Category: HEALTH

research
  • HEALTH

भारत में मेडिकल लेजर बाजार बढ़ती पहुंच के कारण तेजी से बढ़ रहा है

अल्मा मेडिकल प्रा. लि., प्रसिद्ध इजरायली निर्माता की भारतीय सहायक कंपनी, चिकित्सा, प्रकाश-आधारित, रेडियोफ्रीक्वेंसी और अल्ट्रासाउंड समाधानों के लिए लेज़रों के क्षेत्र में अग्रणी वैश्विक नवप्रवर्तक है। सौंदर्यशास्त्र, शल्य चिकित्सा और सौंदर्य (स्पा) बाजारों में विशेषज्ञता रखने वाली अल्मा एशिया में अपने मजबूत उपस्थिति का विस्तार कर रही है, विशेष रूप से भारत, चीन, कोरिया, जापान और ऑस्ट्रेलिया में।

उद्योग के अनुमानों के अनुसार, भारतीय चिकित्सा लेज़रों का बाजार, जिसमें सौंदर्यशास्त्र भी शामिल है, का मूल्य FY2023 में ₹715.72 मिलियन था और FY2031 तक यह ₹1,835.08 मिलियन तक बढ़ने की संभावना है, जिसमें 12.49% की वार्षिक वृद्धि दर (CAGR) है।

अल्मा का लेज़र प्लेटफ़ॉर्म, जो 2007 से भारत में उपलब्ध है, एक प्रसिद्ध ब्रांड है। कंपनी का दावा है कि उसने पिछले 25 वर्षों में अपनी नैदानिक रूप से सिद्ध अनुप्रयोगों के माध्यम से दुनिया भर में लाखों लोगों के जीवन को बदल दिया है। अल्मा इंडिया प्रा. लि. के अध्यक्ष एलेन त्ज़िओनिट ने कहा, "सौंदर्य की उपलब्धता अल्मा की अनुसंधान एवं विकास प्रक्रिया का हिस्सा है। हम विभिन्न त्वचा प्रकारों, यहां तक कि सबसे जटिल त्वचा के लिए भी उपचार सक्षम करने के लिए अभिनव समाधानों में निवेश कर रहे हैं।"

भारत में अब लेज़र उपचार अधिक सुलभ है, धन्यवाद बढ़ते जीडीपी और कम लागतों का। अल्मा इंडिया ने तेजी से विस्तार किया है, और द्वितीय और तृतीय श्रेणी के शहरों तक पहुंच बनाई है। भारत के बी2बी, बी2सी और सी2बी लेज़र हेयर रिमूवल बाजार में अल्मा का सोप्रानो टाइटेनियम 'गोल्ड स्टैंडर्ड' माना जाता है।

"भारतीय डॉक्टर सर्वोत्तम सौंदर्य परिणाम प्रदान करना चाहते हैं, और वे इसे प्राप्त करने के लिए अल्मा प्लेटफ़ॉर्म चुनते हैं। डॉक्टरों की प्राथमिकताओं और मजबूत ब्रांडों के कारण, अल्मा द्वितीय और तृतीय श्रेणी के शहरों तक पहुंचने में सक्षम है," त्ज़िओनिट ने बताया।

अंतरराष्ट्रीय स्तर पर, अल्मा सेवाओं में इंजेक्टेबल्स, स्किनकेयर, सौंदर्यशास्त्र, डिजिटल डेंटिस्ट्री और घरेलू उपयोग के उपकरण शामिल हैं। भारत में अल्मा के उत्पाद रोलआउट रोडमैप के बारे में त्ज़िओनिट ने कहा, "हम अगले दो वर्षों में और अधिक प्लेटफ़ॉर्म, इंजेक्टेबल्स, स्किनकेयर समाधानों और अभिनव प्रोटोकॉल के साथ अपने उत्पाद पोर्टफोलियो का विस्तार करेंगे।"

भारतीय बाजार की अनूठी चुनौतियों का सामना करते हुए, त्ज़िओनिट ने कहा, "भारत अभी भी एक मूल्य संवेदनशील बाजार है। अल्मा अपने ग्राहक आधार का विस्तार कर रही है और नए अवसरों की खोज कर रही है, जिसमें डेंटल मार्केट भी शामिल है। अल्मा विशिष्ट उत्पाद क्षमताओं और अत्याधुनिक तकनीकों के बीच समन्वय के कारण दुनिया भर में शीर्ष तीन चिकित्सा सौंदर्य कंपनियों में से एक है।"

नेशनल इनवेस्टमेंट प्रमोशन और सुविधा एजेंसी, इनवेस्ट इंडिया के अनुसार, भारतीय चिकित्सा उपकरण बाजार का आकार $11 बिलियन से अधिक आंका गया है और 2025 तक यह ₹50 बिलियन तक बढ़ने की उम्मीद है, और पिछले तीन वर्षों में यह क्षेत्र 15% की वार्षिक वृद्धि दर (CAGR) के साथ लगातार बढ़ रहा है।

research
  • HEALTH

2019 और 2023 में भारतीय जनता पार्टी (बीजेपी) के टिकट पर चुनाव लड़ने और हारने के बाद, नारायणन श्री गण

2019 और 2023 में भारतीय जनता पार्टी (बीजेपी) के टिकट पर चुनाव लड़ने और हारने के बाद, नारायणन श्री गणेश ने भारतीय राष्ट्रीय कांग्रेस (आईएनसी) के टिकट पर सिकंदराबाद छावनी सीट जीती। नए सांसद (विधायक) के रूप में उन्होंने पानी की आपूर्ति, शैक्षिक बुनियादी ढांचे और विवादास्पद सिकंदराबाद छावनी बोर्ड (एससीबी)-ग्रेटर हैदराबाद नगर निगम (जीएचएमसी) विलय सहित कई मुद्दों पर सवाल उठाए। सिद्धार्थ कुमार सिंह के साथ एक साक्षात्कार के अंश:

कांग्रेस में शामिल होने का कारण

प्रश्न: 2019 और 2023 में बीजेपी के टिकट पर चुनाव लड़ने के बाद इस साल आपने कांग्रेस क्यों जॉइन की?

उत्तर: मेरा मुख्य उद्देश्य सिकंदराबाद छावनी के लोगों की सेवा करना है। मुझे लगा कि कांग्रेस में यह संभव हो सकेगा। कांग्रेस ने अपने अधिकांश पूर्व-चुनाव वादों को तीन महीनों में पूरा किया है, केवल कुछ योजनाएं आदर्श आचार संहिता (एमसीसी) के कारण विलंबित हो गई हैं। इसके बावजूद, वर्तमान राज्य सरकार से सभी खुश हैं।

राजनीतिक बदलाव पर जनता की प्रतिक्रिया

प्रश्न: जब आपने बीजेपी से कांग्रेस में कदम रखा तो लोगों की प्रतिक्रिया कैसी रही?**

उत्तर: मेरे बदलाव के प्रति लोगों की प्रतिक्रिया मेरे 13,206 मतों की बहुमत से स्पष्ट है। निवासी आश्वस्त हैं कि मैं राज्य सरकार के साथ मिलकर क्षेत्र में आवश्यक विकास लाऊंगा। वे विश्वास करते हैं कि राज्य सरकार द्वारा शुरू की गई योजनाएं सीधे और बिना भ्रष्टाचार के उनके पास पहुंचेंगी।

कांग्रेस सरकार के साथ संबंध

प्रश्न: वर्तमान कांग्रेस सरकार के साथ आपके संबंध कैसे हैं?

उत्तर: वर्तमान सरकार के साथ मेरे संबंध बहुत अच्छे हैं। मैंने कांग्रेस के साथ अपनी राजनीतिक यात्रा शुरू की और अन्य पार्टियों में समय बिताने के बाद अब वापस आया हूं। इसके अलावा, मुख्यमंत्री ए रेवंत रेड्डी, जो 2019 से मलकाजगिरी सांसद थे और अब सीएम हैं, छावनी के हर हिस्से की समस्याओं से भलीभांति अवगत हैं। चुनाव अभियान के दौरान उन्होंने छावनी के लोगों से जीएचएमसी-एससीबी के विलय का वादा किया था।

जी. सयाना की राजनीतिक विरासत का अंत

प्रश्न: इस चुनाव में आपकी जीत के साथ जी. सयाना की राजनीतिक विरासत समाप्त हो गई है। आप इसे कैसे देखते हैं?

उत्तर: लोग बहुत सोच-समझकर चुनते हैं। वे जानते हैं कि उनकी समस्याओं को कौन समझेगा और उनका समाधान करेगा। उन्होंने मुझे इसलिए चुना क्योंकि चुनाव हारने के बावजूद, मैं लगातार छावनी की गतिविधियों में सक्रिय था और क्षेत्र में अपना सामाजिक कार्य जारी रखा। छावनी की कई समस्याएं पिछले विधायक और सरकार की विफलताओं के कारण वर्षों से बनी हुई हैं।

एससीबी-जीएचएमसी विलय

प्रश्न: वर्तमान में इस क्षेत्र में सबसे बड़ा मुद्दा एससीबी का जीएचएमसी के साथ विलय है।

उत्तर: पिछले दशक से कई नेताओं ने इस विलय के लिए संघर्ष किया है, लेकिन बीजेपी सरकार ने लगातार इसका विरोध किया है। बीजेपी के एक नामांकित एससीबी सदस्य ने भी रक्षा मंत्री को विलय के खिलाफ पत्र लिखा था, जिसे बीजेपी तेलंगाना अध्यक्ष जी. किशन रेड्डी ने समर्थन किया था। इसके अलावा, एससीबी के लिए चुनाव हुए लगभग नौ साल हो गए हैं। अब, मैं राज्य सरकार के साथ मिलकर इस विलय मुद्दे का सक्रिय रूप से पालन करूंगा। यदि केंद्र सरकार उत्तर नहीं देती है, तो मैं दिल्ली में उत्तर मिलने तक भूख हड़ताल पर जाने के लिए तैयार हूं।

क्षेत्र के लिए योजनाएं

प्रश्न: क्षेत्र के लिए आपकी योजनाएं क्या हैं?

उत्तर: सिकंदराबाद छावनी बोर्ड (एससीबी) में आठ वार्ड हैं, लेकिन वर्तमान में केवल एक वार्ड में हर दूसरे दिन पानी मिलता है, जबकि बाकी सात वार्ड पानी की भारी कमी का सामना कर रहे हैं। मेरी पहली प्राथमिकता है कि प्रत्येक वार्ड में नियमित पानी की आपूर्ति सुनिश्चित की जाए। दूसरी बात, क्षेत्र में शैक्षिक बुनियादी ढांचे की कमी है, क्योंकि यहां कोई डिग्री कॉलेज नहीं है। हम जल्द ही एक स्थापित करने की योजना बना रहे हैं। इसके अतिरिक्त, हम सड़कों, जल निकासी प्रणालियों और अन्य आवश्यक बुनियादी ढांचे में सुधार पर ध्यान केंद्रित करेंगे। महिलाओं के लिए, हम महिला भवन स्थापित करेंगे और बेरोजगारी को कम करने के लिए कौशल प्रशिक्षण केंद्र स्थापित करेंगे। छावनी में प्लॉट खरीदने वालों को अतिरिक्त 3.5% स्टांप और शुल्क का भुगतान करना पड़ता है। जबकि राज्य के बाकी हिस्सों में भवन अनुमति प्राप्त करना आसान है, छावनी में निवासियों को अक्सर महीनों या वर्षों तक देरी का सामना करना पड़ता है।

 

 

Photo courtesy: Ramakrishna G

research
  • HEALTH

केरल ने 2024 में हीटस्ट्रोक के कारण दो मौतों की पुष्टि की है, जो जलवायु परिवर्तन से जुड़े बढ़ते तापम

पहली आधिकारिक पुष्टि की गई हीटस्ट्रोक से मौत 2016 में हुई, जो एल नीनो द्वारा उत्पन्न राज्य के सबसे भयानक सूखे के साथ मेल खाती है। सरकारी आंकड़ों ने इस वर्ष पांच सनस्ट्रोक मौतों की प्रारंभिक रिपोर्ट की। विशेष रूप से, पलक्कड़ में दो पुष्टि की गई मौतें हुईं: एल्पुली की 90 वर्षीय महिला और कुत्तनूर के 65 वर्षीय पुरुष।

हालांकि कोझिकोड, मलप्पुरम और एर्नाकुलम में संदिग्ध हीटस्ट्रोक से मौतें हुईं, पोस्ट-मॉर्टम रिपोर्ट ने इन मामलों की पुष्टि नहीं की। इसके अतिरिक्त, 26 अप्रैल को मतदान के दिन, पलक्कड़ और कोझिकोड में तीन-तीन व्यक्ति बेहोश हो गए और बाद में उनकी मृत्यु हो गई, लेकिन गर्मी से संबंधित कारणों की पुष्टि नहीं हुई।

हीटस्ट्रोक पीड़ितों के लिए वित्तीय सहायता

केरल राज्य आपदा प्रबंधन प्राधिकरण (केएसडीएमए) के सदस्य सचिव शेखर एल. कुरियाकोस ने कहा कि केवल सनस्ट्रोक से होने वाली मौतों को राज्य आपदा प्रतिक्रिया कोष (एसडीआरएफ) से वित्तीय सहायता प्राप्त होगी। 2019 में, केरल ने हीटवेव, सनस्ट्रोक और सनबर्न को 'राज्य-विशिष्ट आपदाएं' घोषित किया, जिससे पीड़ितों को एसडीआरएफ राहत के लिए पात्र बनाया गया।

केरल में हीटवेव अवलोकन

भारतीय मौसम विज्ञान विभाग (आईएमडी) के अनुसार, केरल ने अपनी पहली दर्ज की गई हीटवेव का अनुभव किया, जिसमें पलक्कड़ ने 25 से 29 अप्रैल, 2024 के बीच हीटवेव मानदंडों को पूरा किया। पलक्कड़ ने 1 अप्रैल से 16 मई के बीच 40 डिग्री सेल्सियस से अधिक तापमान 16 दिनों तक दर्ज किया। हालांकि त्रिशूर, अलप्पुझा, कोल्लम में पुनालुर और तिरुवनंतपुरम ने तापमान मानदंडों को पूरा किया, उन्होंने हीटवेव घोषणा के लिए लगातार दिन की आवश्यकता को पूरा नहीं किया। इन अभूतपूर्व तापमानों में एल नीनो की स्थिति का योगदान माना जाता है।

Photo credit: Newsx

research
  • HEALTH

Protect your kids from air pollution by 5 simple precautions | EXPLAINED

Air Pollution: Inhaling Polluted Air Can Harm Your Child's Lungs, Brain, and Heart. To Keep Them Healthy in Worsening Air Quality, India TV Has Listed 5 Steps to Protect Kids.

Air Pollution: The Deteriorating Air Quality in Delhi-NCR, Caused by Changing Weather Patterns and Stubble Burning, Has Left Citizens Concerned. The Polluted Air Is Not Only Affecting the Health of Adults but Also Poses a Significant Health Risk to a Child's Well-being. Prolonged Exposure to Air Pollution Can Hamper a Child's Physical and Cognitive Development, Potentially Leading to Learning Difficulties and Behavioral Challenges.

As per a WHO Report on Air Pollution and Child Health, Every Day, Approximately 93% of the World’s Children Under the Age of 15 Years (1.8 Billion Children) Breathe Air That is So Polluted It Jeopardizes Their Health and Development. The Report Revealed That When Pregnant Women Are Exposed to Polluted Air, They Are More Likely to Give Birth Prematurely and Have Small, Low Birth-weight Children. Air Pollution Also Impacts Neurodevelopment and Cognitive Ability and Can Trigger Asthma and Childhood Cancer. Children Who Have Been Exposed to High Levels of Air Pollution May Be at Greater Risk for Chronic Diseases Such as Cardiovascular Disease Later in Life.

“Polluted Air is Poisoning Millions of Children and Ruining Their Lives. This is Inexcusable. Every Child Should Be Able to Breathe Clean Air So They Can Grow and Fulfil Their Full Potential,” Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, Said.

Air Pollution Can Affect a Child's Health in Several Ways. Check the 8 Points Below:

1. Respiratory Problems: Children Breathing Polluted Air Are at Higher Risk of Developing Asthma and Other Respiratory Diseases. Airborne Pollutants Can Irritate Their Airways and Make It Difficult to Breathe.

2. Developmental Delays: Prolonged Exposure to Air Pollution Can Affect a Child's Cognitive and Physical Development. It May Lead to Learning Difficulties and Behavioral Issues.

3. Low Birth Weight: Pregnant Women Exposed to Air Pollution Are at Risk of Giving Birth to Low-weight Babies, Who May Experience Health Problems and Developmental Issues.

4. Weakened Immune System: Pollutants in the Air Can Weaken a Child's Immune System, Making Them More Susceptible to Illnesses, Including Common Infections.

5. Heart Problems: Long-term Exposure to Air Pollution Can Increase the Risk of Heart Problems in Children, Such as Cardiovascular Diseases Later in Life.

6. Reduced Lung Function: Air Pollution Can Hinder the Growth of a Child's Lung Capacity, Which May Lead to Chronic Lung Diseases in Adulthood.

7. Cognitive Impairment: Poor Air Quality Has Been Linked to Cognitive Impairments, Potentially Affecting a Child's Ability to Concentrate and Perform Well in School.

8. Emotional Stress: Living in Areas with High Air Pollution Can Cause Emotional Stress in Children, Leading to Anxiety and Depression.

How to Protect Children from Air Pollution:
Protecting Children from Air Pollution Requires Multiple Actions, Involving Individuals, Communities, and Government Policies. People Need to Collaborate to Make the Air Cleaner and Healthier for Kids. WHO Has Listed Measures That Can Be Taken to Protect Children from the Harmful Effects of Air Pollution. Check Those Measures Below:

1. Stop Burning Household and Farm Waste.
2. Reduce Children’s Exposure to Air Pollution Caused by Vehicle Exhaust Emissions.
3. Keep Your Children Healthy – Ensure They Get Their Vaccinations, Consume Nutritious Food, and Have Ample Opportunities to Play and Stay Active.
4. Keep an Eye on Air Pollution Levels if the City You Reside in Has an Air Quality Monitoring Station.
5. Raise Awareness Among Your Community About the Health Impacts of Air Pollution.
image source freepic

research
  • HEALTH

7 Yoga Asanas To Strengthen Your Knees

If you're interested in bolstering the strength of your knees, here are seven yoga poses, or "asanas," that can contribute to knee stability and robustness.

Yoga serves not only as a means to enhance flexibility and alleviate stress but also as a potent instrument for fortifying particular body regions. Yoga presents a comprehensive strategy for enhancing knee health and vigour, although the key factor is consistency. Consistently engaging in these asanas, combined with other knee-friendly workouts, can significantly contribute to the upkeep of resilient and injury-free knees.

When you're performing these asanas, it's vital to sustain correct alignment and heed your body's signals. Prior to attempting these poses, it's always advisable to perform a warm-up. In case you have a history of knee injuries or discomfort, it's prudent to seek guidance on adjustments or substitute poses from a yoga instructor or a healthcare professional.

For individuals aspiring to reinforce their knees, we present seven yoga asanas that can play a part in nurturing knee strength and stability.

  1. Mountain Pose (Tadasana): Although it may seem uncomplicated, the mountain pose is a fundamental yoga posture that fosters accurate alignment and equitable weight distribution. It advances stability across the entire body, including the knees.

  2. Chair Pose (Utkatasana): Utkatasana is an outstanding pose for invigorating the quadriceps and, consequently, lending support to the knees. This pose subjects the muscles in your lower body to a test and heightens balance.

  3. Warrior I (Virabhadrasana I): This pose is exceptional for cultivating leg strength and augmenting knee steadiness. It extends the hip flexors and reinforces the quadriceps.

  4. Bridge Pose (Setu Bandha Sarvangasana): The bridge pose offers a brilliant approach to target the glutes, hamstrings, and quadriceps. A robust posterior chain can help alleviate pressure on the knees.

  5. Extended Triangle Pose (Trikonasana): Trikonasana extends and strengthens the legs, which includes the knees. It also enhances general equilibrium and flexibility.

  6. Tree Pose (Vrikshasana): In Vrikshasana, maintaining equilibrium on one leg engages the supporting leg, which, in turn, bolsters the knee and ankle. This pose additionally enriches concentration and balance.

  7. Child's Pose (Balasana): Though not a pose aimed directly at reinforcing the knees, Balasana is an exceptional restorative posture. It allows the knees to unwind and recuperate after more strenuous asanas, thereby helping to forestall overuse injuries.

research
  • HEALTH

World Polio Day 2023: What is polio disease, know symptoms and methods of prevention

World Polio Day is observed annually on October 24. This day serves as a global effort to raise awareness about the significance of polio vaccination.

World Polio Day takes place each year on October 24. It's a time when concerted campaigns are launched worldwide to eliminate polio and highlight the importance of vaccination against this disease. Interestingly, World Polio Day was initiated by Rotary International and coincides with the birthday of Jonas Salk, the leader of the pioneering team that developed the first polio vaccine. In 1988, the World Health Assembly embarked on a mission to eradicate polio from all nations. This initiative focused on administering vaccines to all children, safeguarding them from this devastating ailment, and World Polio Day is a part of this endeavour.

Polio is a dreadful ailment that can lead to paralysis when contracted, primarily affecting children under the age of 5. Therefore, it is crucial to administer timely vaccinations to all children. Notably, India achieved the status of being polio-free in 2014.

What is Polio? Polio, also known as poliomyelitis, results from an infection with the polio virus, which impacts the nerves in the spinal cord. This infection can lead to paralysis or even fatalities. As per the Cleveland Clinic, the polio virus initially infects the throat and subsequently the intestines, presenting flu-like symptoms. Following this, the infection affects the brain and spinal cord. It is a contagious disease that spreads easily from one person to another.

How Does Polio Spread? Polio can be transmitted through various means, including:

  1. Inadequate handwashing after using the toilet
  2. Consuming or preparing food with contaminated water
  3. Coming into contact with the saliva, spit, or feces of an infected individual
  4. Swimming in contaminated water
  5. Consuming contaminated food

What are the Symptoms? Polio may manifest with a range of symptoms, including:

  • Sore throat
  • Fever
  • Headache
  • Stomach pain
  • Vomiting
  • Diarrhea
  • Fatigue
  • Stiffness in the neck and back
  • Muscle pain
  • Difficulty moving legs or arms
  • Paralysis

How Can Polio be Prevented? The sole method of preventing polio is through vaccination. In India, oral polio vaccine drops are administered to every child under the age of 5. It is crucial to ensure that children receive these vaccinations on time to safeguard them from polio.

image source freepic

research
  • HEALTH

Nipah virus | General alert to continue in six districts in Kerala

Health Minister Veena George has stated that there have been no new cases of Nipah virus infection since September 15. However, 71 more samples have tested positive for the virus.

Individuals who had contact with Nipah-infected patients in Kozhikode district, Kerala, have been advised to self-isolate for at least 21 days. This announcement comes after 71 body fluid samples sent for lab testing turned out negative for the virus.

Health Minister Veena George made this announcement following a meeting with district medical officers from Kozhikode, Malappuram, Kannur, Wayanad, Thrissur, and Palakkad districts on Monday.

Apart from Kozhikode, 45 individuals in other districts are in quarantine due to their contact with infected individuals. Isolation wards and special ambulances are on standby in these areas, and the situation is reportedly under control.

Ms. George emphasized that despite no new cases since September 15, vigilance against the infection must continue for some more days.

Out of the six infected individuals, two have unfortunately passed away, while the others are receiving medical treatment. The condition of a nine-year-old child among them is improving, while the rest are stable.

Meanwhile, a Central team of officials, after visiting affected areas and interacting with locals and relatives of infected individuals, expressed satisfaction with the containment measures. They have collected samples from fruit-eating bats in Maruthonkara, the hometown of the first patient, and nearby areas.

Notably, teams from the National Institute of Virology, Pune, the National Centre for Disease Control, and the Indian Council of Medical Research are involved in this effort.

Another Central team from the Department of Animal Husbandry and Dairying is conducting field-level investigations in affected areas, collecting samples from pet animals, pigs, and fruit-eating bats. An online meeting with State Minister for Animal Husbandry J. Chinchurani took place later. These officials are expected to continue their work until Wednesday, with support from a team from the State Institute for Animal Diseases, Kerala.

On Monday, the Kozhikode district administration eased certain restrictions in nine gram panchayats that were declared as containment zones on September 13.

Photo Credit: PTI

research
  • HEALTH

43 lakh children below the age of five identified as obese or overweight: official data

In the last month, official data revealed that over 43 lakh children in the age group of 0-5 were identified as obese or overweight in India. This accounts for roughly 6% of all children surveyed at Anganwadi centers across the nation, as per the data.

The information collected from these government-run rural childcare centers also revealed that the percentage of obese or overweight children is almost equal to that of severely and moderately malnourished children found in Anganwadis, which stands at 6%.

Out of the total 7,24,56,458 children in the 0-5 age category who were "measured," approximately 6%, or 43,47,387 children, were classified as obese or overweight, according to data collated from the growth monitoring app 'Poshan Tracker'.

Thirteen states and union territories, including Madhya Pradesh, Maharashtra, Bihar, Rajasthan, Uttarakhand, and West Bengal, have obesity rates exceeding the national average of 6%, as indicated by the data.

Childhood obesity has been on the rise in recent years, which is a cause for concern. There has been a noticeable increase in the percentage of children under five years of age who are overweight in NFHS-5 compared to NFHS-4, as per data from the NHFS-4 (2015-16) and the NFHS-5 (2019-21).

Before the introduction of 'Poshan Tracker' in 2021, data was collected under the National Family Health Survey (NFHS).

In the NFHS-5, Mizoram, Arunachal Pradesh, and Jammu and Kashmir recorded the highest percentages of overweight children under five years of age, closely followed by Sikkim and Tripura. On the other hand, Madhya Pradesh, Bihar, and Andhra Pradesh reported the lowest percentages of overweight children under five years of age.

With the exception of Tamil Nadu and Goa, every state has seen an increase in the percentage of overweight children under five years of age in the NFHS-5 compared to the NFHS-4, according to survey data.

A recent global study by the World Obesity Federation underscored the seriousness of childhood obesity worldwide, and India is no exception. The study cautioned that if not addressed promptly, childhood obesity in India could witness an annual increase of 9.1% by 2035.

The study also pointed out that the risk of obesity for boys in India may rise from 3% in 2020 to 12% within the next 12 years. For girls, the risk, which was at 2% in 2020, may increase to 7% over the same period.

It is estimated that around 11% of the Indian population will be obese by 2035, with an annual increase in adult obesity projected to be around 5.2% between 2020 and 2035.

The study suggested that the continued failure to address and manage obesity could result in a global economic impact of USD 4.32 trillion by 2035, equivalent to nearly 3% of the global GDP. The report indicated that the likely impact on India's national GDP will be close to 1.8%.

Puja Marwaha, CEO of the child rights organization CRY, has identified several key factors contributing to the rising childhood obesity in India. These factors include a shift towards unbalanced diets, increased consumption of highly processed and packaged foods, and a sedentary lifestyle that limits the burning of excess calories.

She also emphasized the change in children's dietary habits, particularly in urban and semi-urban areas. Ms. Marwaha noted that children's preferences increasingly influence the purchase of marketed snacks, leading them to consume fast foods and sugary drinks, accumulating empty calories that their sedentary lifestyle does not allow them to burn off.

Highlighting another major contributor to dietary imbalance, she said that micronutrients are disappearing from the diet of the poor as traditional kitchen gardens are replaced by cash crops in villages. She stressed that the cost of nutritious vegetables, fruits, and protein sources has become unaffordable for many low-income families.

When asked about how to tackle obesity, Ms. Marwaha said that, like other behavioral issues among children, addressing childhood obesity must begin with proper parenting. Raising awareness among parents about what constitutes a balanced diet is crucial.

Ms. Marwaha pointed out that in urban areas, children often consume minimal fresh vegetables and fruits, and working parents may resort to offering junk food to ensure proper behavior in their absence.

This trend is not limited to urban areas, as even in rural settings, where both parents work as daily wage earners, children are sometimes given inexpensive packets of potato chips for lunch, she said.

Dr. Jyoti Kapoor, founder and director of Manasthali, said obese children face an elevated risk of developing various health problems, including Type-2 diabetes, heart disease, high blood pressure, and sleep apnea. These conditions can have immediate and long-term consequences on a child's quality of life and life expectancy.

Ms. Kapoor noted that childhood obesity often persists into adulthood, further increasing the risk of chronic health conditions and early mortality.

research
  • HEALTH

Deadly outbreak | Nipah virus

A zoonotic disease that jumped from animals to humans, NiV highlights the reality that human activities are driving the emergence of new global pandemics.

The Nipah virus outbreak in Kerala in 2018 was, looking back, the first major outbreak that people could remember. In a society accustomed to fast-paced narratives and thrilling stories of diseases, horror, and death, the 2018 Nipah virus (NiV) outbreak turned into a horrifying reality. In the recent outbreak in Kozhikode, six individuals tested positive, and two lost their lives. NiV, with its recurrent outbreaks in Kerala (now the fourth), has come to symbolize the fear and helplessness surrounding emerging diseases in the modern era.

NiV is a zoonotic disease that made the leap from animals to humans through a 'zoonotic spillover,' underscoring the fact that human-driven causes are responsible for the new pandemics worldwide. With these diseases emerging frequently, disrupting daily life and altering societal norms, it's crucial for those in positions of authority and healthcare professionals to recognize the evolving dynamics of diseases and address healthcare more comprehensively.

The name 'Nipah' originated from a Malaysian village where the first outbreak was reported in 1998. Initially, symptoms resembled encephalitis, but doctors soon realized that, in addition to neurological symptoms, there was acute respiratory distress syndrome, respiratory failure, and multi-organ dysfunction syndrome. Over time, the world learned about this new disease strain caused by a paramyxovirus, with pigs and fruit bats as vectors. Since then, India has witnessed several NiV outbreaks, primarily in Kerala (2018, 2019, 2021, and 2023), as well as in Siliguri in 2001 and a relatively small outbreak in Nadia, West Bengal, in 2007.

No licensed treatment
In Kerala, fruit bats are believed to be the primary reservoirs of infection, with the consumption of fruits or berries contaminated with bat saliva potentially causing the outbreaks. In other regions like Bangladesh and West Bengal, the consumption of date palm sap, also contaminated by bats, has been linked to outbreaks. Currently, there are no licensed treatments available for NiV infection, according to the Centers for Disease Control and Prevention. Treatment mainly involves supportive care, including rest, hydration, and symptom management. Some doctors have reported that the antiviral drug Favipiravir has shown some effectiveness against NiV. The m102.4 monoclonal antibody is also undergoing development and evaluation.

It was in 2018, when NiV struck Kozhikode district in Kerala, resulting in 21 out of 23 infected individuals losing their lives, that both the healthcare system and the public's attention were involuntarily drawn to the virus. Kerala's handling of the outbreak offered valuable lessons for dealing with public health emergencies, including patient isolation, contact tracing, quarantine measures, triage, and the implementation of infection control protocols.

Human-to-human transmission was how Patient Zero, Mohammed Salih, from Perambra in Kozhikode, contracted the virus. His brother had succumbed to similar symptoms the previous week. Even in the recent outbreak, healthcare workers were affected, indicating the potential for nosocomial transmission. The high mortality rates, along with the risk to healthcare workers and the possibility of multi-modal transmission, raised concerns.

It's now evident that addressing a single outbreak is not sufficient. Larger factors are at play, and a comprehensive approach to healthcare is required. Nations must recognize that human activities such as rapid expansion of agricultural lands and the destruction of natural habitats for wildlife, compounded by climate change, are contributing factors. The 'One Health' approach is increasingly being advocated. According to the WHO, 'One Health' is an integrated, holistic approach to optimizing the health of people, animals, and the environment. It's essential for preventing, predicting, detecting, and responding to health threats.

Ideally, this approach involves collaboration across multiple sectors, disciplines, and communities at various societal levels to tackle root causes and establish long-term, sustainable solutions. 'One Health' encompasses public health, veterinary medicine, and environmental concerns and is especially relevant for controlling zoonotic diseases.

research
  • HEALTH

Centre aims to open 10,000 new Janaushadhi Kendras across India by end of 2023

Uttar Pradesh leads with the highest number of outlets, while Ladakh has the fewest. Currently, there are Janaushadhi Kendras in only 651 districts, and online applications are being accepted from 765 districts.

Uttar Pradesh (1,432), Karnataka (1,098), Kerala (983), and Tamil Nadu (940) top the list of states with the most Janaushadhi Kendras across India. In contrast, Ladakh (two), Sikkim (five), and Andaman and Nicobar Islands (nine) lag behind.

With 9,782 outlets already operational, the Health Ministry aims to establish 10,000 new Janaushadhi Kendras across the country by year-end. The goal is to have a presence in 745 districts (including 112 aspirational districts), and the plan is to expand to 25,000 outlets by 2028-29, according to government data.

Janaushadhi Kendras, part of the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), are dedicated to providing quality medicines at affordable prices, especially to the underprivileged. A senior Health Ministry official noted that in addition to reducing healthcare expenses, these Kendras are expanding their range of medicines and supplies.

As per the government's expansion plans, around 2,500-3,000 new Janaushadhi Kendras will be opened annually. Currently, Janaushadhi Kendras are present in only 651 districts, but online applications are being accepted from 765 districts.

The existing distance criteria of 1-1.5 km will also be revised based on viability and sales potential. Efforts are underway to cover all blocks in the country, as only 56% are currently covered under the scheme. The product range will be expanded to include up to 2,500 medicines and 350 surgical and consumable items. The objective is to establish a robust supply chain solution from end to end.

State governments, along with reputable NGOs, doctors, unemployed pharmacists, and individual entrepreneurs, are eligible to apply for new Janaushadhi Kendra stores. Applicants must employ a pharmacist with a B. Pharma or D. Pharma degree in their proposed store.

The Janaushadhi initiative not only ensures the availability of quality medicines at affordable prices through dedicated stores selling generic medicines but also promotes awareness about cost-effective drugs with prescriptions. It encourages doctors, particularly in government hospitals, to prescribe generic medicines.

The Central government is also actively identifying more high-quality suppliers to meet the growing demand for medicines and other equipment. Plans include increasing the number of warehouses to around 10 across India and establishing more testing labs with National Accreditation Board for Testing and Calibration Laboratories (NABL) accreditation, with approximately 25-50 labs spread across the country.

research
  • HEALTH

ICMR to expand its network of laboratories to strengthen health research and diagnostic infrastructu

It is also collaborating with eight premier scientific organizations in India to establish the National Institute of One Health, aimed at rolling out the National One Health Mission throughout the country.

Within the framework of the Prime Minister-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), the Indian Council of Medical Research is partnering with eight esteemed scientific institutions in India to set up the National Institute of One Health, with the goal of implementing the National One Health Mission across the nation. This initiative aims to bolster interdisciplinary approaches in health research.

Additionally, ICMR is actively working to expand its network of BSL-3 and BSL-4 laboratories to enhance diagnostic infrastructure and improve access to laboratory services across India. Rajiv Bahl, the Director-General of ICMR, discussed these initiatives during a recent press conference, outlining the council's vision for health research in India.

Dr. Bahl highlighted the government's efforts to fortify and advance public health research in India. He stated, 'As part of these ongoing efforts, ICMR has streamlined its Intramural Research Programme funding to support research on various priority health issues. Furthermore, we have increased funding under the Extramural Research Programme to promote research on vaccines, medications, disease diagnostics, and treatments, thereby strengthening public health systems.'

He also announced that with the introduction of the National Health Research Programme, ICMR will engage in extensive collaborative studies with national and state-level Departments of Health and Family Welfare, focusing on 12 key health areas. These areas encompass infectious diseases, non-communicable diseases, child health and nutrition, and the generation of crucial evidence to enhance health interventions in these domains.

Photo Credit: The Hindu

research
  • HEALTH

Nipah outbreak | Number of cases rises to six in Kozhikode

The tally of individuals affected by the Nipah virus has risen to 1,080, with 624 falling into the high-risk category, including 327 healthcare workers. In a recent development, another person has tested positive for Nipah in Kozhikode district, Kerala, bringing the total number of infected individuals to six.

Additionally, lab tests have confirmed that E. Mohammedali, the initial patient who passed away on August 30, was indeed infected with Nipah. Unfortunately, his body fluid samples couldn't be dispatched earlier. However, a throat swab, which had been preserved at a private hospital where he had been admitted, was eventually located and sent for testing. The results were disclosed on Friday. The infection is reported to have spread within this private hospital. Notably, 30 samples from healthcare workers at this facility have tested negative for the virus, and a total of 100 samples have been forwarded for lab analysis.

A team of Central officials visited Kallad near Kuttiadi, where Mohammedali's residence is situated. They conducted inspections at his house, a relative's house, and the farms in the backyard, where he is suspected to have been. They also examined the fruit plants on the premises and gathered information about his occupation and other details from family members. Representatives from the State Health department and local health authorities accompanied the team.

Health Minister Veena George previously mentioned that the condition of the 39-year-old Cheruvannur native, who tested positive for the virus on Friday morning, remains stable. He had come into contact with Mohammedali while the latter was receiving treatment at the hospital, where he had been acting as a caregiver for another patient.

The individuals who have contracted the virus include Mohammadali, 47, of Maruthonkara, who passed away on August 30, and M. Haris, 40, of Ayancheri, who succumbed on September 11. Among those currently receiving treatment are Mohammedali's nine-year-old son, his 24-year-old brother-in-law, and a 24-year-old healthcare worker. The count of individuals on the contact list for the infected has now reached 1,080, with 624 categorized as high-risk, including 327 healthcare workers.

research
  • HEALTH

Central team of officials to visit Nipah-hit areas

Five individuals have tested positive for the Nipah virus up to this point, and sadly, two of them have passed away.

A team of central officials is anticipated to visit the Maruthonkara and Ayancheri areas in Kozhikode district of Kerala on Friday, where two individuals recently lost their lives due to Nipah infection.

The count of confirmed virus cases currently stands at five, with two of them having succumbed to the illness, while the remaining individuals are presently receiving medical care. Restrictions are still in effect in at least nine grama panchayats in Kozhikode district, with educational institutions also observing a holiday until Saturday.

The central team arrived in Kozhikode on Thursday morning and held discussions with state authorities. As per sources, they will collaborate with the State Health and Animal Husbandry departments to implement containment measures.

This team comprises members from the National Centre for Disease Control, the Atal Bihari Vajpayee Institute of Medical Sciences in New Delhi, and the National Institute of Mental Health and Neurosciences in Bengaluru.

On September 14, 2023, the police erected barricades in the Ayanchery grama panchayat of Kozhikode district, which has been designated as a containment zone.

The National Institute of Virology in Pune has established a mobile testing laboratory at the Government Medical College Hospital in Kozhikode to analyze body fluid samples from suspected Nipah patients.

Official sources have confirmed that this lab adheres to biosafety level-III standards. Consequently, there is no need to dispatch samples from individuals who have been in contact with infected persons to Pune. The mobile lab is staffed by four scientists and four technicians, and there are sufficient monoclonal antibodies available to treat 25 patients.

Simultaneously, another mobile testing laboratory under the Rajiv Gandhi Centre for Biotechnology is expected to arrive in Kozhikode soon to expedite testing procedures. This lab complies with biosafety level-II standards and can process up to 96 samples simultaneously, with results available within three hours.

Health Minister Veena George has announced that all high-risk contacts of E. Mohammadali, the initial Nipah victim who passed away on August 30, will undergo lab tests. These individuals must self-isolate for a minimum of 21 days, and medical boards will be established in all hospitals treating Nipah patients to determine treatment protocols.

Photo Credit: PTI

research
  • HEALTH

Central and ICMR teams equipped with BSL-3 labs reach Kozhikode for on-ground testing of Nipah virus

A proficient team from the Department of Animal Husbandry has also been dispatched to aid the State in animal surveillance, according to official sources.

Distinguished teams from the Centre and ICMR-NIV, equipped with BSL-3 laboratories in mobile units, have reached Kozhikode. They will conduct on-ground testing, as stated by Union Minister of State for Health and Family Welfare, Dr. Bharati Pravin Pawar, on September 14, following her assessment of the measures taken to contain the Nipah virus outbreak in Kozhikode, Kerala.

This meeting was organized by the Indian Council of Medical Research – National Institute of Virology (ICMR-NIV) in Pune.

The Minister also declared that the affected gram panchayats in the Kozhikode area have been designated as quarantine zones.

A multi-disciplinary team, led by the Union Health Ministry, has also been assigned to support the state in implementing public health measures to address this outbreak.

"The Health Ministry and ICMR-NIV are closely monitoring the situation on a daily basis, and all necessary preparations are being made to address the viral outbreak," she stated.

The neurologically damaging virus has claimed two lives and infected three others in Kozhikode district thus far. On Wednesday, a 24-year-old healthcare worker became Kerala's fifth confirmed Nipah case since the recent outbreak.

"ICMR's mBSL-3, South Asia's first biosafety level-3 containment mobile laboratory, has been stationed in Kozhikode. It will facilitate early testing and detection of infections within the district," disclosed an official source.

Until now, samples were sent to the National Institute of Virology in Pune.

This mobile laboratory was established in February last year to investigate newly emerging and reemerging viral infections that are highly infectious and potentially lethal to humans.

Union Minister of State for Health Bharati Pravin Pawar visited the ICMR's National Institute of Virology in Pune and convened a review meeting in light of the reported Nipah virus cases in Kozhikode.

A five-member central team, comprising experts from the National Centre for Disease Control, RML Hospital, and NIMHANS, has been stationed in Kerala to assess the situation and assist the state government in managing the Nipah virus infection.

On September 14, the Kerala government reassured that there is no need to panic regarding the Nipah outbreak in Kozhikode district. However, they emphasized that caution should be exercised by the public in their daily activities.

The Kerala government also confirmed that the monoclonal antibody required for treating those infected with the Nipah virus has arrived in the state. State Health Minister Veena George mentioned that a meeting took place earlier in the day between the Principal Secretary of the Health Department and the Union Health Ministry, and now the monoclonal antibody has been delivered.

(with inputs from PTI)

research
  • HEALTH

Nipah outbreak | Number of cases rises to 5 in Kerala; 789 contacts kept under watch

In Kozhikode, the latest individual to test positive for Nipah virus is a healthcare worker from a private hospital, bringing the total number of cases in the district to five. The Kerala Health Department has swiftly responded to this development by compiling a list of 789 people connected to the two unfortunate individuals who succumbed to the infection and two others currently receiving treatment after testing positive.

To enhance public awareness and contact tracing, the department has unveiled a 'route map' detailing the travel history of the deceased patients, starting from the onset of their symptoms. In response to the situation, the government has imposed restrictions on large gatherings in Kozhikode until September 24.

The Indian Council of Medical Research (ICMR) is expected to provide monoclonal antibodies for treating the infected patients by Thursday morning.

Kerala's Health Minister, Veena George, conveyed to the media in Thiruvananthapuram that the cases are associated with the Bangladesh strain of the virus, which is relatively less contagious but has a significantly high mortality rate of 70%.

Official sources indicate that there are 371 individuals under medical surveillance who came into contact with the first victim, a 47-year-old man from Maruthonkara in Kozhikode. Additionally, 60 contacts of his nine-year-old son, currently receiving treatment at a private hospital in the city, have been identified. One of his brothers-in-law, a 24-year-old man, has 77 contacts, including the health worker who tested positive on Wednesday. Another health worker on the contact list has tested negative for the virus.

The second victim, a 40-year-old man from Ayancheri, has 281 persons on his contact list, and their conditions are reportedly stable, with most of them in isolation at their homes.

In a proactive move, the Health Department has sent 11 more body-fluid samples from suspected patients for laboratory testing at the National Institute of Virology (NIV) in Pune. Currently, 20 people are under medical observation: 13 at the isolation ward in the Government Medical College Hospital, Kozhikode, and seven at a private hospital in the city.

An expert panel of doctors has indicated that the 47-year-old victim may be the index patient from whom others contracted the virus. The second victim had come into contact with him at a private hospital in the city where the former was receiving treatment. The first patient sadly passed away on August 30, and the second on September 11.

Chief Minister Pinarayi Vijayan convened a meeting with Ministers and top government officials to evaluate the situation. Health volunteers conducted a fever survey, covering 313 households in the affected areas on Wednesday. Nine gram panchayats have been designated as containment zones in the district.

Ms. George announced the establishment of a State-level control room at the Directorate of Health Sciences. She also mentioned that a mobile laboratory set up by the ICMR would be operational at the medical college hospital by Thursday afternoon to expedite the testing of samples collected from suspected patients. Furthermore, a team from the NIV will conduct a bat survey, and another team of epidemiologists from Chennai will arrive in the State to conduct research studies.

research
  • HEALTH

Efforts to get permanent disability certificates for SCD patients stuck between Ministries for nearl

While Sickle-Cell Disease (SCD) remains a "lifelong" ailment, disability certificates issued to SCD patients are valid for only three years, according to the Health Minister. The government's current focus is on identifying the disease rather than extending the validity of these certificates.

A plan to secure permanent disability certificates for SCD patients over 5 years old has been entangled in bureaucratic hurdles for nearly three years, involving three Union Ministries. During the Monsoon Session of Parliament, a House panel called upon the government to expedite the process.

The Health Ministry determines the criteria and rules for disability certificates, while the Social Justice and Empowerment Ministry issues the certificates necessary for accessing reservations and other benefits. Given the prevalence of Sickle Cell Disease among tribal communities in India, the Tribal Affairs Ministry is eager to ensure that SCD patients, who endure chronic anemia, painful events, and complications resulting from damage to tissues and organs due to the destruction of red blood cell membranes, receive these certificates.

Despite the chronic and progressive nature of SCD, current patients are only eligible for disability certificates valid for three years, as the Union government promotes its campaign to "eradicate" SCD in India by 2047.

Health Minister Mansukh Mandaviya, in response to questions about permanent disability certificates, stated that the current focus is on "detection." A project is currently underway to screen seven crore tribal people in 17 States and Union Territories for SCD under the National Health Mission, coordinated by the Tribal Affairs Ministry.

Tribal Affairs Minister Arjun Munda has advocated for the issuance of these certificates. However, the Department of Empowerment of Persons with Disabilities (DEPwD) within the Social Justice Ministry maintains that the Health Ministry holds the final decision on permanent certificates for SCD patients. The Health Ministry is expected to release its report on the matter in a month.

When SCD was included in the list of disabilities under the Rights of Persons with Disabilities Act in 2016, patients could only obtain one-year validity disability certificates. In 2020, the Tribal Affairs Ministry initiated discussions with the DEPwD regarding the possibility of issuing permanent disability certificates in response to patient complaints about the renewal process and expert opinions that the disease only progresses.

Although the DEPwD extended the validity of disability certificates for SCD patients to three years, requiring a minimum of 25% disability, Mr. Munda emphasized the need for permanent certificates due to the progressive nature of the disease in those who survive beyond the age of five.

Officials within the DEPwD have formed a special committee to address stakeholders' and SCD patients' concerns about disability certificates, with consultations held earlier this year. DEPwD Secretary Rajesh Aggarwal stated, "Once the Health Ministry's Expert Committees complete their report, expected in about a month, we will know if they have recommended permanent disability certificates for SCD patients."

Responding to questions about the progress of obtaining permanent disability certificates for SCD patients, the Health Minister emphasized, "Sickle cell is a significant issue in India, especially in tribal areas. Our Ministry's primary focus is on identifying and, in the long term, preventing SCD. This will reduce our response time and help alleviate the disease's burden in the long run. Regarding permanent disability certificates, our current emphasis is on detection."

In a report presented in Parliament in August, the Parliamentary Standing Committee on Empowerment of Women examined health issues affecting tribal women in India. The Committee recognized SCD as a "lifelong illness" and suggested that blood and bone marrow transplants were the only cure, an option few, particularly among the tribal population, can undertake. The Committee recommended the government find a way to issue permanent disability certificates to SCD patients above the age of five who meet the criteria. If this is not feasible, it suggested increasing the temporary certificate's validity to five years.

research
  • HEALTH

Union Health Minister Mansukh Mandaviya confirms two Nipah virus deaths in Kerala

Union Health Minister Mansukh Mandaviya revealed on Tuesday that two fatalities in Kerala's Kozhikode district have been attributed to the Nipah virus. Mr. Mandaviya stated that a team of experts from the central government has been dispatched to Kerala to assess the situation and provide support to the state administration in managing the Nipah virus outbreak.

Official sources have indicated that samples from four more individuals in Kerala have been dispatched to the National Institute of Virology in Pune for testing against this deadly virus.

Simultaneously, the Kerala government has established a control center in Kozhikode and recommended the use of masks as a preventive measure. Chief Minister Pinarayi Vijayan, in a Facebook update, expressed serious concern over the two fatalities and disclosed that the health department has issued an alert in Kozhikode.

Photo Credit: Reuters

research
  • HEALTH

After WHO alerts, drugs regulator asks States to keep vigil against sale of falsified versions of 2

The Drugs Controller General of India has issued a crucial advisory urging patients to purchase medical products exclusively from authorized sources and ensure they have a proper purchase invoice.

The Drugs Controller General of India (DCGI) has instructed the drug controllers in all Indian States and Union Territories to maintain strict oversight over the sale and distribution of counterfeit versions of two vital drugs: Defitelio, a liver medication, and Adcetris, a cancer drug by Takeda (injection). This directive comes in response to alerts issued by the World Health Organization (WHO).

In an advisory dated September 5, the DCGI highlighted that WHO had issued a safety alert concerning multiple counterfeit versions of Adcetris injection 50 mg, produced by Takeda Pharmaceutical Company Limited, which were found in several countries, including India. These falsified products are typically accessible at the patient level and are distributed through unregulated supply chains, primarily online. WHO reported the presence of at least eight different batch numbers of these counterfeit versions.

Adcetris (Brentuximab Vedotin) is an antibody-drug conjugate directed towards CD30, indicated for treating patients with Hodgkin's lymphoma following an autologous stem cell transplant failure and systemic anaplastic large cell lymphoma.

On September 6, the DCGI issued another advisory, referencing a WHO safety alert dated September 4 regarding counterfeit Defitelio (Defibrotide) 80 mg/ml concentrate for infusion, manufactured by Gentium Srl. This falsified product was detected in India (April 2023) and Turkey (July 2023) and was distributed outside of regulated and authorized channels. The genuine manufacturer of Defitelio confirmed the falsification, emphasizing that using counterfeit Defitelio could result in ineffective treatment and pose serious health risks due to its intravenous administration, potentially being life-threatening in certain situations, as stated by the United Nations' health body.

In response to these safety alerts for both products, the DCGI has advised doctors and healthcare professionals to prescribe drugs carefully and educate patients about reporting any adverse drug reactions (ADRs). Additionally, the DCGI has called upon State and regional regulatory offices to closely monitor the movement, sale, distribution, and stock of these drugs in the market, taking necessary actions in accordance with the Drugs and Cosmetics Act and its rules.

For consumers and patients, the apex drug regulator has stressed the importance of procuring medical products exclusively from authorized sources and ensuring they obtain a proper purchase invoice.

On August 31, the DCGI issued an advisory alert regarding Abbott's antacid Digene gel, citing safety concerns. This came after the US-based drug maker voluntarily recalled several batches of Digene gel in India, following the drug regulator's alert. The DCGI urged consumers and patients to discontinue the use of Digene gel, manufactured at a Goa facility.

Regarding wholesalers and distributors, the DCGI recommended removing all impacted batches of the product, produced at the Goa facility and within its active shelf life, from distribution.

Takeda Pharmaceutical Company Limited responded to the situation by emphasizing that Adcetris (injection) should only be obtained from authorized distribution sources. They clarified that the Central Drugs Standard Control Organisation had issued a general advisory cautioning against counterfeit versions of Adcetris Injection in India. Takeda, authorized by the Drug Controller General of India, imports, sells, and distributes Adcetris in India through established supply chain networks. They strongly recommended procuring Adcetris exclusively from authorized Takeda distribution sources to ensure patient safety and combat counterfeit medicines, which pose a significant threat to public health, thereby emphasizing their commitment to safeguarding product integrity and patient safety as their top priority.

Photo: cdsco.gov.in

research
  • HEALTH

Drugs regulator issues alert after pharma firm Abbott India recalls antacid syrup Digene Gel

The Drugs Controller General of India, in a move aimed at ensuring public health and safety, has issued a strong advisory to patients and healthcare professionals regarding the discontinuation of the use of Digene gel, a widely used antacid, due to concerns about its safety.

The Central Drugs Standard Control Organisation (CDSCO) has taken proactive steps to alert various stakeholders, including healthcare professionals, consumers, patients, wholesalers, distributors, and regulatory authorities, regarding the voluntary recall of Abbott India's popular antacid syrup, Digene Gel. This product was manufactured at the company's facility in Goa.

A public notice published on the apex drug controller's website stated, "The impugned product may be unsafe, and its use may result in adverse reactions."

The Drugs Controller General of India (DCGI), who oversees the CDSCO, has also advised doctors and healthcare professionals to exercise caution when prescribing this product. They are encouraged to educate their patients about discontinuing the use of Digene Gel and promptly report any adverse drug reactions that may arise from its consumption.

In a formal statement, the DCGI emphasized, "Healthcare professionals should promptly report any suspicious cases of adverse events linked to this product."

The drug controller's notice detailed that the company initially withdrew one batch of its product available in mint flavor and four batches in orange flavor following a complaint received in early August. The reported issues included the product being white in color, having a bitter taste, and emitting a pungent odor. Subsequently, within a week, the company decided to recall all batches of Digene syrup, including those in mint, orange, and mixed-fruit flavors, that were manufactured at its Goa facility.

On August 9, it was reported that one bottle of Digene Gel Mint Flavor, used by customers, exhibited regular sweet taste and light pink color, while another bottle from the same batch was white in color with a bitter taste and pungent odor, as per the complaint.

Abbott India Limited voluntarily initiated the product recall and ceased the production of all variants of Digene Gel manufactured at their Goa facility. CDSCO has also urged distributors and users to discontinue the use of Digene Gel produced at the Goa facility, emphasizing that there is no need for panic.

Digene Gel is a well-known remedy for acidity and its associated symptoms such as heartburn, stomach discomfort, abdominal pain, and gas. It can also be prescribed for conditions like gastritis (inflammation of the stomach lining) and acid reflux (a condition in which stomach acid flows back into the food pipe). The product uses basic compounds like magnesium hydroxide to neutralize stomach acid.

An Abbott spokesperson clarified that the voluntary recall was initiated due to isolated customer complaints about taste and odor, with no reported concerns about patient health. The spokesperson also assured that other forms of Digene, such as tablets and stick packs, remain unaffected, and Digene Gel manufactured at their other production site in Baddi continues to be available in ample quantities to meet current demand.

Photo: digeneindia.com

research
  • HEALTH

Finding proof for the axiom that nutrition aids in health care recoveries

Traditional medicine relies on medication or surgery, but doctors always stress the importance of a proper diet. While the significance of nutrition is generally understood, periodic studies are needed to confirm its critical role in the body's healing process.

It appears that ideal nutrition, crucial for all bodily processes to function effectively, is a fundamental principle. Consequently, it becomes widely accepted that the right nutrition must be consumed for the body to recover and heal while undergoing medical treatment. However, there is often a significant gap between this principle and its practical application.

Nutritional and environmental factors influencing health are now extensively studied. While conventional medicine primarily employs medication and surgery for treatment and recovery, doctors rarely forget to recommend an appropriate diet. The challenge arises when conditions are treated in a fragmented manner, without considering the patient's culture or affordability, particularly regarding food. This is why research confirming the importance of nutrition in the body's recovery process is periodically conducted.

The latest development in this field is the RATIONS trial led by Anurag Bhargava and his team, which explores the relationship between nutrition and tuberculosis within a syndemics framework. The researchers examined the impact of enhanced nutrition through a combination of food provisions and micronutrients on TB patient recovery and the prevention of TB in close family members of infected individuals. Prof. Bhargava elaborates, "This trial has a backstory. My wife, Madhavi, and I worked with the non-profit organization Jan Swasthya Sahyog, which we co-founded in the rural Bilaspur district. We ran a TB treatment program and realized that undernutrition was a blind spot in TB care and prevention. In 2013, we published a study showing that low body weight in Indian patients posed a risk factor for TB mortality." This was followed by a 2014 paper demonstrating that undernutrition was the primary risk factor for TB incidence in India, and addressing it could substantially reduce TB cases.

"In the current RATIONS trial, conducted in collaboration with the NTEP in 28 tuberculosis units across 4 districts in Jharkhand, we focused on two target populations: household members in contact with pulmonary tuberculosis patients and the patients themselves undergoing treatment."

In the study, he adds, "Household members in 14 TB units were randomly assigned to an intervention group that received a 6.5 kg food basket (5 kg rice + 1.5 kg pulses per head per month). The control group in the other 14 TB units continued with their usual PDS-based diet. Patients were not randomized because it was deemed unethical to withhold a food basket, which consisted of 10 kg per month, including rice, milk powder, and oil. All participants were followed up for two years in this pioneering trial sponsored by the ICMR and led by us at Yenepoya Medical College, with contributions from the National Institute of Research on Tuberculosis - Chennai."

The study revealed a high prevalence of undernutrition among household members, with one-third experiencing undernourishment. In patients, he notes, "We observed some of the lowest weights recorded in TB literature, with one in every two patients having a BMI below 16." Dr. Madhavi and Dr. Bhargava explain that early weight gain of about 5% of body weight in the first two months was associated with a 60% reduction in the risk of death. The RATIONS patients exhibited higher weight gain, lower mortality, and only a 1% dropout rate from treatment. "Most importantly, 75% of patients returned to work after treatment, compared to just over 5% at the start of treatment," she added.

It is also believed that an inadequate diet is a significant, largely preventable risk factor for non-communicable diseases, which appear to be affecting India extensively. A 2017 study conducted by GBD Diet Collaborators and published in Pubmed estimated that in that year alone, 11 million deaths and 255 million Disability Adjusted Life Years were attributed to dietary risk factors.

An emerging and compelling body of research highlights the potential of food and nutrition in preventing, managing, and even reversing diseases. Incorporating food into healthcare interventions may lead to improved health outcomes and reduced healthcare costs, as discussed by Sarah Downer and her colleagues in an article in the British Medical Journal. They emphasize how a global epidemic of diet-related chronic diseases has prompted experimentation with food as an integral part of patient care and treatment. Suboptimal diets are responsible for one in every five deaths worldwide, surpassing other risk factors like tobacco.

Another field where the role of nutrition in recovery is well-documented is in the context of HIV/AIDS. HIV infection and poor nutritional status are closely intertwined, as L. M. Houtzager noted in a 2009 article in the Benin Journal of Post Graduate Medicine. The impact of HIV infection on nutrition was recognized early in the epidemic, with wasting being one of the most noticeable signs of malnutrition in AIDS patients. Houtzager's review highlights that malnutrition impairs immune function and weakens the body's ability to resist infection. The combined effects of HIV and malnutrition further damage the immune system and worsen nutritional status.

In response to these concerns, the World Food Programme initiated a pilot phase of distributing nutrition supplements along with nutritional counseling for People Living with HIV (PLHIV) receiving Anti-retroviral Therapy (ART) in Tamil Nadu around 16 years ago. This initiative, in collaboration with the Tamil Nadu State AIDS Control Society, began in September 2007 in all ART centers in the state, benefiting over 25,000 PLHIV. In a mid-term assessment, researchers observed improvements in both BMI levels and hemoglobin in the experimental group compared to the control group. BMI and HB were considered crucial indicators for assessing outcomes and impact.

In a welfare state, the responsibility for ensuring adequate nutrition unquestionably falls on the government. Any shortcomings in this regard must be rectified, taking into account the relevant political and social contexts to support healthcare with nutritional supplements and provide the best possible chances of recovery for patients.

research
  • HEALTH

Chest X-ray interpretation using AI can detect more TB cases

In 2021, the World Health Organization (WHO) recommended the use of Computer-Aided Detection (CAD) products that employ Artificial Intelligence (AI) to automate the interpretation of digital chest X-rays for tuberculosis (TB) screening and triage in individuals above 15 years of age.

India possesses a powerful technology known as AI-assisted chest X-ray for screening potential TB cases. The AI algorithm, called qXR, developed by Mumbai-based Qure.ai, can swiftly detect individuals with suspected TB, including those with subclinical TB, in less than a minute. According to the 2019-2021 National TB Prevalence Survey in India report, omitting chest X-rays would have resulted in missing nearly 43% of TB cases.

When implemented on a large scale for population-based or targeted screening, the AI software, in combination with molecular TB confirmation tests, significantly enhances the detection rates. Systematic TB screening for early diagnosis is a key component of the End TB strategy.

qXR received European CE certification earlier this year and was also cleared by the Indian drug regulator a few months ago. WHO referenced qXR as one of the three AI algorithms when updating TB screening guidelines in March 2021.

Awaiting Approval

Although there are no restrictions on State governments using the software for TB detection, the Central TB Division's directive to States to procure and deploy the tool for early TB disease diagnosis will greatly promote widespread adoption. The Central TB Division has not yet recommended the use of qXR as it awaits approval from the Health Technology Assessment, which has evaluated three AI software options, including qXR.

qXR software meets WHO requirements with over 90% sensitivity and more than 70% specificity for individuals older than 15 years. In a large study conducted in Bangladesh involving nearly 24,000 individuals aged over 15 years, qXR demonstrated a sensitivity of 90.2% and specificity of 74.3%. A 2019 study found qXR to have over 95% sensitivity and over 80% specificity.

The 2019 study demonstrated that qXR has the potential to increase capacity and aid in TB diagnosis, especially in settings with a shortage of trained human readers, which is a significant challenge in using chest X-rays for TB screening.

India's ambitious goal to "eliminate" TB by 2025 can become achievable only when early diagnosis and initiation of care for millions of TB patients become a reality. The large-scale use of AI-assisted chest X-rays for screening is a critical first step in achieving this goal.

In Vietnam's Ca Mau Province, community-wide screening of individuals older than 15 years using a molecular test between 2014 and 2017 resulted in a lower prevalence of pulmonary TB in 2018 compared to standard passive case detection alone. Unlike in Vietnam, using the AI algorithm to interpret digital X-rays before molecular testing as part of community screening can reduce TB prevalence and minimize the number of molecular tests needed to detect TB cases.

qXR is already being used in over 50 countries. In India, 24 states are using it in approximately 150 sites. However, the software is not yet widely adopted in India, and in some states, it is used in only one site, such as in Kerala, according to Dr. Shibu Vijayan, Medical Director-Global Health at Qure.ai. Dr. Vijayan emphasizes that a digital solution must be implemented at scale to have a significant impact. In Chennai, around six outreach mobile vans use qXR for TB case detection, while nine government hospitals and one mobile van in Mumbai are equipped with the AI software for TB surveillance. The AI algorithm was first installed at S.K. Patil Hospital in Mumbai in January 2021 and in a mobile van a month earlier, in December 2020.

Promising Results

As of December 2022, over 100,000 X-rays from the nine Mumbai hospitals were screened for TB. Dr. Vijayan explains that these X-rays were taken for various purposes, making it possible to detect TB in non-presumptive TB cases. The Mumbai exercise led to the detection of 13% additional TB cases, and the use of the algorithm for X-ray screening increased the yield of GeneXpert molecular tests by 18-27%.

In the case of the mobile van using the qXR algorithm, of the 10,000 people screened for TB, one in four presumptive TB cases identified by the algorithm turned out to be confirmed TB cases.

Dr. Mangala Gomare, former Executive Health Officer at Brihanmumbai Municipal Corporation (BMC), Mumbai, remarks that the AI algorithm for screening presumptive TB cases has been quite useful. It enabled the incidental diagnosis of TB in people who had come for completely different purposes.

Active case finding received a boost when Qure.ai partnered with Mylab Discovery Solutions to use the qXR software in Mylab's portable chest X-ray device, MyBeam. This allows screening of presumptive TB cases with the AI algorithm even in rural areas.

Apart from digital X-rays, the qXR algorithm can also detect TB disease from film-based X-rays. A photograph of the X-ray film is taken and processed by the algorithm, similar to digital X-rays. Dr. Vijayan notes that there is no significant difference in the impact of the AI algorithm between digital and analogue (film-based) X-rays for TB detection.

The significant advantage of using the AI algorithm on film-based X-rays, if adopted in all 730 district hospitals in India, is the potential to detect around 80,000 incidental TB cases from approximately 280,000 chest X-rays taken each year for purposes other than TB diagnosis.

While WHO's guidelines for AI-assisted TB detection using digital X-rays are limited to individuals above 15 years, qXR's AI algorithm has CE certification for use in the pediatric population. It has been successfully used in children above three years in Bangladesh and children above four years in Myanmar. Dr. Vijayan mentions ongoing efforts to develop more pediatric-specific algorithms with disease severity probability as radiological evidence of TB in children is less specific than in adults.

Photo Credit: Getty Images

research
  • HEALTH

Most avian flu outbreaks in India reported from post-monsoon to pre-summer season: study

HPAI H5N1 Viruses Continuously Evolve Globally, Affecting Poultry, Wild Birds, and Humans, Reveals Study

Highly pathogenic avian influenza (HPAI) viruses, specifically H5N1 and H5N8, have emerged as prominent causes of avian diseases worldwide. These viruses have inflicted substantial economic losses and pose potential risks to human health. They are known to infect individuals who have close contact with infected poultry, leading to respiratory illnesses, ranging from mild to severe, and even fatalities. A recent study has cast more light on HPAI outbreaks in India.

The most recent research paper titled "Spatial and Temporal Patterns of Highly Pathogenic Avian Influenza H5N1 and H5N8 Outbreaks in India, 2006-2021," published in the Indian Journal of Medical Research, reports a total of 284 H5N1 outbreaks since 2006, with a significant surge in 2021. Initially, H5N1 outbreaks primarily affected poultry. Similarly, since 2016, there have been 57 outbreaks of H5N8, primarily affecting wild birds.

The study further reveals that the majority of HPAI outbreaks occurred between the post-monsoon and pre-summer seasons, specifically between October and March, peaking in January during the winter.

In addition to poultry, various bird species like owls, Indian peafowls, lesser adjutants, crows, and wild migratory birds such as demoiselle cranes, northern pintails, and bar-headed geese have tested positive for HPAI.

The paper emphasizes the importance of studying the seasonality of HPAI outbreaks to develop effective prevention and control strategies. Recent human infections with H5N1 and H9N2 viruses underscore the need to enhance surveillance among wild, resident, migratory birds, and poultry.

To compile data for the paper, information on outbreak occurrences and locations in India and affected bird species were collected from the Food and Agriculture Organization (FAO) of the United Nations database. This data was then grouped by month and year to analyze the distribution and seasonality of HPAI H5N1 and H5N8 viruses.

As of December 2021, H5N1 virus outbreaks had been documented on a significant scale among poultry and wild birds in over 77 countries. By March 2022, there were 863 reported human cases of avian influenza (AI) H5N1 worldwide, with an average case fatality rate of 53%.

The paper reports a notable increase in HPAI outbreaks among domestic and wild birds in October 2021, indicating expanded virus circulation. India reported its first human case of H5N1 virus infection in June 2021, coinciding with the monsoon season.

The study concludes by highlighting that HPAI H5N1 viruses are continually evolving globally through complex genetic changes, affecting poultry, wild birds, and even humans.

According to the paper, India's first HPAI H5N1 outbreak was reported in 2006 in Navapur, Maharashtra, followed by annual outbreaks. From 2007 to 2010, most outbreaks occurred in eastern and northeastern states, primarily in West Bengal. Odisha reported outbreaks from 2011 to 2020, with the highest number in 2018. The H5N8 virus was first reported in India in November 2016, causing mortality in wild birds in five states, with Kerala reporting the highest number of cases (25). There were no reports of H5N8 in India in 2018 and 2019.

A sudden increase in H5N8 outbreaks began in 2020, suggesting a potential reintroduction of the virus.

research
  • HEALTH

Long-term health issues following COVID-19

The impact of COVID-19 on blood vessels, heart, and nervous system has raised concerns about potential health issues in the future.

In May 2023, the WHO declared that the emergency phase of the pandemic was over. While COVID-19 continues to come in waves, its effects have reduced. Now, the focus is shifting towards the ongoing health of those who survived the initial infection. The impact of COVID-19 on blood vessels, heart, and nervous system is causing worries about possible delayed health problems.

Since this is a new disease, it takes time to get definite answers. Examining large amounts of data can reveal hidden patterns — for example, the connection between smoking and cancer was established when large groups of smokers and non-smokers were studied. COVID-19 is similar in this regard. Many individuals who survive COVID-19 and feel alright might believe it's just a regular cold, which is not accurate.

Three studies published this month have tackled this concern. They analyzed extensive databases of individuals who had COVID-19 and were followed up for one to two years.

The group from Washington University/VA St. Louis Health Care System examined 1,38,818 individuals who survived COVID-19, out of which 20,580 had been hospitalized. Those initially hospitalized faced more problems later on compared to those who hadn't been infected. They had higher death rates, more hospitalizations, and other health issues for at least two years. In contrast, the death rates among those who had COVID-19 but didn't require hospitalization were higher, but only for the first six months.

However, the risk of other health outcomes including hospitalization persisted. The risk of Long COVID, a range of health conditions, continued for two years. This was more noticeable in the hospitalized group compared to the non-hospitalized group. Among the 80 health conditions that make up Long COVID, 65% of them persisted at two years in the hospitalized group, while 31% persisted in the latter group. Compared to uninfected individuals, those who had previously contracted COVID-19 had a higher risk of issues like blood clots, lung disease, fatigue, digestive problems, muscle and joint issues, and diabetes for up to two years. A significant level of disability occurred, with 25% of it reported in the second year. These findings were published in Nature Medicine.

A study in JAMA compared over 0.2 million people who had survived COVID-19 with over one million uninfected individuals. The difference in death rates between the two groups was striking. At the end of two years, 8.7% of those with a history of COVID-19 had died, compared to only 4.1% in the other group. The death rate was highest in the initial few months. Among those who survived the first six months, the death rate decreased afterward, unexpectedly falling below the average death risk of the comparison group.

This apparent drop could be due to a phenomenon known as the 'depletion of susceptibles' in the COVID-19 group — the initial period might have eliminated those more likely to die. The individuals who survived and were relatively healthier had a lower death rate than the comparison group. Additionally, close healthcare monitoring might have contributed to preventing a few deaths.

An ICMR study examined 14,419 individuals who had survived COVID-19 hospitalization, revealing a one-year death rate of 6.5%. New or persistent symptoms of post-COVID conditions such as fatigue, breathlessness, and memory problems lasting four to eight weeks were present in 17% of the patients. Death during the follow-up period was more common among such individuals. Those who had received prior vaccination had a lower risk of death.

These extensive studies emphasize the necessity of reducing the risk of infection, particularly during surges.

Photo Credit: Getty Images/iStockphoto

research
  • HEALTH

Cinnamon and its active components prevent prostate cancer: National Institute of Nutrition study

An announcement shared by NIN has revealed that as part of a research initiative, mature rats were provided with cinnamon or its active components through their diet before the onset of cancer. This feeding continued for a span of 16 weeks.

A research endeavor conducted by the ICMR-National Institute of Nutrition (NIN) has indicated that cinnamon and its active constituents - cinnamaldehyde & procyanidin B2 — when ingested by rats, exhibited a hindering impact on early-stage prostate cancer.

The study, titled 'Chemopreventive effect of cinnamon and its bioactive compounds in a rat model of premalignant prostate carcinogenesis', which was published in the globally recognized journal Cancer Prevention Research, aimed to gauge the effectiveness of cinnamon (CN) and its bioactive elements (cinnamaldehyde or procyanidin B2) in controlling cancer development in male rats. NIN, in a statement, highlighted that during this research, fully grown rats were fed with cinnamon or its active compounds through their diet prior to the commencement of cancer induction, and this dietary regimen was continued for a duration of 16 weeks.

The statement pointed out, "It was observed that feeding cinnamon or its active compounds led to 60-70% of rats exhibiting a normal prostate histologically."

Dr. Ayesha Ismail, who headed the study as Scientist F and also leads the Endocrinology Division, conveyed, "We attempted to unravel the potential mechanism(s) for the cancer-preventive effect and observed that both cinnamon and its active components were able to alleviate oxidative stress, curtail the spread of cancer cells in the prostate gland. Interestingly, we also noticed positive effects on bone mineral content and a reduction in bone degeneration among these rats."

Dr. Hemalatha R, Director of ICMR-NIN, shared, "It is heartening to witness these findings regarding cinnamon, an Indian spice that is commonly incorporated in our culinary practices. However, it is imperative for more comprehensive investigations to be conducted before formulating any specific dietary recommendations.
Photo used for representation purpose only.

research
  • HEALTH

Health Ministry withdraws fiat mandating doctors prescribe only generic drugs

The earlier notification from the National Medical Commission (NMC) stated: 'Every Registered Medical Practitioner (RMP) should prescribe drugs using generic names written legibly and prescribe drugs rationally, avoiding unnecessary medications and irrational fixed-dose combination tablets.' The Indian Medical Association (IMA) had requested its withdrawal, stating that it should not be implemented until the quality standards of medicines are assured.

On Thursday evening, the National Medical Commission (NMC), India's regulatory body for medical professionals, and the Indian Medical Association (IMA), a nationwide voluntary organization of physicians with over 300,000 members, resolved a two-week-long dispute. This standoff was centered around one aspect of the NMC's August 2 notification, which urged registered medical practitioners (RMPs) to exclusively prescribe generic medicines. The Ministry of Health has now extended the negotiation period for both parties.

In the most recent notification, the NMC has temporarily suspended the proposed regulations until further notice. The Commission stated, "The NMC Registered Medical Practitioner (Professional Conduct) regulations, 2023 are hereby held in abeyance with immediate effect."

Dr. Sharad Agarwal, the national president of the IMA, stated, "This is a significant victory as all the regulations have been suspended. The medical community has stood up for the benefit of the people."

The previous NMC notification emphasized, "Every RMP should prescribe drugs using generic names written legibly and prescribe drugs rationally, avoiding unnecessary medications and irrational fixed-dose combination tablets."

The IMA demanded the withdrawal of this requirement, arguing that it shouldn't be enforced until the quality standards of the medicines are guaranteed.

Advantages of Generic Medicines The NMC explained its standpoint, emphasizing that individual spending on medication is high, and since generic medicines are 30% to 80% cheaper than branded drugs, promoting their prescription could reduce healthcare costs and enhance access to quality care.

In contrast, the IMA contested this directive, expressing concerns about the perceived low quality of generic medicines available in India and their potential negative impact on patient health and treatment. They even met with the Union Health Minister to voice their strong objections. Other arguments against the move include the sale of medicines by chemists, where the prices of generic medicines vary significantly, and substantial profit margins exist for the same combination drugs produced by different companies. The unregulated proliferation of pharma companies producing generic drugs and limited options for patients are also points of concern.

While doctors were previously expected to prescribe generic drugs, there were no outlined penalties for non-compliance.

The suspended notification, however, indicates that in case of violations, a doctor might receive a warning to adhere to the regulations more carefully, attend an ethics-focused workshop or academic program, or face the suspension of their medical license for a specific period after repeated violations.

K. Senthil, State President of the T.N. Government Doctors Association, noted that the idea of prescribing generic drugs isn't new and dates back to 2016. He highlighted that the primary difference now lies in the severity of the punishment prescribed.

Challenges and Concerns A challenge pointed out is that even if doctors prescribe generic drugs, pharmacists or chemists are not obligated to provide them, and they could instead offer branded drugs. Additionally, prescribing combination drugs using generic names is not feasible.

Regarding the quality of drugs, concerns were raised about the shortage of personnel in the Drug Controller's offices in most states, making it difficult to ensure the quality of drugs. Drugs in India fall into categories such as branded patent drugs, branded generics, and generic drugs. Branded generics, which are cheaper than branded patents but costlier than bulk-manufactured generic versions, lack strict price regulation. This raises concerns among doctors that patients might not fully benefit from a particular drug due to variations in quality.

The Importance of Quality C.N. Manjunath, director of the state-run Sri Jayadeva Institute of Cardiovascular Sciences and Research, highlighted that the quality of a generic drug isn't guaranteed through quality control or clinical trials. He pointed out that the same company manufacturing both branded and generic drugs indicates a shift in quality.

Maintaining stable drug levels in patients is crucial, especially in cases like transplant recipients. Differences in formulation and potency between branded and non-branded generic drugs can impact drug levels and outcomes for patients. Doctors argued that ensuring consistency in brand usage is essential for drugs with a narrow therapeutic window. Switching between different generic brands could lead to variations in drug levels, jeopardizing patient care.

The Perspective on Prescriptions Rajeev Jayadevan, a member of the Public Health Advisory Panel of the Kerala State IMA, emphasized that doctors aim for complete patient recovery and well-being. Doctors develop prescribing patterns based on years of practice and patient feedback, fostering a unique patient-doctor relationship. Writing only a generic name on the prescription might lead pharmacy salespeople to dispense products with the highest profit margins. The non-uniform quality control, storage, distribution, and dispensation of drugs in India remain a significant concern for doctors.

Prescription Guidelines The NMC's notification outlined prescription guidelines, emphasizing the prescription of drugs using generic names. Exceptions could be made for drugs with a narrow therapeutic index, biosimilars, and similar cases. The notification also stressed rational and optimal drug prescription to avoid overprescribing and underprescribing, considering possible drug interactions. Judicious use of fixed-dose combinations was recommended, and only approved rational fixed-dose combinations were to be prescribed.

Hospitals and local pharmacies were advised to stock generic drugs and prescribe those available and accessible to patients. The notification discouraged the prescription of "branded" generic drugs and encouraged patients to purchase drugs from Jan Aushadhi Kendras and other generic pharmacy outlets.

India's Healthcare Approach During the recent G-20 health summit, the Indian Health Ministry reaffirmed its commitment to making healthcare affordable and accessible. India is a major supplier of vaccines globally and a significant exporter of generic medicines. The country's $50 billion drug-manufacturing industry exports medicines to over 200 nations.

Individual doctors and healthcare activists have shared their perspectives on the NMC-IMA dispute. S.P. Kalantri, director professor of MGIMS and Medical Superintendent of Kasturba Hospital, questioned whether the strict approach of severing links between medical professionals and the pharma industry is the solution. He raised the idea of subjecting all drugs, generic or branded, to bioequivalence testing before entering the market. Gopal Dabade, president of Drug Action Forum, Karnataka, welcomed the NMC's notification, asserting that using generic drugs will enhance healthcare affordability and reduce patient out-of-pocket expenses. He disputed claims that switching to generic drugs could harm patients, citing a lack of scientific evidence.

(Inputs from Afshan Yasmeen in Bengaluru, Zubeda Hamid in Chennai, and C. Maya in Tiruvananthapuram contributed to this article.)

research
  • HEALTH

‘India must ramp up testing and maintain close watch on new global variants of COVID-19’

The Health Ministry of India has presented a comprehensive update on the global status of COVID-19, along with insights into newer strains such as BA.2.86 (Pirola) and EG.5 (Eris), which have been identified on a worldwide scale.

"While our country's COVID-19 situation remains stable and our healthcare systems are fully prepared, it is essential for the states to closely track instances of Influenza-like Illness (ILI) and Severe Acute Respiratory Infections (SARI). They should also send ample samples for COVID-19 testing, while concurrently enhancing Whole Genome Sequencing efforts," stated P.K. Mishra, Principal Secretary to Prime Minister Narendra Modi. He shared these remarks following a high-level meeting on August 21, which aimed to assess the global and domestic COVID-19 scenario, the emergence of new virus variations, and their implications for public health.

He also emphasized the need for India to vigilantly monitor emerging global virus strains.

In a recent update, the Health Ministry shed light on the current worldwide COVID-19 landscape, incorporating insights into newer strains BA.2.86 (Pirola) and EG.5 (Eris), both of which have been reported internationally.

As per information from the World Health Organization (WHO), the EG.5 (Eris) variant has been documented in over 50 countries, while the BA.2.86 (Pirola) variant has been identified in four countries.

The update also highlighted that globally, a total of 296,219 fresh COVID-19 cases were reported during the past week. Remarkably, despite representing nearly 17% of the global population, India contributed only 223 cases (0.075% of the global new cases) during the same period.

Furthermore, the daily average of new COVID-19 infections across the entire nation has consistently remained below 50 cases. Impressively, India has managed to sustain a weekly test positivity rate of under 0.2%. The update also offered insights into the genetic makeup of various circulating variants within India.

The meeting witnessed the presence of several prominent figures, including Vinod Paul, Member of NITI Aayog, and Rajiv Gauba, Union Cabinet Secretary, among others.

(Stay informed about the most recent health updates by subscribing to our Health Matters newsletter.)