First it was stents now Knee implants face the heat

•Earlier this year NPPA slashed the prices of heart stents by up to 75%. Now NPPA has struck again this time cutting Knee implants cost upto 69% with immediate effect.

•Every year, up to 1.5 lakh knee replacement procedures are carried out in India.

•Cobalt-chromium implants used in total knee replacement will cost ₹54,720 which costs ₹1.5-2.5 lakh right now (effective reduction of 65%)

•Titanium and oxidised zirconium implants are capped at max ₹76,600 compared to ₹2.5-4.5 lakh earlier.

•High flexibility implants will cost ₹56,490 than ₹181,728 at present.

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•But the real issue here is these cappings already hampered the quality of stents. Now the question will this be the same case with knee implants? Although it's good for poor patients but this can seriously compromise the quality of implants being provided as the larger players tend to withdraw superior tech from INDIA.

•Back then Abbott withdrew its revolutionary dissolvable stent called Absorb, which was priced at Rs 1.9 lakh. Other stent called Xience Alpine was priced at Rs 1.5 lakh was also withdrwan

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Mammoth increment in death due to antibiotic resistance predicted - UN concerned

●This prediction reveals the extent of threat antibiotic resistance is posing which is really becoming a huge concern,  and most of it is due to irrational use of antibiotics.
●Concerned from this threat, for the fourth time United Nations (UN) has elevated a health issue to crisis level.

●More than 200,000 newborn children are estimated to die each year from infections that do not respond to available antibiotics. ●“In a world where all our antibiotics could be ineffective, common infections would kill once again and surgeries and cancer therapies, which are dependent on antibiotics, would be threatened,” notes Joseph Libuano.

●There are already cases of XDR TB Reported in more than 100 countries.
Resistance to drygs against Malaria, HIV is also on rise. Many more infections like Pneumococcal, Nesseria gonorrhoeae, Salmonella etc.

●Focused research on the issue has led to studies that rely on recent breakthroughs, such as CRISPR, to reverse antibiotic resistance in bacteria, by transferring “edited” DNA to resistant bacteria, thus killing off resistant strains.

●For the Staphylococcus aureus infections newer type of antibiotics are being tested which contain iridium content, a transition metal that doesn’t easily breakdown, which could prove to be a more effective way to deliver antibiotics.

●German scientists may also have found a crucial weapon in our fight against superbugs. After discovering a strain of bacterium called Staphylococcus lugdunensis, researchers developed a drug based on the strain that could potentially become a new class of antibiotics.
●So for better tomorrow we must unite to step up against the injudicious and irrational use of the antibiotics. Unless this could prove to be catastrophic.

Gift capping on pharmaceuticals of upto Rs 1000 to doctors by DOP

NEW DELHI-
●Govt is set to impose a cap of Rs1000 on freebies given by pharmaceuticals to doctors.
●There might also be ban on expensive freebies such as cruise or vacation tickets and sponsored educational conferences and seminars that can be means of making payments and offering benefits.
●The department of pharmaceuticals (DoP) is in the final stages of issuing an executive order making Uniform Code for Pharmaceutical Marketing Practices (UCPMP) mandatory for the drug manufacturing industry.
●The health ministry and Medical Council of India have been consulted on the decision. In case of any violation will be punishment and penalty.
●This is considered to curb unethical practices by favouring pharmaceuticals.
●The Indian pharmaceutical market generates the revenue of Rs 1 lakh crore annually.
●Companies are also barred from extending hospitality to any doctor, healthcare professional or their family.
●Apart from pharmaceutical companies, the code also covers retailers, distributors, wholesalers and doctors. It will also cover the whole supply chain for medical devices along with medicines.
Source: TOI

Vertebral hemangioma treated using ABSOLUTE ALCOHOL in AIIMS

Dr P S Chandra, a professor of neurosurgery at AIIMS has done something very few people manage to do in life- saving the life of someone who was said couldn’t be saved. And he did this with the help of some alcohol- ‘absolute alcohol’, that is.
The 28 year old pregnant woman whom the doctor treated was paralyzed below the waist for many months. The reason- a rare type of spinal tumor. Dr Chandra pumped in a measured volume of absolute alcohol which is a neuro-toxic drug into the turmor. This helped destroy the lump.

Said to be ‘Beyond cure’, but the doctor went beyond that

The MRI, as per the doctor, suggested the problem as spine tumor. Many opined that the cancerous tumor didn’t have any cure. The patient was brought to AIIMS where the doctors diagnosed the issue as vertebral haemangioma. It’s a slow-growing vertebral tumour that’s not malignant. However, according to Dr Chandra the greatest challenge with the disease is that the surgery is rather vascular and if touched by a doctor during surgery, it bleeds heavily.

The usual practice in such a scenario is to perform ‘intra-arterial embolization’ by which certain glue is injected into the tumour. This is done prior to the surgery and is time consuming- taking some 4 to 6 hours. Also, the cost comes to about 3 to 4 lakhs. On the other hand, absolute alcohol costs just a few hundred rupees.

Absolute alcohol is 99% ethanol. It destroys the tumour by drawing water from the cells. This dehydrates the cells which causes the structure of the cellular proteins to be altered. Over time, this would lead to new bone formation which in turn helps the spine heal. Not just that, it’s also an embolization agent that curbs blood supply towards the tumour.

Post surgery, the patient started feeling relief in her legs. A couple of months later, she gave birth to a healthy baby. It’s been reported that she could now walk and even workout at the gym.

Many term the doctor’s idea of using absolute alcohol to tackle the tumour unique.

Image credits: dailymail.co.uk
Post credit: Daily rounds

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India's 1st Robotic Intravesical Bilateral Ureteric Reimplant

Dr. Gursev Sandlas: India’s 1st Robotic Intravesical Bilateral Ureteric Reimplantation
A 12 year old boy from Jalgaon was brought by parents with complaints of frequent stomach aches. He was investigated in Jalgaon and found to have a unique and rare problem. He had a duplex system on the Right Kidney and a bilateral Vesico-Ureteric Reflux.
In simple terms this means that he had two tubes draining his right kidney in to the bladder and the valves of the tubes on both sides was defective leading to backflow of urine from the bladder back towards the kidneys. This kind of REFLUX can cause kidney damage in long run. He was advised open surgery and even removal of the anomalous kidney. He researched on the internet and decided to seek a second opinion at KDAH with me. Given the complex nature of malformation we counselled the parents that an intravesical Robotic repair would be best suited to the child. In this repair the robotic arms were inserted inside his bladder and the entire surgery was carried out inside his bladder.
The surgery was all the more challenging considering he had two ureters on the right side.
He underwent the surgery on 7 Feb and is doing extremely well and on road to full uneventful recovery and has been discharged.
This surgery is the first of its kind in India. Even around the world there are only a handful of centres who have even attempted this kind of procedure.

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Hospitals in Madhya Pradesh to get a STAR rating

Hospitals, like hotels will soon have a star rating. To begin with, benchmark rating would be for 50-bed hospitals and above, across the state. The proposal under deliberation, aims at working out uniformity in charges across the spectrum and help ease cost of healthcare.

An elaborate guideline for star rating of hospital is already being discussed at the Union government level for over two years. Taking a cue, Madhya Pradesh health department has set in motion process for coming up with benchmark rating.

Department of health and family welfare director Dr KK Thassu said the proposal aims at fixing cost of healthcare services in private hospitals. "Variation in costs for procedures has to be justified. It is a Union government proposal that we hope will bring about transparency and give relief to patients in the state," says Dr Thassu.

Experts indicate benchmark rating for hospitals is not similar to rating services for hotel industry. "The question is not limited to patient charges. Rating of any healthcare facility has to attribute the quality and safety standards of any hospital," said Dr Anoop Hajela, advisor, MP Nursing Home Association.
From a patient's standpoint, the initiative aims at having cumulative star ratings that would ideally fix cost of treatment. Other benchmarks will include cleanliness, staff behaviour, quality of treatment, equipment and infrastructure among others.
"The best possible way forward is to classify hospitals between NABH and non-NABH," said Dr Hajela. National Accreditation Board for Hospitals and Healthcare Providers (NABH) is a constituent board of Quality Council of India, set up to establish and operate accreditation programme for healthcare organisations. There are just three hospitals in Bhopal with full-NABH accreditation.
"Two hospitals can have the same diagnostic machine. One can cost Rs 50 lakh and the other Rs 5 lakh. Besides, the new benchmark should factor in experience of doctors, equipment and facilities provided," he said.
Proposal for star ratings of hospitals awaits clarification of government stance and objections by private hospitals over the implementation of New Clinical Establishment Act.
For the moment, government focus is to define minimum facilities in hospital. As per policy, patients that receive aid from the state government for medical interventions, are only sent to accredited hospitals.
The state government is set to include procedures for speciality services. It includes endoscopic surgeries, joint replacement, hip replacement, prostrate, hernia and advanced ENT procedures. Most of these patients would receive treatment in private hospitals.

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This perdator larva can help INDIA reduce Dengue incidence.

This mosquito eats the Dengue-causing one

KOLKATA: Scientists at the Calcutta University have examined the Lutzia Fuscana larvae and found mosquito can kill the Aedes Aegypti that transmits dengue.
"The immature forms of Lutzia Fuscana mosquito, currently in its larval stages, have been collected from swamps, marshes, bogs, rice fields, ditches, grassy pools, rock and flood pools, stream pools and margins, tree stump holes, crab holes, artificial containers, and tire depressions," a researcher explained.

Dengue is one of the world's most serious infectious diseases and affects more than 390 million people each year.
In the laboratory, Lutzia Fuscana larvae demonstrated a feeding preference for Aedes Aegypti larvae, with Anopheles stephensi and Culex larvae of lower preference, consuming an average of 19-24 larvae per day, the researchers said.
The species has been found in Bangladesh, Cambodia, China, India, Indonesia, Japan, South Korea, Macau, Malaysia, Mariana Islands, Micronesia (Wake Island), Myanmar (Burma), Nepal, Pakistan, Palau, Philippines, Russia, Singapore, Sri Lanka, Taiwan, Thailand, Timor, and Vietnam.
If Kolkata Corporation spreads the larvae of this mosquito, Aedes Aegypti larvae can be erased," a research report published in Italy magazine on December last year said.

"The Lutzia larvae is spread in America and Japan by the civic authority. Lutzia can be more effective than other process to eradicate any virus carrying mosquito," Calcutta University Professor Gautam Aditya claimed.
"Right now we are trying to create mosquito cage to produce Lutzia larvae scientifically. After that they larvae may be spread in High drains to kill Aedes Aegyptai," Aditya added.

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