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NLEM 2022: Union health minister Mansukh Mandaviya launched the new list of essential medicines and also announced a price cap on commonly used drugs.

Union health minister Mansukh Mandaviya on Tuesday released a revised National List of Essential Medicines (NLEM), in which 384 drugs from 27 categories do not feature, including ranitidine - often taken for acidity and other stomach-related ailments and sold under brand names like Rantac, Zinetac and Aciloc, but removed now over cancer-causing concerns.

In 2020 the Food and Drug Administration (FDA) had recalled all ranitidine products (injectable and oral) after the revelation of low-level N-nitrosodimethylamine (NDMA) presence; according to a study published by the Indian Journal of Pharmacology N-Nitrosamines are associated with stomach, esophagus, nasopharynx, and bladder cancers.

As many as 34 drugs -including some anti-infectives like ivermectin, mupirocin and nicotine replacement therapy - have been added to the NLEM, taking the total drugs under it to 384.

News agency PTI said endocrine medicines and contraceptives fludrocortisone, ormeloxifene, insulin glargine and teneliglitin had also been added to the list. Montelukast, which acts on the respiratory tract, and ophthalmological drug Latanoprost are also in the list.

Cardiovascular medicines Dabigatran and Tenecteplase are also included, the PTI report said.

The health minister also announced a price cap on commonly-used drugs and said some antibiotics, vaccines and anti-cancer drugs would now be “more affordable and accessible” in an effort to “reduce patients' out-of-pocket expenditure”.

“The National List of Essential Medicines is being published today. Based on that... the National Pharma Pricing Authority will set its ceiling price... it is also based on this that it is decided no company increases price (of essential medicines) on its own.”

“It's a very long process. All the work is done by an independent committee. Interacted with more than 350 experts and 140 consultations,” Mandaviya said on the new NLEM.

This is the full list of medicines removed from the NLEM 2022:

1. Alteplase

2. Atenolol

3. Bleaching Powder

4. Capreomycin

5. Cetrimide

6. Chlorpheniramine

7. Diloxanide furoate

8. Dimercaprol

9. Erythromycin

10. Ethinylestradiol

11. Ethinylestradiol(A) + Norethisterone (B)

12. Ganciclovir

13. Kanamycin

14. Lamivudine (A) + Nevirapine (B) + Stavudine (C)

15. Leflunomide

16. Methyldopa

17. Nicotinamide

18. Pegylated interferon alfa 2a, Pegylated interferon alfa 2b

19. Pentamidine

20. Prilocaine (A) + Lignocaine (B)

21. Procarbazine

22. Ranitidine

23. Rifabutin

24. Stavudine (A) + Lamivudine (B)

25. Sucralfate

26. White Petrolatum

Source : ht

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Struggling with persistent eye symptoms like red, watery eyes, blurry vision or dry eyes? Do not ignore eye infections as they can lead to blindness, severe complications and even death.

It is difficult to imagine a normal life without our precious eyes, yet we take them for granted most of the times. Symptoms like redness of eyes, watery eyes, blurry vision and dry eyes are often ignored as minor problems and not addressed seriously. While most of these symptoms resolve on their own, in rare cases, if left untreated they can lead to serious complications from blindness to death.

A review published in National Library of Medicine says that while most ocular infections are benign, others can be associated with devastating visual consequences. Most patients present with either ocular discharge, visual symptoms or a red or painful eye.

Experts are of the view that some diseases and infections may manifest first as an eye symptom because eyes are the only organ in the body where neurons and blood vessels can be directly visualized and hence the first organ to give us a sneak peak into the possible systemic disease and also in confirming the diagnosis.

"With advancement in medical sciences, the idea that eyes are only for vision has changed. Some diseases of the eye can cause loss of vision and in some rare events, become fatal if neglected or diagnosed in an advanced stage," says Dr. Pooja A Angadi, Senior Consultant, Sharp Sight Eye Hospitals.

"The eye is considered to be the anatomical extension of the brain and so serious infections of the eye can spread to the brain. Newer drugs, newer technologies have led to advancement in treatment," adds the expert.

Mucormyosis and Aspergillosis of the eye are two of the infections which once held a small note in ophthalmology textbooks have now become common in Covid-19 era. These have been known to have fatal implications if untreated.

Here's a list of eye infections that can have devastating consequences if left untreated:

1. Rhino orbital Cerebral mucormycosis: Commonly known as the Black fungus it is an uncommon infection caused by Mucorales and has a high morbidity and mortality rate. "It occurs mainly in immunocompromised patients like those with uncontrolled diabetes, cancer, post organ transplantation, on chronic steroid therapy and as of late it has been seen in patients with severe Covid infection. The fungus invades the blood vessels entering through the nasal cavity and spreading to the sinuses and orbit and finally reaching the brain which can be deadly," says Dr Angadi.

2. Aspergillosis: Similar to mucormycosis, orbital aspergillosis occurs in immunocompromised patients and has the same passage from nasal cavity to the orbits and subsequently gaining access to the brain.

"Intracranial extension can lead to brain abscess, vasculitis, thrombosis and eventually cerebral ischemia and necrosis which can be fatal," adds Dr Angadi.

3. Conjunctivitis (pink eye): "Conjunctiva is a thin layer of tissue covering the whites of the eyes and insides of the eyelids. Conjunctivitis can be described as an infection or inflammation of the conjunctiva. The symptoms are itchiness and watery discharge. One may get this infection in one eye or both. It can be serious if not treated at the right time," says Dr Ashwini Seth, Ophthalmologist at Apollo Spectra in Karol Bagh Delhi.

"Mortality in the setting of bacterial conjunctivitis is related to the failure to recognize and treat the underlying disease. Sepsis and meningitis caused by N gonorrhoeae can be life-threatening," according to Medscape.

4. Blepharitis: It is an inflammation of the eyelids, and is seen due to bacterial infection, allergies, clogged oil glands in the eyelids, and certain skin conditions.

"One may notice symptoms such as redness and swelling of the eyelids, burning and watery eyes, flaky skin around the eyes. Blepharitis will not lead to blindness, but it can invite several other complications like the eyelashes may fall out or growing in strange directions," says Dr Seth.

5. Uveitis: It is inflammation of the uvea (the middle layer of the eyeball containing the iris.). It is associated with various conditions like psoriasis, herpes zoster infection, or rheumatoid arthritis. One may notice symptoms like blurry vision, redness of the eyes, and floaters, according to Dr Seth.

6. Keratitis: It is known as the inflammation or infection of the cornea (the clear outer layer on the colored part of the eye. The misuse of contact lenses can be the culprit behind the infection.

"Wearing lenses for extended hours, not cleaning them and improper storage of them can raise the risk of germs getting into the cornea. Neglecting it and not seeking immediate treatment can lead to scarring on the cornea and permanent loss of vision," says Dr Seth. Source : HT

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According to a PTI report, the woman is undergoing treatment at Lok Nayak Hospital. Another person suspected of suffering from monkeypox has also been admitted to the Delhi government-run hospital.

Delhi on Friday reported its eighth monkeypox case after a Nigerian woman tested positive for the viral infection. The patient is a 30-year-old woman. The total number of monkeypox infections in India now stands at 13.

According to a PTI report, the woman is undergoing treatment at Lok Nayak Hospital. Another person suspected of suffering from monkeypox has also been admitted to the Delhi government-run hospital.

"A total of eight cases of monkeypox have been reported in Delhi so far. The latest being a Nigerian woman, who is aged 30, and admitted at the LNJP Hospital. Her condition is being monitored," an official was quoted as saying by the news agency.

The patient whose infection is yet to be confirmed is also a Nigerian woman. She was hospitalised on September 14, another official said, adding, the seventh and eighth confirmed cases and the suspected case are undergoing treatment. "All three patients are doing fine.”

The first case of monkeypox, a rare but potentially serious viral illness, was reported from Kerala’s Kollam district on July 14 and the patient was discharged from the hospital last week. All five monkeypox patients in Kerala had a travel history of the UAE

Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms similar to those in smallpox patients. The World Health Organisation declared it a public health emergency on July 23 and it is clinically less severe than smallpox.

The infection, unlike Covid-19, is not easily airborne and transmits through direct contact with bodily fluids or the lesions of the infected person. It can also be spread through indirect contact with lesion material, such as through contaminated clothing or linen. (With inputs from agencies) Source : ht

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The study titled, 'Adolescent psychological well-being and adulthood cardiovascular disease risk: longitudinal association and implications for care quality management,' was published in 'Benchmarking: An International Journal'.

It has been a long-known fact that a person's risk of cardiovascular disease (CVD) can be lowered with lifestyle changes such as modifying diet, exercise, alcohol and tobacco use. Now, Anand Chockalingam and Sharan Srinivas at the University of Missouri demonstrated in a new study that a long-term association also exists between an adolescent's psychological well-being and their risk of CVD as an adult.

The study titled, 'Adolescent psychological well-being and adulthood cardiovascular disease risk: longitudinal association and implications for care quality management,' was published in 'Benchmarking: An International Journal'.

Specifically, Chockalingam, a professor of clinical medicine, and Srinivas, an assistant professor of industrial and manufacturing systems engineering, found that people who were more optimistic or positive when they were adolescents could lower their chances of being in the high-risk category for CVD as an adult.

"Here, we are recognizing the role of the environment and lifestyle in heart disease," said, Chockalingam, who is also a cardiologist with MU Health Care. "Some prior research has shown that more than 80 per cent of all heart attacks can be prevented with a few simple lifestyle interventions at any point in the individual's life. Although a heart attack may occur at the age of 55, the underlying build-up of plaque or atherosclerosis starts much earlier, often in teenage years. By exploring healthy habits and connecting with optimistic peers in the impressionable teenage years, it becomes intuitive to sustain a good lifestyle."

Chockalingam believed that this study emphasized the value of optimism in an adolescent's life.

"Adolescents are simultaneously understanding the world as well as their own inner nature and mindset," Chockalingam said. "Therefore, parents and other caregivers have a substantial role in the lifetime resilience and outlook of children. The biggest legacy that anyone can pass on for subsequent generations is optimism."

The team analyzed data from study participants involved with the National Longitudinal Study of Adolescent to Adult Health (Add Health). Chockalingam said the database served as a rich source of information for their study.

"The Add Health database meticulously collected data from over 20,000 adolescents when they were about 15 years of age, and followed up every few years afterwards with repeated surveys of several hundred health aspects for the same group of children," Chockalingam said. "This gives us a unique window into the lifetime risk and correlation between various social, economic, psychological and genetic health determinants."

Both researchers have personal experiences that reflected in the results of their study. Srinivas credited his involvement in sports as a youth in India, including playing competitive tennis until age 18, for leading to a life and career advocating for a healthy lifestyle, both mentally and physically.

His passion, along with a continued interest in playing tennis, also led to a serendipitous research collaboration with Chockalingam. What began as a friendly game of tennis between two working professionals -- Srinivas and Chockalingam -- grew over time to include discussions of their mutual interests in health care-related research. Eventually, the two began working together on research projects, and their expertise complements one another -- Srinivas focused on data analytics and industrial engineering tools to improve both the patient and health care provider experience; Chockalingam provided clinical insights and a health care provider perspective.

Srinivas believed that this study could help clinicians develop a personalized approach to lower someone's CVD risk by integrating problem-solving techniques currently used by industrial engineers that place an emphasis on prevention and early detection.

"There are several step-by-step techniques established by industrial engineers that help with early detection of problems in the manufacturing and service industries," said Srinivas, who has a joint appointment in the Trulaske College of Business. "This is an opportunity to adapt some of these techniques to enable health care practitioners to monitor the well-being of an adolescent over time, because that's the formative stage where your outlook on life is established, and it doesn't change much after that."

Srinivas acknowledged that this study was only a first step toward establishing the association between adolescent well-being and CVD risk. He believed that additional analysis of other data sets was needed to help overcome a limitation they had in this study, which was only taking a snapshot of someone's life during adolescence and again during young adulthood. He said that there needs to be additional insights into how people are doing in between these life stages.

In the future, Srinivas said that he would like to explore the use of other industrial engineering and data analytics techniques, such as machine learning.

"We want to use these techniques to help predict the long-term risk for CVD among adolescents, and uncover the impact that underlying factors can have on a person's chance to develop CVD, including the influence of a person's well-being," Srinivas said. Source : ht



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MMC Act to be implemented in state to control mosquitoes

Written by Thursday, 14 September 2017 06:06

With mosquito-borne diseases on the rise in the state, the public health department is planning to expand the scope of the Mumbai Municipal Corporation Act (MMC Act), 1888, to the entire state to effectively act against offenders allowing mosquito breeding in private spaces.

In a meeting held by state Health Minister Deepak Sawant and senior state health officials on Monday, it was decided to seek the opinion of the law and judiciary department on enforcing sections of the Brihanmumbai Municipal Corporation’s Act in state.

“This will be similar to Bombay Nursing Homes Registration Act initially limited to only Mumbai and later enforced in the entire state,” said Dr Satish Pawar, director at the Directorate of Health Services. The state government plans to pick specific sections from MMC Act, such as reporting of certain communicable diseases, sections on water and sanitation, and legal action taken for allowing mosquito breeding.

The most important section the state hopes to implement is Section 381 of MMC Act that allows civic body to prosecute a person found guilty of allowing mosquito breeding in public or personal space. The fine ranges between Rs 2,000-10,000. Section 381(B) of the Act deals with those who default on making water tanks mosquito proof.
In June, BMC found maximum mosquito breeding in public buildings.

The public works department buildings had 536 non-mosquito proof spots, central railways had 446 spots and central public works department was found with 252 breeding spots. Western railways owned 636 buildings, where 3.7 per cent tanks had no mosquito proofing. Central railways, which owns 577 premises, had a significant 23.5 per cent breeding spots. All government agencies were issued notices by BMC.

“The fine is minimal. Offenders are let off easily which is why we have been asking to increase it to prevent multiple offences,” Dr Rajan Naringrekar, insecticide officer, BMC, said. With monsoon receding and weather conducive for viral infection to multiply, the state is taking special efforts to control malaria and dengue, both spread by mosquito. In Mumbai itself, 271 malaria cases and 102 dengue cases were recorded since September 1.

While malaria is carried by anopheles, dengue is spread by aedes aegypti. Indoors, aedes mosquito breeds in feng-shui plants, flower pots, fish tanks, unused tyres and petri-dishes. “We are expecting a spike in dengue, leptospirosis and gastroenteritis in the coming days because of flooding in Mumbai. Steps have been taken to ensure medicines are adequately stocked,” a civic official said. Dr Pradeep Awate, state epidermiologist, said H1N1 cases have also been high. In the state, 4,628 have been diagnosed with H1N1 infection, including 488 who succumbed until August end.




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Member of Parliament (MP) Kirron Kher has submitted proposals to Union Minister of State for Health and Family Welfare Ashwini Kumar Chaubey, regarding setting up of a 300-bedded trauma centre in Chandigarh, apart from construction of a sports injury centre at Government Medical College and Hospital(GMCH), Sector 32.
A statement issued Tuesday said Kher met Chaubey Monday and submitted the proposals.

“In one of the letter addressed to Chaubey, she mentioned that the Trauma Centre already running at PGIMER is over burdened and not sufficient to cater to the needs of the region (i.e Punjab, Haryana, Himachal Pradesh and Jammu & Kashmir). Construction of the proposed trauma centre is need of the hour. In a separate letter, she has written that Chandigarh Administration has proposed to construct sports injury centre in GMCH, Sector-32,” the statement said. It further said that the project report has already been submitted to the Director General Health Services, Government of India, for approval.

Kher, during the meet, requested Chaubey to look into the matter and arrange requisite approval for the project.
The MP also told Chaubey that Ministry of Health and Family Welfare has already granted its approval regarding setting up of a Trauma Centre as an extension of GMCH. “Chandigarh Administration has already earmarked a plot measuring 9.6 acres for setting up of a Trauma Centre in Sector 53, Chandigarh, and a detailed Project Report (DPR) of the Trauma Centre has also been prepared. Whereas the project related to construction of Sports Injury Centre is pending with the Ministry of Health and Family Welfare, New Delhi, since April 2013,” the statement said.

The statement further stated that GMCH has established itself in the region in the field of sports injuries and on an average is performing 100 surgeries on elite players of different games coming from all over the country.

“Presently, there is only one dedicated Sports Injury Centre in the country which is based at Safdarjung Hospital, New Delhi. Chandigarh Administration has already earmarked a plot measuring 1.43 acres for setting up of this centre. Accordingly, a Detailed Project Report (DPR) of the proposed centre has been prepared. It is felt that setting up of a similar centre in Chandigarh, which caters to the needs of Punjab, Haryana, Himachal Pradesh, Rajasthan, Jammu & Kashmir and Uttarakhand, will go a long way in restoring the health of athletes in the region so that they can go back to the pre-injury level of games at the earliest,” the statement added.




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CHENNAI: AIADMK general secretary V K Sasikala's husband M Natarajan is in a critical condition after sufferingmultiple organ failure on Sunday. Natarajan, 74, has been admitted to Gleneagles Global Health City in Perumbakkam, where he is under intensive care.

According to a medical bulletin released by the hospital administration, Natarajan suffers from chronic liver disease and has been receiving treatment for it for the past six months. "He is admitted at the Liver Intensive Care Unit with decompensated liver disease leading to liver and kidney failure and lung congestion. He is receiving dialysis and other intensive care therapies," the hospital statement said.

Natarajan has been registered with the Tamil Nadu Organ Sharing (TNOS) waiting list for deceased donor liver transplantation. "He is being taken care by a multidisciplinary team of liver specialists headed by Prof. Mohamed Rela," the hospital note said.

According to hospital sources, Natarajan had undergone a dialysis session for more than eight hours on Sunday. This is not the first-time Natarajan has been hospitalised this year. On February 5, he was brought to Apollo Hospitals on Greams Road after complaining of breathing problems.




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Swine flu spurts in Delhi: 1,066 cases last month

Written by Saturday, 19 August 2017 06:15


Swine flu has surged sharply in the capital with 1,066 cases being confirmed in the last one month, which is more than four times the number reported during the rest of this year.

The total number of cases till August 13 this year stands at 1,307, more than six times the corresponding period of 2016.

Nationally, 18,855 cases of theH1N1 influenza have been reported this year, claiming 929 lives.

But despite the spurt in cases in the capital, the number of deaths has not risen significantly. "Only four deaths have been reported: two from Delhi and two patients from outside have died," Delhi health minister Satyendra Jain said in the assembly last week. At a review meeting on Friday , Delhi health department officials told their counterparts in the Centre that the city has sufficient training and stocks of medicines to tackle the swine flu outbreak.

Health experts said there was no cause for panic over the sudden spurt in swine flu in Delhi. "People should not panic if they suffer normal viral infection. The high risk groups include people with heart diseases, pregnant women, children below eight years of age, senior citizens, diabetics and kidney disease patients. These patients need special treatment," said a doctor.

Dr Jagdish Prasad, director general of health services, told TOI that the Centre had offered to train doctors of Delhi government and private hospitals on treating swine flu cases. "If any hospital wants training, we can send our doctors," he said. Delhi health minister Sandar Jain said in the as tyendar Jain said in the assembly last week that the government had enough stocks of medicines and vaccines to tackle the outbreak.

"Adequate facilities for treatment are available in Delhi. We have placed orders for advance purchase of medicines," Jain said. He added that there were reserved beds for patients in government hospitals and not even 5% of these beds had been occupied.

The spike in the cases at this time of the year has come as a surprise because swine flu usually peaks in the postmonsoon season and early winter. Some health conscious people have started maintaining caution when they are in public places because the H1N1 virus, which causes swine flu, transmits from human to human.

"The spike in swine flu at this time is also due to infection coming in from states where a very high number of cases have been reported.Such a big outbreak in the month of August is a matter of concern since swine flu usually rises in October and November," said Dr K K Aggrawal, national president of the IMA. The association has planned to launch a poster campaign against swine flu."






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A study has warned that cloudy drinking water is linked to increased cases of gastrointestinal illness. Cloudiness in water is caused by material floating in it. The undissolved particles may actually provide some protection for harmful pathogens against disinfectants.

Researcher Anneclaire De Roos from Drexel University in Philadelphia, US found associations between acute gastrointestinal illness (AGI) and water turbidity, a term meaning cloudiness or opacity. Turbidity is the cloudiness or haziness of a fluid caused by large numbers of individual particles that are generally invisible to the naked eye, similar to smoke in air.

The results revealed that exposures through drinking water caused a low but detectable number of AGI cases in the regions. There is no clear, alternative explanation for the patterns of associations — particularly when a similar pattern was seen multiple times. Acute gastrointestinal illness could be caused by waterborne pathogens like norovirus, Giardia, or Cryptosporidium and carry symptoms like diarrhoea and vomiting. Researchers looked into a collection of studies that had been done on the topic.

These studies were designed to evaluate risks from contamination of source waters (usually rivers in the cities studied), before the water entered cities’ distribution systems. They found that turbidity of drinking water was linked to increased AGI in multiple studies, and not just when there was increased cloudiness. “As expected, the association between turbidity and AGI was found in cities with relatively high turbidity levels, often in unfiltered drinking water supplies,” De Roos noted.




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AHMEDABAD: Gujaratgovernment and theAhmedabad Municipal Corporation (AMC) once again got a rebuke from Gujarat high court on Wednesday "for taking its direction lightly" in response to a petition seeking prompt measure to curb spread of swine flu, which has already claimed over 200 lives across the state.

A bench headed by Justice M R Shah told government's law officers that everything looks all right on paper, but the reality is different. The court asked the state government to state what measures have been taken to curb the spread of the disease.

The court said that so many people dying of the disease is really serious, and the authorities must take prompt steps in public interest. The court has sought a report in this regard by Monday.

The court also expressed concern about testing facilities and commented whether there is a provision to provide this facility free of cost to the poor.

The court's chiding came after advocate K R Koshti urged the court to issue directions to arrest further damage due to swine flu spread in absence of proper facilities. By adding the issue of swine flu in his last year's PIL to curb vector-borne diseases, the lawyer submitted that the state government and AMC machinery was never prepared to fight against H1N1 virus, and to prevent loss of life.

The PIL has demanded appointment of a committee of experts for field visit to take stock of the situation and to report to the court about the reality.

It seeks directions for creating facilities of diagnosis and free treatment for the poor. It has also asked for compensation for the victims.

Meanwhile, Justice Shah recalled the directions issued last week to AMC to clear roads of stray cattle and garbage.

The judge said that heaps of garbage have not been removed yet, though the authorities had promised to bring in visible change in a week's time.

The PIL stated that despite World Health Organization (WHO) warning, no effective measure has been chalked out by the administration to tackle the outbreak. Till August 15, 208 people died out of total 1,883 swine flu patients in Gujarat.

The petitioner complained that the government has not set up laboratories at districts across the state for testing the virus, and delay caused in diagnosis proves fatal in most cases. The PIL has complained that AMC does not have enough staff in its health department to deal with the situation.





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