September 2024

Sep 27, 2024 Seoul: South Korea will use 10 trillion won ($7.59 billion) in health insurance funds over three years to raise fees doctors receive for treating severe illnesses, the health ministry said on Friday, as a walkout by young doctors strains the health system. The move will incentivise major general hospitals to focus more on treating severe, emergency or rare diseases, and is part of a push to gradually reduce dependence on trainee doctors who should focus on training, the ministry announced at a briefing. Hospitals which had relied on trainee doctors across multiple medical disciplines have had to turn away patients at emergency rooms or reduce opening hours, while existing doctors have experienced heavier workloads. Since then, the government has made a series of attempts to reduce the pressures on the medical system due to the young doctors’ walkout, including deploying military doctors to assist in hospital emergency rooms, and asking the public to refrain from visiting emergency rooms with non-severe symptoms. On Friday, the health ministry said major general hospitals providing specialised care will receive a 50% increase in fees for running intensive care units, as well as providing surgical procedures for severe illnesses such as cancer. Driven by the move, 70% of treatment at such hospitals will eventually be for severe illnesses, up from 50% now, the health minisuy said. Source: Economic Times

Sep 18, 2024 The National Accreditation Board for Hospitals and Healthcare Providers (NABH), a constituent Board of the Quality Council of India (QCI), successfully hosted the NABH Patient Safety Conference (NPSC 2024) on World Patient Safety Day recently. The event, aimed at advancing patient safety and healthcare quality, was graced virtually by JP Nadda, Union minister of health and family welfare, alongside distinguished leaders and over 500 healthcare providers- Speakers and attendees included representatives from the National Health Authority (NHA) Ministry of Ayusht Ministry of Social Justice, and top government and private hospitals The conference showcased groundbreaking initiatives by NABH, underscoring its leadership in patient safety and healthcare transformation. Key Announcements at NPSC 2024 were E-Mitra Chatbot: A 24/7 Al-powered tool on WhatsApp and the NABH website to streamline accreditation processes, Mitra Physical Centres: Tailored support for small hospitals in Tier 2, Tier 3 cities, and rural areas to promote NABH standards and entry-level certifications, E-Skilling Modules: Interactive training for healthcare management, with digital certificates upon completion and Architects Empanelment: Ensures compliance with NABH safety standards through expert infrastructure planning and design. Addressing the gathering through a video message, Nadda said, “l am honoured to be here to celebrate this significant day. Patient Safety transcends the responsibilities of healthcare providers; it should be a global objective. Our systems must be designed with the utmost priority for patient safety. I extend my gratitude to NABH for organizing this Patient Safety Conference, which brings together experts from the healthcare sector to collaborate and advance our shared goals.” Speaking at the event, Jaxay Shah, chairperson, QCI, highlighted, ‘The NABH Patient Safety Conference (NPSC 2024) aligns with the vision of ‘One Earth, One Health,’ championed by our Hon’ble Prime Minister, Shri Narendra Modi. The initiatives like the E-Mitra Chatbot, Mitra physical centres, and e-skilling modules, etc. introduced at the conference today will make Indian healthcare more efficient, transparent, and patient-centric_ These efforts will play a pivotal role in further strengthening patient safety and elevating the quality of care, especially at the grassroots level in tier 2 and tier 3 cities and villages. Together, we are ensuring that quality healthcare becomes a reality for all, one hospital at a time. Chakravarthy T Kannan, secretary general, QCI, reinforced the significance of World Patient Safety Day 2024 and said, a We unite in a global call to ‘Get it right, make it safe!’ Patient safety is paramount in building trust between patients and healthcare providers, with the focus this year on enhancing diagnosis. As India gets ready for Viksit Bharat journey, NABH and its healthcare community joins this journey. The focus areas are customer centricity, reaching the last mile and future ready. Our aspiration is Quality healthcare reaching all corners of India.” Rizwan Koita, chairperson, NABH, said, “l am honoured to announce the National Patient Safety Conference that is taking place today. This event brings together a diverse group of stakeholders, including leaders from hospitals, technology companies, insurance firms, and senior healthcare experts. We are excited to unveil several new initiatives, including the new digital standards for HIS/EMR systems a key component of our digital transformation strategy to enhance healthcare delivery. We look forward to engaging with all participants as we advance our collective mission to improve patient care and safety. “ Dr. Atul Mohan Kochhar, CEO, NABH, said, “We are thrilled to unveil our latest standards and initiatives at the NABH Patient Safety Conference 2024. These advancements, including the new NABH Accreditation Standards and Digital Health Standards, represent our unwavering commitment to improving patient safety, fostering innovation, and supporting sustainable healthcare practices- Our goal is to continue setting benchmarks in quality and safety, driving progress across the healthcare landscape.” Source: Pharma Biz

Sep 21, 2024 New Delhi: The Lancet Citizens’ Commission on Reimagining India’s Health System has run into controversy even before its report has been published with one of its members, former union health secretary Sujatha Rao, tweeting her withdrawal from the commission earlier this week. She stated that the commission was proposing the colporatization of primalY care in India and called that a “recipe for disaster”. Her withdrawal drew attention to the fact that several experts who were listed as members of the commission initially are not palt of it anymore. According to the commission’s website, with the Covid pandemic bringing into focus the need for universal health coverage (UHC) in India, a Lancet Citizens’ Commission was constituted in 2020 to lay out the path to achieving UHC in India in the coming decade. “Unclelpinning the Commission’s work is a normative commitment to strengthening India’s public health system in all its dimensions including promotive, preventive, and curative care. The state must take a leadership role as provider, financier, regulator, and steward of the health system,” stated a paper on the commission’s work published in the Lancet in April 2021. Key questions include negotiating the intersections and complementarities between public and private health provision and the design of a regulatcny structure that holds each component of the health system accountable, stated the paper. Funders of the commission include the Azim Premji Foundation, Rohini Nilekani Philanthropies, Vikram Kirloskar, and The Lakshmi Mittal and Family South Asia Institute, Haward University. Dr Yogesh Jain, a well-known public health physician who has worked extensively on developing a blueplint for UHC in India was among the first to withdraw from the commission. “I was not comfortable with the head of a pharma company being one of the four co-chairs of the commission. There is such an obvious conflict of interest that a person who has openly pushed for privatization will be weighing in on designing a public health system,” said Dr Jain. Dr Srinath Reddy, former president of the Public Health Foundation of India (PHFI) and chailperson of the High-Level Expert Group (HLEG) on Universal Health Coverage of 2010 was also listed as a member. Dr Reddy confirmed that he was not a member of the commission and did not contribute to its report. He did not provide reasons and said that he would comment on the report when it is published. Sujatha Rao’s tweet stated that the commission was “proposing the corporatization of primary care and replicating the US model, the only countl•y that despite spending 18% GDP on health has no UHC. In an already unequal society, it’s a recipe for disaster”. Dr Rakhal Gaitonde, professor of public health at the Achutha Menon Centre for Health Science Studies of the Sree Chitra Tirunal Institute for Medical Sciences and Technology, whose work includes research on health inequity and health policy and systems research, continues to be a member of the commission but has withdrawn from the authorship team of its report. However, he did not want to comment till the report was published. Many of the members that TOI wrote to did not respond, while some responded that since the commission’s report was under review they were not authorized to speak to the media. Interestingly, three of the commission’s members are directly connected to Narayana Health, a for- profit healthcare company that recently launched a subsidiary company for managed care, which includes preventive and primalry care. Dr Devi Shetty, founder and chailperson of Narayana Health and Nachiket Mor, an independent director of the company, are among the 20 commissioners. Kiran Mazumdar Shaw, Chairperson and MD of Biocon Ltd is a non-executive director in Narayana Health and is one of the co-chairs of the commission. Tarun Khanna of Haward Business School and director of the Lakshmi Mittal and Family South Asia Institute in Halyard University, another co-chair of the commission, was the one who wrote the case study on Dr Shetty and Narayana Hrudayalaya in 2005 for Haward Business School’s case collection. Some of the experts felt it was better to stay in the commission and engage with the process despite misgivings than to withdraw. According to some of the members, there will be disclaimers by some of the authors regarding some of the recommendations or sections of the repolt. The report of the commission, which has gone for peer review, is expected to be published before the end of the year. Lancet Commission members Co-Chairs 1.Vikram Patel is a founder of Librum, a mental health consulting firm, and co-founder of Sangath, India. 2.Kiram Mazumdar-Shaw is the Chairperson and Managing Director of the biopharmaceutical company Biocon. 3.Tarun Khanna is a co-founder of Jana Care, a chronic disease diagnostics company but does not have any operating role or board stewardship role in the company. 4.Gagandeep Kang serves on the Boards of the Coalition for Epidemic Preparedness Innovations and Hilleman Laboratories Pvt Ltd. PD declares no competing interests. Commissioners of the Lancet Citizens’ Commission are: I.Devi Shetty (Chairman, Narayana Hrudayalaya Limited) 2.Nachiket Mor (visiting scientist, The Banyan Academy of Leadership in Mental Health) 3.Mirai Chatterjee (Director, Social Security Team, Self-Employed Women’s Association [SEWA]) 4.Poonam Muttreja- Executive Director, Population Foundation of India 5.Sharad Sharma (Co-founder, iSPIRT Foundation) 6. Yamini Aiyar- former president of Centre for Policy Research 7.Bhushan Patwardhan Distinguished Professor, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University; Vice Chairman, University Grants Commission 8.Arnab Mukherji- Professor of Public Policy, Center for Public Policy, IIM Bangalore 9.Thelma Narayan- Director, Academics & Policy Action, SOCHARA 10. Sapna Desai- Associate, Population Council 11.Leila E Caleb Varkey-lndependent Public Health researcher 12.Vijay Chandru- Professor, Interdisciplinary Research, Indian Institute of Science 13.Atul Gupta- Assistant Professor, Department of Health Care Management, Wharton School, University of Pennsylvania. .14.Sandhya Venkateswaran-Senior Fellow, Centre for Social and Economic Progress 15. Sandra Albeit -Director, Indian Institute of Public Health Shillong and Professor of Public Health 16. Preeti John- Associate Professor and Deputy Director, UCL Global Business School for Health; Faculty of Population Health Sciences, UCL, London, UK 17.

Sep 25, 2024 NEW DELHI: Over 50 medicines, including those for diabetes, hypertension, vitamins, calcium D3 supplements, bacterial infections, and acid reflux, have failed quality tests conducted by India’s drug regulator. The Central Drugs Standard Control Organisation (CDSCO) issued a ‘Not of Standard Quality’ (NSQ) alert for August, highlighting that some of the top- selling medicines were produced by well-known pharmaceutical companies, including Alkem Laboratories, Hetero Drugs, Hindustan Antibiotics Limited (HAL), and Karnataka Antibiotics and Pharmaceuticals Ltd. Among the medicines flagged as NSQare paracetamol tablets (500 mg), the anti-diabetic drug Glimepiride, high blood pressure medication Telma H (Telmisartan 40 mg), acid reflux medication Pan D, and calcium supplements Shelcal C and D3. The list also includes the widely used antibiotic Metronidazole, manufactured by HAL, and Shelcal, distributed by Torrent Pharmaceuticals and produced by Pure & Cure Healthcare in Uttarakhand. Alkem Health Science’s antibiotics, Clavam 625 and Pan D, were also identified as substandard by a Kolkata state-run laboratory. This lab found that Cepodem XP 50 dry suspension from Hyderabad-based Hetero, prescribed for severe bacterial infections in children, did not meet quality standards. Further concerns were raised over paracetamol tablets from Karnataka Antibiotics & Pharmaceuticals Ltd. Additionally, Sun Pharma Laboratories Ltd.’s Ursocol 300, designed to dissolve certain gallstones, was flagged as spurious. Multiple batches of Telmisartan manufactured by Life Max Cancer Lab in Haridwar also failed quality tests. CDSCO has released two lists of drugs that did not pass quality checks: one containing 48 popular drugs and the other detailing responses from the pharmaceutical companies whose products failed. The manufacturers’ responses indicated that the actual manufacturers (as per the label claim) did not produce the flagged batches, suggesting that these may be spurious drugs. However, the final determination is subject to ongoing investigations. Companies such as Sun Pharma and Glenmark provided similar replies, asserting they had not manufactured the implicated medicines. Sun Pharma’s three drugs—Pulmosil for erectile dysfunction, Pantocid for acid reflux, and Ursocol 300 —were among those that failed the tests. Glenmark’s hypertension drug Telma H (Telmisartan) and Macleods Pharma’s Defcort 6 for arthritis treatment also did not meet quality standards. All three companies echoed that they had not produced these medicines. The drug regulator issues NSQalerts following random monthly sample checks carried out by state drug officials. In August, the CDSCO banned over 156 fixed-dose drug combinations deemed “likely to involve risk to humans. ” These included popular fever medications, painkillers, and allergy tablets, such as Cheston Cold and Foracet, commonly used for cold, fever, and pain relief. Since 2014, the regulator has prohibited 499 FDCs—combinations of two or more known drugs in a single dosage form Source: New Indian Express

Yes, our intestines contain germs. Germs aren’t all bad—in fact, some are helpful. For example, the common bacterium E. coli can be found in our intestines, and it helps us digest green vegetables and beans (also making gases). These same bacteria also make vitamin K, which causes blood to clot. Source: Britannica

Sep 23, 2024 New Delhi: A recent study published in Cell highlights the potential of metformin, a widely used diabetes medication, to slow ageing in monkeys. The research demonstrates that daily doses of metformin can preserve cognitive function and delay ageing effects in various tissues, especially the brain. This finding suggests that metformin could one day be used to delay ageing in humans. Metformin’s Impact on Cognitive Function The study, led by Guanghui Liu and his team at the Chinese Academy of Sciences, involved administering metformin to 12 elderly male cynomolgus macaques for 40 months, equivalent to about 13 human years. Results showed that metformin-treated monkeys experienced significantly slower cognitive decline than the non-treated control group. The neuronal activity in these monkeys resembled that of animals around six years younger, or approximately IS human years, indicating that metformin may help maintain brain health and cognitive function. Effect on Other Tissues Beyond the brain, the study explored metformin’s impact on other tissues, including the lung, kidney, liver, skin, and brain’s frontal lobe. The drug was found to slow the biological ageing of these tissues and reduce chronic inflammation, a common marker of ageing. These results suggest that metformin’s benefits extend beyond cognitive presewation, potentially offering broader anti-ageing effects. Mechanisms and Future Research Researchers proposed that metformin’s anti-ageing effects could be due to the activation of NRF2, a protein that protects cells from inflammation and injury. While the study primarily focused on healthspan—the period during which an organism remains in good health—it did not assess the drug’s impact on overall lifespan. Challenges and Next Steps Despite the promising findings, the study has limitations, including a small sample size of male monkeys. Fulther research is needed to determine if these effects are consistent across sexes and larger populations. Liu and his team are now conducting a trial with 120 human participants, in partnership with Merck, to test metformin’s impact on human ageing. Additionally, plans are underway for a larger-scale trial involving 3,000 individuals aged 65—79 to further explore the drug’s potential to extend healthspan and improve quality of life in older adults. The study offers new insights into metformin’s potential beyond diabetes treatment, highlighting its possible role in promoting healthier ageing. While these initial results are encouraging, more comprehensive studies are necessary to confirm metformin’s impact on human health and longevity. Source: Economic Times

Sep 25, 2024 New Delhi: StlYker, a medical technology company, announced the launch of its ‘1788 Advanced Imaging Platform,’ a visualization system designed for use across multiple specialties that provides surgeons with enhanced imaging capabilities for improved patient outcomes in India. The 1788 platform delivers high-resolution images that enable surgeons to visualize critical anatomy with greater clarity. It features advanced fluorescence imaging capabilities, offering clearer perfusion imaging and detailed visualization of complex anatomical structures, the company said. It is compatible with currently marketed imaging agents and is adaptable to new agents and fluorescence modes as they become available, the company added. Aman Rishi, Vice President and General Manager, India, said, “Fluorescence-guided surgery is emerging as a promising solution, enabling surgeons to better visualize perfusion, tumors, and critical anatomy intraoperatively. The 1788 imaging platform, with advanced fluorescence imaging capabilities, ensures better healthcare.” Stryker stated that the launched platform features a color gamut for 62.5 times more visible colors, high dynamic range with a new tone mode for more balanced lighting, and a Color Segmented Fluorescence mode, which shows a color map based on ICG intensities, especially useful for perfusion assessment and lymph node mapping. Source: Economic Times

Sep 22, 2024 • In a new study conducted in cynomolgus monkeys, researchers have shown that metformin, a medication used to treat type 2 diabetes, can slow aging in multiple organs, including the brain. • Over a three-and-a-half-year period, they found that monkeys treated with metformin showed reduced age-related decline, with some exhibiting a six-year regression in certain aging indicators. • While the study suggests promising anti-aging benefits, there is a need for further research, including human trials, to further explore the drug’s potential. Metformin, a drug traditionally used to treat type 2 diabetes, has garnered significant attention for its potential anti-aging effects. Its mechanism involves improving insulin sensitivity, reducing inflammation and promoting cellular repair processes, all important factors in aging. In this new research, experts in China, along with U.S. colleagues, have discovered that administering the diabetes drug metformin to cynomolgus monkeys can slow aging across multiple organs, including the brain. The study was carried out by teams from several institutions, including the Institute of Zoology and the Beijing Institute of Genomics, both part of the Chinese Academy of Sciences. Their study, published in Celle, details the researchers’ nearly three-and-a-half-year study on the   effects of metformin on the bodies of cynomolgus monkeys Cynomolgus monkeys (Macaca fascicu/aris) are a suitable model for aging studies because, like other nonhuman primates, their physiological and functional characteristics resemble those of humans. Source: Medical News Today

Sep 22, 2024 New Delhi: The Drugs Controller General of India (DCGI) has declared as many as 16 commonly-used medicines as spurious, after they failed the regulator’s quality and safety tests. These include Glenmark Pharmaceuticals’ Telma H, prescribed by doctors to manage blood pressure, and Sun Pharmaceutical’s Ursocol 300 used for gallstones treatment, a drug alert issued by DCGI, and seen by Mint, said. The other heavily-prescribed medicines that have failed India’s apex drug regulator’s tests include Pulmosil injection used for managing pulmonary arterial hypertension, and Pantocid for gastric issues. These tests come in the backdrop of some instances of Indian medicines failing quality checks abroad, following which Central Drugs Standard Control Organisation (CDSCO) along with state drugs controllers (SDCs) have conducted risk-based inspections of more than 400 premises in the last one year. As a result, over 300 actions like issuance of show-cause notices, stop production order, suspension, cancellation of licences /product licences etc. have been taken by state licensing authorities as per the provisions of the Drugs Rules, 1945. Paziva —40, Pantomed —40, Cefixime Oral Suspension IP, Moxymed CV, Frusemide Injection IP 20 mg, Tab Nodosis, Pantoprazole Inj. BP 40 mg — were listed in Inot of standard quality (NSQ)I by the regulator’s database for the month August. “Pulmosil, an indication used to treat pulmonary arterial hypertension, Pantocid used against gastroesophageal reflux disease (GERD), Ursocol 300 mg used for the treatment of gallstones manufactured by Sun Pharmaceuticals Ltd have been detected as “spurious”. Popularly used Telma H drug– manufactured by Glenmark Pharmaceuticals Ltd is used for managing high blood pressure. The drug has been declared spurious by the regulator,” stated the drug alert issued by DCGI. Sun Pharmaceutical Ltd and Glenmark Pharmaceuticals, in a reply to the drug regulator, have said that the impugned batch of the product has not been manufactured by them and that it is a spurious drug. “The product is purported to be spurious, however, the same is subjected to outcome of investigation,” they said. Quality control These poor quality and unsafe medicines have been reported by the drugs inspector, East Zone, CDSCO, that has a mandate to pick samples to ensure that genuine product is available in the market. During 2022-23, at least 3,053 drugs were found substandard and 424 spurious or adulterated, Union minister of state for health and family welfare Anupriya Patel said in Parliament in July. Earlier in February, the apex drug regulator instructed the states/Union Territories to keep a strong vigilance and surveillance on the quality of drugs available in the market by doing random sampling of the medicines. The initiative helps create a monthly database of spurious and NSQ medicines and keep a check on manufacturers. Another important drug, Defcort 6 Tablets, have been found to be unsafe by the Delhi drug regulator. The indication is used to treat Duchenne muscular dystrophy (DMD), a rare health condition. Source: Live Mint

Sep 24, 2024 Kerala: The Kerala health department announced plans to release revised guidelines for the prevention and treatment of Mpox, a decision that came in the wake of the southern state repolting the country’s first confirmed case of the new strain on Monday. The State Level Rapid Response Team (RRT) held a meeting to assess the overall situation in the state. After the meeting, state Health Minister Veena George said instructions have been given to take necessaiY action if the number of cases increases. “Isolation facilities have been set up in all districts, and monitoring has been strengthened, including at airports. Currently, testing facilities have been arranged in five laboratories. If required, testing facilities will be expanded to more labs,” she said in a statement. She said those arriving from other countries who show symptoms should inform the health department and seek treatment. The minister also instructed that if anyone with Mpox symptoms comes to government or private hospitals, the health depaltment should be informed. Earlier, official sources in New Delhi said India had repcn•tecl the first case of the Mpox strain in a patient from Kerala who tested positive last week. They said the Clade 1b strain was detected in a 38-year-old man from Malappuram district who had recently returned from the United Arab Emirates. The patient is stable, the sources said, adding, “This was the first case of the current strain that led the World Health Organization (WHO) to declare Mpox a public health emergency last month for a second time.” The earlier case of Mpox that emerged in the national capital was a 26- yem=old resident of Haiyana’s Hisar who tested positive for the previous West African Clade 2 strain earlier this month. Since the WHO’s 2022 declaration of Mpox as a Public Health Emergency of International Concern, 30 cases have been reported in India. Mpox infections are generally self-limiting, lasting between two and four weeks, and patients usually recover with suppcntive medical care and management. It is transmitted through prolonged and close contact with an infected patient. Mpox typically manifests itself with fever, rash and swollen lymph nodes and may lead to a range of medical complications. Source: Economic Times