a gap.
But this break journey renders
tuberculosis drug resistant. For
instance, multi-drug resistant
(MDR) is extensively drug resistant (XDR) and in some cases total drug resistant (TDR).
In these cases no drugs available will work. The current
drug duration course is for six
months. Although researches are
on way to minimise the course
as it might be the long duration
by which people get fed up and
leave the medicine.
In India, to the earliest diagnosis of MDR is almost two to
three months. During this period,
many people lose their lives as
they live without medicine. Now,
under the new technique named
“gene expert”, the diagnosis for
MDR will take only a couple of
hours. Before gene expert there
was a technique called “lipa
method” which takes two days in
diagnosis MDR.
With the help of these two
techniques our Government has
initiated a pilot testing project in
more than 90 districts. The objective is to replace the earlier
test method so that it can save
the valuable time spent on diagnosis to bring down the causality.
The first TB control programme was started in 1962 by
the Government of India called
National TB control program
(NTCP). To analyze the benefit
in 1992 our government with the
help of WHO had evaluated the
programme. In evaluation the
expected result were not found
due to some shortcomings in implementation. To overcome all
the drawbacks the government
again moved up with the Revised
National TB control programme
(RNTCP). In NTCP the period
of treatment was one year but
in RNTCP it is minimized by six
months. DOTS were introduced
in RNTCP.
The government has put all
his effort to restrain the causality. This RNTCP has brings down
the causality to almost 2.5 lakhs
against 5 lakhs. There still remain
many challenges to tackle and to
do so the government is trying
to bring private hospitals, NGOs,
health activists under one platform.
Moreover, the government has
made it a notifiable disease. In
this case we can avail the actual
data of people suffering from TB
and through this we can gives
the best treatment. Our effort is
to diagnose it early to provide
the best medicine in right dose
so that the MDR and XDR will
not evolve. The government has
decided to eliminate TB by 2050.
(With inputs from Prof Rajendra Prasad,
director, Vallabhbhai Patel Chest Institute.)
Medical Business
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Global sales boost Sun profit
DTMT NETWORK
Sun Pharmaceutical Industries reported a 74 per cent increase in consolidated net profit to Rs 1,531.09
crore in the quarter ended December 31 on robust sales in the global
markets. “Profit a year earlier was Rs
881.3 crore”, Sun Pharma said in a
statement.
Net sales of the pharma major
climbed 50 per cent to Rs 4,286.59
crore from Rs 2,852.01 crore in the
year-ago period. Branded generic
sales in India rose 20 per cent to
Rs 947 crore, while finished dosage
sales in the US grew 57 per cent to
$434 million, it said.
According to market analysts, the
top two pharma majors, Sun Pharma
and Lupin, have beaten street expectations by a long margin on all
counts. Lupin had posted a 42 per
cent increase in consolidated net
profit to Rs 476.1 crore in Q3.
International formulation sales
outside the US were up 16 per cent
at $84 million. International revenue
accounted for more than 75 per cent
of the total in the quarter.
“Our overall performance reflects
the focus on execution of our strategy. We are developing a differentiated and specialty business and
continue to evaluate opportunities
to enhance our global presence,” Sun
Pharma Managing Director Dilip
Shanghvi said.
Sun Pharma said it is ranked second with a 5.3 per cent share in India’s Rs 74,000 crore pharmaceutical market, citing a December report
by market research organisation
AIOCD-AWACS.
Shares of the company gained 0.6
per cent to Rs 614.70 at the close on
the BSE. External sales of its active
pharmaceutical ingredients (API)
business posted a 17 per cent decline to Rs 174 crore, mainly due to
increased captive consumption, the
company said.
Consolidated R&D expenses were
at Rs 306 crore, or 7.1 per cent of
sales. During the period, the company filed abbreviated new drug applications (ANDA) for five products.
“After counting these, and adjusting for filings that were dropped,
cumulatively ANDAs for 468 products have been filed with the USFDA
(as on December 31),” the company
said.
ANDAs for four products received
approvals in the third quarter, taking the total number of approvals to
337.
Applications for 131 products
await USFDA approval, including 14
tentative approvals, it said.
The company revised its consolidated revenue growth forecast to 29
per cent compared with the previous estimate of 25 per cent.
“The revised guidance takes into
account the performance achieved
in first nine months of the fiscal,
higher base of Q4FY13 on consolidation of acquisitions as well as
the risks associated with increase
in competition for some products,”
it said.
Big layoff in Novartis: Cipla shares tank as Q3
earnings lag estimates
4,000 workers face
DTMT NETWORK
job loss or transfer
DTMT NETWORK
MUMBAI
Swiss drug maker Novartis
plans to cut or transfer up
to 4,000 jobs and move a
significant part of it to its
India facility in Hyderabad,
a news report said, quoting
the German newspaper NZZ
am Sonntag.
The move, affecting up
to 6 per cent of its workforce, is part
of a cost-cutting strategy
through which
the company
will be reducing the number
of manufacturing sites, the
agency cited
the newspaper
as saying.
Novartis could not be
reached for comment. The
development comes at a
time when multinational
drug makers are facing increasing pressure to cut
costs as patents expire.
The measures “reflect the
need to respond to a dynamically changing healthcare environment”, it said,
adding that Novartis expects group headcount to
remain largely flat in 2014.
“We expect that an equal
number of jobs will be cre-
ated as are reduced,” the
statement said.
A significant number of
jobs are expected to be
moved to India, with the
company saying that it
plans to move existing operations in Hyderabad to
a business services centre
as part of its consolidation
strategy.
“The new centre is expected to open in late
2015 or early
2016 and will
bring together
Novartis operations that
are currently
spread across
three sites in
Hyderabad as
well as provide for future
growth,” the statement said.
Novartis, which will face
copycat competition for
blood pressure, Pill Diovan
once Ranbaxy Laboratories
overcomes regulatory delays for its generic version,
posted lower than expected
core earnings per share last
week.
The company is also conducting a review of its overthe-counter, animal health
and vaccines businesses,
which lack the global scale
of
its
pharmaceuticals
operations.
Shares of drug major
Cipla slumped by over 6
per cent after the company posted a lower
than estimated consolidated net profit of Rs
284.31 crore for the third
quarter ended December 31, 2013.
After making a weak
opening, the scrip further lost 6.11 per cent to
Rs 387.55 on the BSE.
At the NSE, Cipla’s scrip
tanked 6.17 per cent to
Rs 387.25.
The stock was the top
loser among the bluechips on both Sensex
and Nifty during the
morning trade.
The company announced results after
market hours on February 12.
“Cipla posted numbers
that were above expectations on sales front,
while net profit came
below
expectations,”
Angel Broking said in a
report.
The company had
posted a net profit of Rs
340.31 crore during the
same period of the previous fiscal.
Consolidated net sales
of the company stood
at Rs 2,552.63 crore for
the third quarter. It had
stood at Rs 2,070.53
crore in the same period
of previous fiscal, Cipla
Ltd said on February 12.
“Current year figures
include the relevant results of Cipla’s subsidiaries from the date they
became subsidiary of
the company and therefore the corresponding
figures for the previous
period are not comparable,” it added.
During the period
under review, the comp a n y ’s
domestic revenues
stood at
Rs 1,044
crore as
against
Rs 927
crore
d u r ing the
s a m e
period
of previous
fiscal.
USFDA ban lands Ranbaxy in the red
DTMT NETWORK
US drug regulator USFDA recently blacklisted Ranbaxy Laboratories’ Toansa plant
in Punjab — the generic
drug makers’ fourth
factory to face such an
import ban — dealing a
body blow to the company’s reputation and
bringing its share prices crashing by nearly
20 per cent.
Japanese drug maker Daiichi Sankyo had
bought the company
for an eye-popping
$4.6 billion (about Rs
20,000 crore at the
time) in 2008 from
its former promoters,
Malvinder Mohan Singh and family.
The latest ban could
not have come at
worse time for the
one-time poster-boy of
India’s pharmaceutical
industry that is nursing a welter of festering wounds from runins with regulators to
employee exits and
penalties for felony.
The company will
now have to negotiate prolonged scrutiny
before it can introduce
new products
in key markets.
Analysts
warned of a
drop in earnings by up to 40
per cent over
the next one
year as exports
from
Indian
are effectively
ruled out.
Disclaimer:
We exercise due care, diligence and
caution in publishing the news and
articles. None of the report or articles constitute any form of advice,
recommendation or arrangement
by us. Readers are requested to
make their own research and enquiries prior to making any investment or other decisions. We are not
liable for any claim of loss or damages suffered by any person due to
such decisions solely based on our
reports or articles.
It could also hit the
company’s plans to
exploit “patent cliff”
opportunities, ruling
out a shot at a multibillion dollar opening
of drugs whose patents
expire soon.
Ranbaxy has been
found wanting compared to its peers, facing pointed posers on
production and hygiene standards. The
USFDA prohibited it
from making and selling active pharmaceutical
ingredients
(API) from its facility
in Toansa.
Violations included
staff re-testing raw
materials and drugs
after they “failed analytical testing and
specifications in order
to produce acceptable
findings.”
15
HCL forays into healthcare business; to invest Rs 1k crore
DTMT NETWORK
NEW DELHI
With the launch of HCL Healthcare,
the technology giant forays into wellness and preventive healthcare market. The company is looking forward
to invest Rs 1,000 crore in next five
years to create India’s largest network of outdoor patient clinics.
Promoted by billionaire Shiv Nadar
the company is already running two
clinics in the Delhi NCR region.
Think smartphone apps, video con-
sultation and online monitoring of
real-time health status of patients
that will help them get rid of unwieldy paperwork.
“The idea is to capture diseases early and nip problems in the bud,” says
CEO of HCL Avitas Harish Natarajan.
Medical Mix
16
DRUG TODAY MEDICAL TIMES
1st - 31st March 2014, New Delhi
Smart glasses to help doctors ‘see’ cancer cells
MUKUL VYAS
A big leap forward in the
treatment of cancer with
accurate precision! Now
special glasses developed
at Washington University
School of Medicine in St
Louis may help surgeons
visualise cancer cells,
which glow blue when
viewed through the glasses. Cancer cells are notoriously difficult to see,
even under high-powered
magnification.
These smart glasses are
designed to make it easier
for surgeons to distinguish cancer cells from
healthy ones and ensure
that no stray tumour cell
is left behind during surgery.
The wearable technology was used during surgery for the first time at
Alvin J. Siteman Cancer
Center at Barnes-Jewish
Hospital and Washington University School of
Medicine.
Julie
Margenthaler,
MD, breast surgeon and
associate professor of
surgery at the Washington University, who performed the operation,
said: “We’re in the early
stages of this technology,
and more development and testing will
be done, but we’re
certainly encouraged
by the potential benefits to patients.”
“Imagine what it
would mean if these
glasses eliminated the
need for follow-up
surgery and the associated pain, inconvenience and anxiety,” he added.
Current standard
of care requires surgeons to remove the
tumour and some
neighboring
tissue
that may or may not
include cancer cells.
The samples are sent
to a pathology lab
and viewed under a
microscope. If cancer cells are found in
neighboring tissue, a second surgery is often recommended to remove additional tissue that also is
checked for the presence
of cancer.
The glasses could re-
duce the need for additional surgical procedures
and subsequent stress on
patients, as well as time
and expense. Margenthaler said about 20 to 25 per
cent of breast cancer pa-
tients who have lumps
removed require a second
surgery because current
technology doesn’t adequately show the extent
of the disease during the
first operation.
RNI No. DELBIL/2012/45560
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Jokes
n
An Old man went to the doctor complaining
a terrible pain in his leg.
“I am afraid it’s just old age”, replied the doctor, “there is nothing we can do about it.”
“That can’t be” replied the old man, adding “you don’t know what you are doing.”
“How can you possibly know I am wrong?” questioned the doctor.
“Well it’s quite obvious. My other leg is fine, and it’s exactly of same age!” reasoned the old man.
n
Lady to Doctor: My husband has the habit of talking in sleep. What should I give him to cure?
Doctor: Give him an Opportunity to speak when he is awake.
n
Dad: What’s your result?
Son: I’ve failed in five subjects.
Dad: Now onwards don’t call me dad!
Son: Oh! Come on dad, it’s my school test, not a DNA test.
n
I was very scared about going to the eye specialist to get a certain procedure done on my Sudoku solution
eyes. The doctor tried to put me at ease but to no avail. It was after he finished with my first eye that I nearly jumped out of
the chair. “There there”, he said “only one eye left!”
Crossword solution
09971523292