Nov 04, 2024 This was at Zomato’s Hyperpure warehouse located in Kukatpally, Hyderabad. The warehouse is known as an FBO (Food Business Operator) operating with a state license. FBOs supply fru its, vegetables, meat, seafood, gourmet foods, packaging, consumables, kitchen equipment, etc, to hotels, restaurants, and caterers. A “future date of packing” like this is a food safety violation and this comes amid the officials uncovering serious food safety issues ahead of Diwali at sweet shops, a momo outlet, and shawarma units in certain places after health complaints. The officials even found house flies inside the warehouse and noted it didn’t have a proper insect-proof screen with few of the food handlers not wearing hair caps and aprons. This is despite the warehouse having its license, medical fitness certificates for food handlers, and pest control records. Zomato CEO Deepinder Goyal responded to the incident saying the packets in question had already been identified by the warehouse team and were rejected during an inward quality check. “l am not sure why just these small number of mushroom packets worth ₹7,200 (out of the crores of inventory in the warehouse), which were never going to make it to customers, are being talked about the media, while we got an A+ rating,” he said in a post on X. All these findings come after the task force in June this year, raided a Blinkit warehouse (Zomato owns quick commerce platform Blinklt) at Devar Yamjal in the Medchal Malkajgiri District near Hyderabad, finding unhygienic premises, expired items, and food that was possibly infested, among several other issues. Another NDTV report on this matter quoted Blinkit as saying in response, “We take safety and hygiene standards very seriously. We are closely working with our warehouse partner and the Food Safety Department to implement corrective actions from the findings.” Source: Hindustan Times

Nov 02, 2024 NEW DELHI: Congress MP Manickam Tagore has written to Prime Minister Narendra Modi, expressing concern over the National Pharmaceutical Pricing Authority’s recent decision to increase prices of eight commonly-used drugs and sought the establishment of an independent review committee to assess the real impact of the price hike. In the letter, Tagore said he was writing to express his concern regarding the recent decision by the National Pharmaceutical Pricing Authority (NPPA) to increase the ceiling prices of eight commonly-used drugs by 50 per cent. “While I understand that the government cited ‘extraordinary circumstances’ and ‘public interest’ as reasons for this increase, I believe it is crucial to clarify the rationale behind such a significant decision,” the Congress MP from Tamil Nadu’s Virudhunagar said. “This price hike affects vital medications for conditions like asthma, tuberculosis, bipolar disorder, and glaucoma, which are essential for millions of citizens,” Tagore said. Many patients and their families already face financial challenges in accessing necessary treatments, he said. A sudden increase in medicine prices can place an additional burden on these individuals, potentially compromising their health outcomes, Tagore said. “I urge the government to provide a more detailed explanation of the extraordinary circumstances that necessitated this price hike. Furthermore, I propose the establishment of an independent review committee to assess the real impact of this increase on patients and healthcare providers,” he said in the letter dated October 25. Such a committee could offer recommendations for future pricing policies that balance industry viability with public health needs, he said. “Transparency in this decision-making process is vital to maintaining public trust. A thorough review could lead to informed policies ensuring that essential medicines remain affordable and accessible for all,” Tagore asserted. “I look forward to your response and hope for a resolution that prioritises the wellbeing of our citizens,” the Congress leader said. Source: Times Of India

Nov 02, 2024 Hyderabad: To help individuals make a conscious decision to eat healthy, pre-packed food will feature pictorial front labels. ICMR-National Institute of Nutrition in the city, which conducted a study on how consumers view labels, has submitted its findings to the Food Safety and Standards Authority of India. It examined consumer reactions to different kinds of labels that would assist them in making the right decision about purchasing something that is ‘overall healthy’ or avoiding food considered not healthy. In the study conducted in various parts of the country, one significant finding was that only a small percentage of consumers actually read the labels. “The first thing that consumers look at is the date of manufacture and date of expiry. They also look at the indication whether the food is veg or non-veg. Only a small percentage of people actually look at the nutrients to understand and make a healthy choice,” said Subba Rao M Gavaravarapu, principal investigator, information, communication and health education, ICMR-NIN. R Hemalatha was project coordinator of the study conducted in 2023. In NIN’s study, the total sample size was 2,500 adults and adolescents, including participants from five regions — north (Delhi), east (Kolkata), west (Pune), south (Hyderabad) and northeast (Jorhat, Assam). Most of the respondents reported that they checked the expiry date (74.2%). Over 60% of the participants also read the brand name, and 57.7% checked the manufacturing date. “A small proportion of participants reported that they also considered nutrition information,” the report said. The most commonly checked nutrients were calories, total fat, sugar, salt, and protein. “In the context of growing overweight, obesity, and non-communicable diseases, if front-of-pack nutrition labelling has to serve as a preventive tool and deter consumers from the consumption of nutrients of concern, then warning indicator labels could be helpful,” NIN said in the report. Source: Economic Times

Oct 31, 2024 When it comes to relishing piping hot momos, spicy red chutney and mayonnaise come as the perfect combo, but in a sad incident, a woman died after eating mayonnaise in Telangana and that led to banning of mayonnaise for a year in the state. Scroll down to read the details. As per news reports, the Telangana state government on Wednesday banned mayonnaise made with raw eggs for a year due to food safety concerns. The state government took this decision after a woman died and 15 others fell ill after eating momos in Hyderabad. It has been stated that many such cases have come to light in recent times, where the issue has arisen due to eating mayonnaise made from eggs, which is used in large scale in the state for making sandwiches, momos, shawarma, and many other dishes. The Telangana Food Safety Commissioner said in a statement, “Observations and complaints received over the last few months have shown that consumption of mayonnaise made from raw eggs is leading to cases of food poisoning.” It is also said that in cases where food products appear to be harmful to public health, that food product would be banned. As per reports, the ban on production, storage, and sale of mayonnaise made using raw eggs has been implemented from October 30, 2024 for a period of one year. For the unversed, the decision came after a 31-year-old woman died and 15 others fell ill after eaing momos in Hyderabad along with mayonnaise. In a similar incident, a few days back, cases of food poisoning were reported at shawarma outlets in the city, after which health officials conducted raids on shawarma outlets. Side effects of mayonnaise While mayonnaise makes for a creamy and delicious condiment, the store bought mayonnaise also poses some important side effects. Take a look High caloric content: It uses a lot of oil, which makes mayonnaise calorie-dense, which can contribute to weight gain if consumed in excess. High fat content: While it contains healthy fats, too much saturated fat can be a concern for heart health. Allergies: Some people may be allergic to eggs (a common ingredient in traditional mayonnaise) or other components, leading to allergic reactions. Foodborne illness: Mayonnaise made with raw eggs carries a risk of salmonella infection if not prepared or stored properly. High sodium: Many commercial mayonnaise brands contain added salt, which can contribute to high blood pressure if consumed excessively. Digestive issues: It may cause digestive discomfort, such as bloating or diarrhea, if a large amount of mayonnaise is consumed. Processed ingredients: Store-bought mayonnaise often contains preservatives and additives, which some people prefer to avoid for health reasons. Source: Times Of India

Oct 31, 2024 Those aged 70 years and above can now benefit from the expansion of the Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) regardless of income, a major shift in the govt policy. Earlier, only poor and vulnerable families and a few specific categories of workers, like ASHA staff, were eligible for the scheme that offers health cover of Rs 5 lakh per family per year for secondary and tertiary-care hospitalisation. Anyone aged 70 years or above can apply for the Ayushman Bharat Senior Citizen Scheme on the website, www.beneficiary.nha.gov.in, or by using the Ayushman App (available for Android on the Google Play Store). Beneficiaries simply need to verify their identity and eligibility through Aadhaar e- KYC. Aadhaar serves as the primary document for confirming both the beneficiary’s age and state of residence and is the only document required to complete the registration process. Yes. Family members can register the eligible an beneficiary through beneficiary login option on the mobile app and website. All they must do is to enter their mobile number and put in the OTP that’s generated to initiate the enrolment process. One can also visit the nearest empanelled hospital and get themselves enrolled. AB PM-JAY is a completely cashless scheme, and govt sources said payments are made to hospitals against the treatment provided to eligible beneficiaries. Empanelled hospitals are mandated to offer cashless treatment to beneficiaries. One can lodge grievances on the AB PM-JAY website or through the national call centre ‘14555’, mail, letter, fax etc. Any complaint regarding denial of treatment by an empaneled hospital is to be seen as an SOS grievance and a ‘turn around time’ of 6 hours has been set for resolving it. Such beneficiaries will have to re-initiate their Aadhaar based e-KYC via the website or mobile app to be registered as a beneficiary under the senior citizen scheme. The list of empanelled hospitals for Ayushman Bharat PM-JAY scheme is available on the website www.dashboard.pmjay.gov.in. As of Sept 30, approximately 30,000 hospitals across the country are empanelled to provide benefits under the scheme, which is run overall by the National Health Authority. The list includes 190 leading corporate hospitals like Centre For Sight (Delhi), Medanta-The Medicity (Gurugram), Metro Hospital and Heart Institute (Noida), Fortis Escorts Hospital (Jaipur), Yashoda Super Speciality Hospital & Heart Institute (Ghaziabad), etc. Public health and hospitals being a state subject under the Indian Constitution, state health agencies (SHAs) are mandated to empanel hospitals under Ayushman Bharat PM-JAY. Beneficiaries can visit any empanelled hospital, present either their Ayushman card or their PMJAY ID to receive treatment. Before visiting, the beneficiary should confirm that the hospital is empanelled to treat the specific condition for which they require assistance. Nearly all treatments covered by the scheme cost below Rs 2 lakh and, so, the Rs 5 lakh cover is sufficient to meet beneficiaries’ healthcare needs, govt sources said. Further, under the umbrella scheme of Rashtriya Arogya Nidhi (RAN), financial assistance up to Rs 15 lakh is provided to patients from poor families — who are eligible for PM-JAY — for availing those treatments that are not covered under PM-JAY. Hence, AB PM-JAY along with other central govt schemes can take care of hospitalisation needs of eligible beneficiaries. No. With these states not implementing the scheme, elderly citizens cannot join or receive the benefits of AB PM-JAY Source: Times Of India

Nov 11, 2024 The cyberattack, reported on Feb. 21, knocked the UnitedHealth Group subsidiary offline, cutting off billions of dollars in payments to medical practices and jeopardizing sensitive information for millions of patients. In an interview with NBC News, Rick Pollack, CEO of American Hospital Association, described the attack as the most serious incident of its kind leveled against a U.S. health care organization. However, it was not an isolated incident. An estimated 725 HIPAA data breaches occurred in 2023, according to the Health Sector Coordinating Council Cybersecurity Working Group, a coalition of health care providers, medical technology companies and other entities that work with the government to mitigate cyber threats to the health care system. Another 141 ransomware attacks struck hospitals, with an average ransom of $1.5 million per institution, according to the working group. On May 8, the Ascension health care organization was struck by the same cybercriminals behind the Change Healthcare event. The attack disrupted Ascension’s 140 hospitals in at least 10 states for more than a month. “It was a single individual who downloaded the wrong software on an email that set off this infiltration of ransomware,” Keith A. Bellovich, DO, chief medical officer at Ascension St. John Hospital in Detroit, told Healio I Nephrology News & Issues. “It could happen anywhere; it could happen to any of us. Yes, we get frustrated with our IT teams for always trying to educate us. But we have to pay attention because this isn’t the end, Bellovich, who is a Healio I Nephrology News & Issues Editorial Advisory Board member, said. The health care sector is ripe for attack because of the amount of money, sensitive data and personal information cybercriminals can steal and exploit, according to experts interviewed for this article. “We have seen it in large health organizations, smaller health systems and in individual practices,” Margaret Lozovatsky, MD, FAMIA, AMA vice president of digital health innovations, said in an interview. “That just speaks to the fact that technology has become such an integral part of care delivery. Every area where we are providing clinical care has the potential to be impacted, and there’s a lot of vulnerabilities in those spaces.” Everyone is a target Change Healthcare paid a $22 million ransom to the hacker to regain control of its system. However, the payment did not prevent myriad disruptions to providers and patients. In a survey about of nearly 1,000 U.S. hospitals conducted by the American Hospital Association (AHA) on March 9-12, nearly all respondents (94%) reported financial impacts, with more than half characterizing these as “serious” or “significant.” Nearly 60% of respondents reported the impact to their revenue totaled $1 million or more per day. “We haven’t even discussed the ongoing damage from records being released, Theresa Payton, CEO of Fortalice Solutions, a boutique cyber firm that serves the Fortune 100 and other large privately held  firms, said in an interview. “Depending on what’s in these records, there could be information that could be used for extortion and blackmail. One-third of all Americans — or more than 110 million people — could have had their personal data compromised in the Change Healthcare ransomware attack, UnitedHealth CEO Andrew Witty told Congress in May. The success of the Change Healthcare attack appears to have prompted a new wave of similar threats. “It is vitally important for organizations to prepare for this reality, ” Payton, who served as the White House chief information officer from 2006 to 2008, said. “When impacted by a cybercriminal syndicate — whether they take a system offline, lock files or steal data — organizations must focus on minimizing and mitigating damages. They need to ensure they can continue to function even while dealing with a cyber incident. It’s easier said than done, but it’s the crucial question every health care organization must address.” Source: Healio

Oct 25, 2024 India’s pharmaceutical landscape is a double-edged sword. On one side, it boasts a vast ecosystem of compliance, with over 69,000 unique regulations governing pharmaceutical companies. On the other hand, the regulatory enforcement capacity struggles to keep pace with industry demands, resulting in significant gaps in oversight. Agrawal highlights the importance of regulatory compliance and the responsibility of manufacturers in maintaining quality control. He emphasised that while counterfeit drugs are manufactured with the intent to deceive, not of standard quality (NSQ) drugs may originate from legitimate sources yet fail to meet required standards due to various factors like poor storage or inadequate testing. Agrawal advocates for a more robust regulatory framework, emphasising the need for a targeted approach to enforcement. He suggests that the 10% of manufacturers engaged in illegal practices should face stringent consequences, while the remaining 90%—the law-abiding companies—should not be burdened with excessive compliance demands. As consumers navigate the choices between local chemists and online pharmacies, the podcast highlights the need for assurance in the quality of medications regardless of the purchasing avenue. Agrawal firmly asserts that the onus of accountability lies with regulators and manufacturers to ensure that all medicines meet safety and efficacy standards, regardless of price. Source: The Hindu Business Line

Oct 06, 2024 New Delhi: India’s apex health research body, ICMR, will undertake a study to evaluate the efficacy of two Polycystic Ovarian Syndrome (PCOS) drugs in improving fertility and bilth outcomes among women suffering from the ovarian condition. The drugs that have been recommended by experts for this purpose are Metformin and Inositol which are used in the treatment of the condition. The ICMR has recently invited expression of interest (EOI): “To undertake a multi-centric randomised controlled trial for evaluating the efficacy of Metformin vs Inositol to improve fertility and birth outcomes among PCOS women”. Polycystic Ovarian Syndrome (PCOS) is a complex disorder ranging from mild to severe disruptions in reproductive, endocrine and metabolic functions, with key features including irregular menstrual periods (anovulation), hyperandrogenism, insulin resistance and abnormal gonadotropin secretion. The prevalence of infertility in women with PCOS is high, varying between 70 and 80 per cent, the ICMR said in the Eol document. Moreover, PCOS women have been found to have increased prevalence of pregnancy complications and less favourable pregnancy outcomes (live births, miscarriage, pregnancy rate) compared with women without PCOS, it stated. In contemporary practice, the use of Metformin and Inositol for the treatment of PCOS is widespread. “However, present evidence on the efficacy of these two drugs in terms of improvement in fertility and other related outcomes is insufficient,” the ICMR said in a document. A Finnish study suggested that, as compared to placebo, metformin improved the pregnancy rate, live birth rate and ovulation rate in the studied population, the document said. However, a Cochrane review with meta-analysis including three other smaller studies reported that as compared with placebo, metformin may have only marginal benefit for live birth rate outcome. Additionally, there is very limited data available globally on the effectiveness of Inositol for PCOS women, especially for birth outcome and cycle regulation. “Evidence on the efficacy of both metformin and inositol in the Indian context is almost non-existent. To address the knowledge gap and to generate evidence on the management of PCOS for improving birth outcomes in the Indian context, the current ICMR call is being proposed,” the document said. The ICMR is looking to partner with interested researchers for the development of a multicentre randomised controlled trial for the management of PCOS in Indian women. The selected researchers shall be invited to join the research team and shall collaborate to develop a full research proposal and roll out the multi-centre research project which will be coordinated by ICMR, the document said. The research question is “Among women with Polycystic Ovary Syndrome (PCOS), how does inositol in comparison to metformin work in terms of efficacy and safety on outcomes including pregnancy conception, menstrual cycle regularisation, and improvement in endocrinological and metabolic parameters?” Source: Economic Times

Nov 11, 2024 In October 2024, approximately 480 Indian students participated in counselling sessions conducted by the Medical Education Commission (MEC) under the government of Nepal. But, now most of them are in a fix due to changing policies introduced by the Nepal Medical Council in April 2023. This implies that Indian students who have enrolled in Nepal after 2021 or are planning to move there for an MBBS or BDS degree will not be granted a license to practice in Nepal. Due to the change in policies international students from the 2021, 2022, and 2023 MBBS batches are considering abandoning their courses and planning to protest against private colleges and the Nepal Medical Council (NMC) over the uncertainty created by licensing regulations. The Global Medical Society (GMS), an association representing Indian MBBS students in Nepal, has informed Education Times that they will soon protest, demanding amendments to NMC Regulations, 2024 (especially to the section 21 f). A student from Muzaffarpur, Bihar, studying at Kathmandu University, on the condition of anonymity says, “After the NMC’s ambiguous notifications released in April 2023 and October 2024, foreign students are struggling to ensure if their medical education will remain valid in India. Since Nepal does not grant licenses to foreign students, it is unclear why we are still expected to take the licensing exam. Without the license to practice in Nepal, our careers are at risk, as we will not be able to qualify for the FMGE or NExT exams in India.” Another student from Gorakhpur, studying at Tribhuvan University, Nepal, says, “Nepal’s medical education is also not yet recognised by the United States Medical Licensing Examination (USMLE), which limits our opportunities worldwide. We have reached out to the Indian Embassy in Nepal for clarifications as well and are awaiting their response. If the NMC does not provide us with a practising license for at least 10 years, we will be forced to return to India.” Around 1,338 Indian students could face severe career setbacks if amendments or special provisions are not made for currently enrolled students in Nepal. “We also do not want more Indian students to get into this entrapment, thus we have asked the authorities to delay the last date of the ongoing admission process so that these students can make an informed decision,” adds the student. Indian students have faced the potential loss of at least Rs 5 lakh each, which was illegally collected by consulting agencies as a pre-booking fee. Dr Kumar from a private medical college in Nepal says, “This year, around 845 students registered for counselling, and 480 students were selected based on the MEC merit list. Following awareness regarding the licensing issue, nearly 50% have withdrawn their applications. Most registrants this year were from Maharashtra, Uttar Pradesh, Bihar, West Bengal, and Gujarat. Many students paid pre-booking fees to agents, ranging from Rs 5 to 15 lakh, despite the NMC’s clear statement that such fees are illegal. Consultants/ agents often mislead students and parents.” Anuj Goyal, co-founder, Get My University, says, “The young Indian medical aspirants are draining their finances due to misleading information from certain consultants and private medical colleges in Nepal. From 2021 to 2024, over 1 ,400 students travelled to Nepal to pursue medical degrees, each investing an average of Rs 30 lakh in tuition fees—a combined total of Rs 400 crore. However, following a circular issued by the MEC on October 17, 2024, these students are now in severe distress, as their education in Nepal risks being invalidated, potentially costing them their savings and jeopardising their futures.” Source: Education Times

Nov 09, 2024 New Delhi: Many ethical concerns are raised when it comes to the In Vitro Fertilization (IVF). In vitro fertilization (IVF) is an innovative medical procedure that has transcended the boundaries of traditional conception methods, offering hope to countless couples who are battling infertility challenges. It is one of the common alternatives chosen by couples to conceive, especially in cases of blocked fallopian tubes in females, male factor infertility, recurrent miscarriages, endometriosis, or diminished ovarian resewe. During this procedure, the eggs and sperms are combined outside the body in a controlled laborat01Y environment, and the resulting embryo is transferred back into the uterus with the aim of fulfilling the dream of having a baby. When exploring the option of in vitro fertilization (IVF), one cannot overlook the ethical complexities that are linked to this popular technique and one such pertinent question which remains unanswered is— the optimum number of embryos to be transferred during IVF. More the number of embryos transferred, more are the chances of multiple pregnancies. This is done to maximize pregnancy rates in order to sustain the competition between IVF units, and making the treatment more cost- effective. The practice of multiple embryo transfer can pose serious risks to both the mother and the infants. Almost every obstetric complication happening in a singleton pregnancy is more common in multiple pregnancy and even routine life after delivery is more difficult for the parents with increased incidences of anxiety and depression. Risks to the children can be due to premature delivery, complications of intra- uterine growth retardation and all these can have short term and long term ill effects on the babies. Further, the health care costs related to the management of these complications increase and higher number of multiple pregnancies can be a public health issue. However simply stating that multiple pregnancy has potential risks to both the mother and child doesn’t mean that multiple embryo transfer should be prohibited. There is a need for proper legislation on the number of emblyos to be transferred to curtail both the parental and physician autonomy. The parents have the right to decide as to how many children they want in their family and the IVF specialist has a moral obligation towards both the parents and the future child. Hence a conscious decision regarding the number of embryos to be transferred has to be made considering many factors because any risk to either the parent or the child may be morally and ethically unacceptable. The key component of IVF treatment is informed consent. In order to make decisions that are consistent with their beliefs and goals, couples must have a thorough understanding of the physical, emotional, financial, medical and ethical components of the procedure. This covers the risks and benefits of single embryo transfer vs multiple embryo transfer and also their choices about cryopreservation, embryo selection and genetic testing. The decision regarding performance and possibility of multifetal reduction should also be discussed in length. The ethical dilemmas of reduction is perceived as a problem of abortion. Regardless of the education provided before treatment, people may still consider decision to reduce the number of emblyos as psychologically demanding and it is better not to go to that stage where couples have to take certain decisions which may jeopardize their present pursuit. Hence prevention of multiple pregnancies should be preferred to multifetal reduction of pregnancy. Age, parity, diagnostic criteria and co-existing medical conditions are examples of patient variables that affect the decision-making process. Couples should be informed about the potential dangers and how these factors may affect the treatment outcome, since they have an impact on the overall success of IVF. Technological advancement such as pre — implantation genetic testing (PGT-A) offers the parents an opportunity to screen for aneuploidy or genetic disorders and provide optimal pregnancy rates after elective transfer of a single normal embryo. Another factor to be considered is concerns of couples on cryopreservation of emblyos as many of them tend to experience emotional distress and this should be well addressed. Finally—the—prognosis – patients need to know about their chances of success depending on their particular medical/ obstetrical background, their profile as a patient — poor responders or poor implanters, their infertility treatment history, the quality of the embryos and the clinic’s experience. This aids them in reaching practical decisions. The treating physician and the couple reach an agreement on the modalities of treatment. Finally as adults, patients should have an ultimate say on the treatment that they would wish to receive within the framework of risks vs benefits and all the associated treatment alternatives prioritizing health outcomes. This article is written by Dr. Vandana Bhatia, Fertility Specialist , Nova Southend Fertility and IVF, Vasant Vihar. Source: Economic Times