March 2024

Mar 26,2024 The Indian Council of Medical Research (ICMR) has invited expressions of interest from researchers to conduct systematic reviews and meta-analyses for generating evidence pertaining to lung cancer prevention, screening, diagnosis, management and palliation. Systematic reviews and meta-analyses play a crucial role in synthesizing existing evidence to inform decision-making in the management of lung cancer to guide clinical practice and improve patient outcomes. “Lung cancer is one of the commonest cancers in India and its incidence is rising every year. It accounts for 10 per cent of the total cancer deaths in the country. Currently, evidence-based guidelines do not exist with respect to its prevention, screening, diagnosis, management and palliation in India,” the ICMR said. Systematic review teams will be commissioned to conduct rigorous evaluations of the available literature on specific 30 review questions identified by the Guideline Development Group of lung cancer guidelines. As far as prevention is concerned, the researchers will have to generate evidence on the link between tobacco smoking, air pollution and lung cancer. The ICMR further stated that the novel process has been instituted within the Ministry of Health to collaboratively formulate a comprehensive set of evidence-based guidelines for the country. This initiative involves the concerted efforts of the Department of Health and Family Welfare, the Directorate General of Health Services and the Department of Health Research. It is a rigorous and robust scientific process, ensuring the integration of the latest evidence. The process of generating such evidence entails compilation of systematic reviews and meta-analyses from the existing literature, focusing on well-defined review questions. Source: Healthworld

Mar 26,2024 The final round of talks on a landmark pandemic accord faces a frantic last push this week, with countries still pulling in different directions on how to handle future global health crises. The last week of negotiations runs until Thursday with nations trying to hammer out an agreement to make sure the world is better prepared to deal with the next pandemic — or better still, stamp it out before it even happens. Shaken by Covid-19, which shredded economies, overturned societies, crippled health systems and killed millions, countries decided in December 2021 to build a framework of binding commitments to stop such trauma from ever happening again. But as two years of talks come to the crunch, major sticking points remain over how far countries are prepared to go. The ninth and final negotiations round opened on March 18, with daily talks ploughing on late into the evening. Sealing a deal will involve some serious horse-trading — but the breakthrough moment remains elusive. Diplomats insist they remain keen to conclude an agreement, but the various alliances still seem far apart. World Health Organization chief Tedros Adhanom Ghebreyesus has repeatedly warned nations that “everyone will have to give something, or no one will get anything. European countries — who led calls for a pandemic treaty — want more money invested in pandemic prevention, while African nations want the knowledge and financing to make that work, plus proper access to pandemic “counter-measures” like vaccines and treatments. The United States wants to ensure all countries share data and samples from emerging outbreaks quickly and transparently, while developing countries are holding out firm for guaranteed equity to stop them getting left behind. According to the roadmap, a finalised accord on pandemic preparedness, prevention and response would be adopted at the May 27 to June 1 World Health Assembly of the WHO’s 194 member states. But there is a sense in diplomatic circles that developing nations are growing weary of Western obduracy and extra negotiations in April may be needed to cross the line. “We all know there remain critical areas where you are yet to reach consensus,” Tedros told the final negotiations round. “You agree on what you are trying to achieve… now you need to agree on how to achieve these objectives. “It’s mission-critical for humanity that you do,” he warned. “We cannot allow the cycle of panic and neglect to repeat.” Source: Healthworld

Lucknow: All govt hospital staff have been put on high alert to manage emergencies during Holi. Following deputy CM Brajesh Pathak’s directive, doctors and paramedical teams will remain on duty. Pathak highlighted concerns like road accidents, skin issues from chemical-based colours, and health complications arising from rich festive foods. To tackle these, hospitals will be stocked with essential medicines. Officials said in case of emergencies, one must dial 108 for a swift response. Pregnant women and children will receive priority care through the 102 ambulance service. TVSK Reddy, senior VPof EMRI Green, said, “In emergencies such as accidents, burns, heart attacks, one must call 108 for a free ambulance. Source: Healthworld

Mar 18,2024 Nestled somewhere remote in the western Indian state of Maharashtra is the district of Gadchiroli. Today home to 10,72,942 residents, the district faces many daunting healthcare-related challenges – scarce resources, high patient loads, overwhelmed systems, and prolonged waits, aggravated by the absence of local radiologists or X-ray machines. Cut to 2047, a Viksit Bharat, where after facing two weeks of consistent cough, a large language model-trained app directs a patient directly to their nearest primary healthcare facility using guidance in Marathi. A mobile van awaits them with a semi-portable X-ray, guided by an AI-based app that automatically analyses their X-Ray. Within two minutes, at no cost to the patient, a healthcare worker with limited technical training diagnoses TB with unmatched accuracy and seamlessly logs the case on the Nikshay TB platform. The patient is immediately linked to effective treatment, is handed a digital pillbox that will support them with adherence to treatment over the next several weeks. Another software offers them personalized care including nutritional guidance, addressing their unique need and medical profile. In another faraway village hidden in Himalayas, ASHA workers employ an app for door-to-door TB screening using a simple mobile phone and a software that can detect the disease from cough sounds. The AI-driven solution is analysing vast amounts of medical data swiftly and precisely, leading to earlier and more accurate diagnoses, and improved patient outcomes. AI-driven healthcare is more cost-effective and is being deployed widely in remote and underserved areas, ensuring access to quality care. Right at this time, in another tribal district deep in the forests of Orissa, an AI and machine learning (ML)-based algorithm automatically analyses blood smear slides testing the presence of malaria parasite, identifying subtle patterns and anomalies in medical imaging and patient data. The patient from an underserved community, once diagnosed, is being linked right away to an expert using telepathology. The integration of AI, machine learning, and Internet of Things (IoT), terms previously confined to other sectors, are now acting as a force for good in healthcare. Access to Universal Health Care enabled by science and tech is a reality. While the above are hypothetical glimpses from 2047, they illustrate a reality that is increasingly feasible and not too far from being true. In a multi-layered and complex healthcare sector like India, ripe for disruption from emerging technologies, AI-driven solutions present the most intuitive and obvious use case for intervention. The increasing activity from both large corporates and start-ups in developing AI-focused healthcare solutions serves as evidence of the sector’s readiness for transformation. The adoption of AI for healthcare applications is expected to witness an exponential increase in the next few years, with the global healthcare market driven by AI projected to register an explosive compound annual growth rate (CAGR) of 40% through 2021 to 2029. Source: Healthworld

Mar 16,2024 New Delhi: Age, sex and location could be important in assessing the antibiotic resistance of a bacterial infection, new research has found. Antibiotic, or antimicrobial, resistance is a global public health threat and occurs when disease-causing germs evolve and develop a resistance to the very drugs designed to kill them, rendering these drugs ineffective. The research, led by those at London School of Hygiene and Tropical Medicine, UK, analysed data on bloodstream infections of nearly 9.5 lakh individuals across 29 European countries. The data was collected through routine surveillance between 2015 and 2019. The team looked at the bacterial species that were isolated and sent to the surveillance service, and the antibiotics that were used to treat these bloodstream or bacterial infections. The findings are published in the journal PLOS Medicine. They observed that gender played a role in antimicrobial resistance, with men at a higher risk of developing it than women. The team also found that the participants’ resistance to various bacterial species peaked at different stages of their lives, with the peaks related to most of these species being seen at the youngest and oldest ages. For example, the superbug MRSA, responsible for many hard-to-treat infections in humans, becomes more resistant with increasing age of the host, whereas resistance of E. coli decreased with age, they said. E. coli can cause infections in the gut and digestive tract. The Pseudomonas aeruginosa- known to cause infections in mainly hospital patients – was found to be most likely to resist several antibiotics when the host is around 30 years old. For women, the team found that the incidence of bloodstream infections due to E. coli peaked between ages 15 and 40. The researchers said that even though antibiotic usage, changes in immunity, and exposure to high-risk settings are all linked to age and sex, little is known how resistance varies with age and sex. “These findings highlight important gaps in our knowledge of the epidemiology of antimicrobial resistance that are difficult to explain through known patterns of antibiotic exposure and healthcare contact,” the authors wrote in their study. “In order for us to address this growing threat to public health, we now need data from a wider range of sources to determine the contribution that cultural versus natural history differences have in driving these patterns globally and the role that they play in the increasing rates of AMR being seen,” they wrote. Source: Healthworld

Mar 17,2024 Amritsar: How does a charity organisation effectively provide medical tests, including dialysis, ECG, etc. at prices that are approximately 10 to 11 per cent of those charged by private and government medical services, while remaining financially sustainable? “We offer kidney dialysis services at Rs 650, which includes a free Dialyzer kit. In comparison, private clinics charge anywhere from Rs 2000 to Rs 4500 for the same service in the government and private laboratories respectively. Additionally, our ECG test costs only Rs 20, while it is charged at Rs 66 and Rs 175 to Rs 200 in government and private clinics respectively “ said Dr SPS Oberoi, Managing Trustee of Sarbat Da Bhala Charitable Trust (SDBCT), while offering the Trust’s expertise to assist the government sector in reducing medical test charges for the benefit of patients. When questioned about the financial viability of providing cost-effective medical tests and services, he explained that the Trust enters into Memorandums of Understanding (MoUs) with both private and government hospitals in the area to provide dialysis services. Under these agreements, the Trust supplies the dialysis machines to the hospital and a cost-sharing arrangement of 70 per cent-30 per cent is established with the hospitals. “The hospital provides 70 per cent of its dialysis services to patients referred by the Trust, charging only Rs 650 while the diaysis kit costing around Rs 1200 is provided free of cost by the Trust For the remaining 30 per cent of patients, they charge their standard rates,” he explained. Oberoi who in the recent past has been accorded the title of ‘Ambassador for Peace’ by the Inter-University Higher Academic Council, Paris, France, was here on Sunday to hold a meeting with his team to chalk out plans for opening as many as 10 free medial laboratories and dialyses centers in various cities of Himachal Pradesh including Dharamshala, Manali, Shimla, Kullu and Manali. He said that even after charging patients Rs 650, the hospital saves around Rs 300 per dialysis, covering their service charges like infrastructure, doctor, and staff expenses, and still makes profits. Similarly, giving an example of ECG test, he informed that the Trust charge Rs 20 per ECG as compared to Rs 175 to Rs 200 by private laboratories and Rs 66 by government hospitals. Despite offering services at minimal charges, the Trust remains sustainable without incurring losses. Oberoi questioned the exorbitant charges levied by government laboratories on patients. He said that private labs operate as businesses and government institutions should prioritise affordable healthcare. MD of SDBCT expressed readiness to guide government bodies in implementing similar cost-effective models. Source: Healthworld

Mar 18,2024 NEW DELHI: Hydroxyurea, a medicine used for treating sickle cell anaemia patients, will now be available in India for Rs 600 per vial — less than 1% of the price of its imported versions. Unlike the versions sold by global brands for around Rs 77,000 per vial, which need a storage temperature of 2-8 degrees Celsius, the Indian variant remains stable at room temperature, claimed its manufacturer Delhi-based Akums Drugs and Pharmaceuticals Ltd. The company said Hydroxyurea will be available to govt at less than Rs 600, “thus embodying the spirit of Make In India and fostering widespread benefit to the masses”. Congratulating the company, Union health minister Mansukh Mandaviya wrote on X, “PM Narendra Modi had in 2023 launched National Sickle Cell Elimination Mission. This medicine will prove to be a blessing for our tribal brothers, sisters and children and we can make India free from sickle cell soon.” Sickle cell disease is a genetic disorder mostly prevalent in districts with high tribal populations. About one in 86 births among STs have sickle cell disease that affects haemoglobin in red blood cells, resulting in morbidity and mortality. The exercise to encourage Indian companies to manufacture generic versions of drugs used in treatment of rare diseases, also referred to as orphan drugs, had started in July 2022 and discussions were held. Source: Pharma

Mar 21,2024 Bengaluru: As India nears its Sustainable Development Goal (SDG) for eliminating chronic hunger by 2030, the country has witnessed remarkable progress in the reduction of malnutrition in recent years, as demonstrated by an almost 3 per cent decrease in the percentage of children below five years of age that are stunted or chronically malnourished, according to the National Health Family Survey 5 (2019–21). Despite various efforts, malnutrition remains a consistent burden on the country. Nutrition experts have pointed out that 74 per cent of Indians have insufficient access to adequate nutrition, highlighting the widespread problem of food insecurity in the country. To combat the nationwide challenge, experts and practitioners emphasised the need for collaborative strategies to engage pre-adolescent and adolescent children in tackling malnutrition. They highlighted the significance of integrating nutrition education in the school curricula to enable children to make knowledgeable food decisions. Archana Sinha, Co-founder and CEO, Nourishing Schools Foundation (NSF), said, “As we move closer towards India’s SDG target of eradicating malnutrition by 2030, Nourishing Schools Foundation envisions further collaborative initiatives to accelerate the country’s battle against chronic hunger.” Stressing the urgency of addressing the nutrition gap in the country, S Veena Rao, Director, Auro Center for Public Health, Public Nutrition, Public Policy, Bangalore, and Former Advisor, Karnataka Nutrition Mission, Government of Karnataka, said, “A strong nation must have strong human capital. Much has been said about India’s demographic dividend, that 67.3 per cent of our population is between 15-59 years of age, and that this demographic advantage will continue for another three decades. Students constitute our present and future demographic dividend and can become critical agents of change. They must be nurtured into becoming India’s strong human capital, especially those from less privileged sections of society.” Highlighting the need for such insightful platforms, Dr K Madan Gopal, Former Senior Consultant, NITI Aayog, GoI, noted, “India has achieved remarkable strides in the battle against malnutrition, particularly in safeguarding the health of children and women, thanks to decades of dedicated policy initiatives. As we zero in on our national aspiration to eliminate malnutrition within the coming decade, we must harness our collective resolve.” Source: Healthworld

Mar 21,2024 Patanjali Ayurved has issued an unconditional apology to the Supreme Court for airing “misleading” advertisements. This comes after the court asked Patanjali’s co-founder Baba Ramdev and managing director Acharya Balkrishna to personally appear before it on April 2 to clarify their failure to respond to the contempt notice issued against them and the company regarding misleading advertisements about medicinal cures. Aacharya Balkrishna says it (misleading advertisements) won’t be repeated in future. Shares of Patanjali Foods cracked over 5% on March 19 following the Supreme Court’s notice. The shares were up 0.7% at Rs 1,368.80 apiece on BSE Sensex, which jumped 550 points in initial trade on Thursday. “How can you be in teeth of our orders?… We had our hands tied earlier but not now (with initiation of contempt proceedings). As an officer of the court, you (Rohatgi) should know your position,” a bench comprising justices Hima Kohli and Ahsanuddin Amanullah on March 19 told senior counsel Mukul Rohatgi, who appeared for Patanjali Ayurved, the parent company of Patanjali Foods. The judges also remarked that Ramdev and Balkrishna were prima facie in violation of Sections 3 and 4 of the Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954. Rohatgi strongly opposed the directions, asking “how does Ramdev come into the picture?… violation of the law is not a contempt of court and what was being relied on in open court has to be recorded in the order.” On February 27, the Supreme Court had expressed dissatisfaction with Patanjali Ayurved’s continued publication of false and misleading advertisements about medicinal cures, despite previously promising not to do so. The Court issued notices to the company and Balkrishna, questioning why contempt proceedings should not be initiated against them. The apex court had also warned the company that it should not make any statement against any system of medicine in the media, both print and electronic and had barred Patanjali Ayurved from advertising or marketing its products which it claimed to treat ailments and disorders specified in Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954. The judges had also flayed the Centre (the AYUSH ministry) for failing to take appropriate action against Patanjali Ayurved under the drugs and magic remedies law in respect of such advertisements. Source: Healthworld

22 Mar 2024 New Delhi: Admonishing the Delhi health minister and health secretary for not complying with judicial orders on enactment of a law to regulate clinical establishments, the Delhi High Court on Thursday warned them that they could be sent to jail. The high court told Health Minister Saurabh Bharadwaj and Health Secretary SB Deepak Kumar, who were present during the proceedings, that they are “servants of government” and can’t have “large egos”. The court had in February asked Bharadwaj and Kumar to be present before it after perusing an email which said the minister was not kept in the loop during discussions on the Delhi Health Establishments (Registration and Regulation) Bill. “What is troubling us is that the petitioner is highlighting the plight of a common man. He is telling us that all sorts of lab reports are being generated which are not true and correct and the common man is suffering. But it is your game of one-upmanship between the two of you and between the various factions that is going on. This is unacceptable to the court. “You have to be practical and ensure that the touts do not benefit from the fight between these two people,” a bench of Acting Chief Justice Manmohan and Justice Manmeet PS Arora said, asking them not to indulge in “brinkmanship”. The bench said if the minister and the secretary are incapable of handling the issues and keep on bickering, the court will ask a third party to handle things or pass an order about what has to be done. “Don’t do this with us otherwise you both will go to jail. We will have no hesitation in sending both of you to jail if the common man benefits from this. Both of you can’t have large egos, you both are servants of the government and you both have to ensure that the common man benefits. What are you doing? People are getting wrong reports of their blood samples,” it said. The high court was hearing a 2018 petition by Bejon Kumar Misra, represented by advocate Shashank Deo Sudhi, who has alleged that unauthorised laboratories and diagnostic centres were functioning in the national capital with unqualified technicians and giving incorrect reports to patients. As the minister said the Delhi Health Bill was finalised in May 2022 itself, the high court asked why it was not yet sent to the Centre for approval. The court said if this was going to take time, the Delhi government should consider implementing the central government statute- The Clinical Establishments (Registration and Regulation) Act, 2010. The submission made by Bharadwaj that the court’s indulgence will help the government to get the bill enacted irked the court which said, “you think we are a pawn in this game and you will use this as a matter of strategy. We are not anyone’s pawn, cure this misconception that you will use the court’s process”. The petitioner had argued before the court that pathological labs in the city are unregulated and pose a threat to the lives of citizens. Source: Healthworld