Tuesday, December 31, 2019

Revisiting Healthcare in 2019

Revisiting Healthcare in 2019

Dr KK Aggarwal
President CMAAO , HCFI and Past National President IMA

The year 2019 saw a lot on new health promises. Let us review some of the important ones.

Disease Outbreaks
1.               As per Who list https://www.who.int/csr/don/archive/year/2019/en/ No major health outbreak in India in 2019.

2.               No case of Polio was noted.

3.               In June 2019, an outbreak of acute encephalitis syndrome occurred in Muzaffarpur and the adjoining districts in Bihar state of India, amidst the second-longest heatwave in the region, resulting in deaths of more than 100 children, mainly due to hypoglycemia.

4.               The index case of Nipah in Koci in June was contained the disease was controlled before it took off

5.               Congo fever: 17 cases were reported in Gujarat and three tested positive in Rajasthan.

6.               More than 67,000 people across India have been diagnosed with dengue so far this year, reports by the National Vector Borne Disease Control Programme (NVBDCP) show. By mid-October, reports show, the disease had claimed 48 lives.

7.               The number of HIV-infected people who go on to develop Tuberculosis (TB) is increasing in India, according to the India TB Report 2019, which was released by the government on September 25, 2019.Nearly 25 per cent of all deaths among PLHIV are estimated to be due to TB. The highest percentage of patients who tested positive for TB and were also infected with HIV came from Nagaland (15.6 per cent), followed by Karnataka (10 per cent), Chandigarh (9.1 per cent) and Manipur (8.9 per cent).

Major Concerns of the year
1.               Pollution in North India
2.               Rising AMR

Parliament Bills
1.               The parliament passed the National Medical Commission (NMC) Bill. The bill provided for setting up a National Medical Commission (NMC) in place of the MCI to develop and regulate all aspects of medical education, profession and institutions in India.

2.               The government in November referred a bill, which seeks to ban commercial surrogacy in India, to a 23-member select committee of Rajya Sabha.

3.               The government passed Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement

4.               The draft bill Healthcare Service Personnel and Clinical Establishments (Prohibition of violence and damage to property) Bill, 2019 is pending to be passed

5.               The Allied and Healthcare Professions Bill, 2018 was introduced in Rajya Sabha by the Minister of Health and Family Welfare, Mr. J P Nadda on December 31, 2018. The Bill seeks to regulate and standardise the education and practice of allied and healthcare professionals. Jan 02, 2019 referred to standing committee

6.               The Occupational Safety, Health and Working Conditions Code, 2019 pending

1.               Delhi health bill, which will replace Delhi Nursing Home act

2.               The Delhi Government will shift serious patient to private ICU. The payment will be done by DG if no bed is available with them

Major Courts Decisions
1.               Delhi high court on ‘courts in its own motion’ has asked the CDSCO to release a list of over the counter drugs
2.               Delhi high court on ‘courts in its own motion’ has asked the Railways to have emergency medical services at all major stations

On 11 June 2019, following the assault of two junior doctors at Nil Ratan Sircar Medical College and Hospital (NRSMCH) the previous night, junior doctors in Kolkata began protesting and demanded the Chief Minister of West Bengal, Mamata Banerjee to intervene and provide adequate security to medical professionals, culminating into the collapse of healthcare facilities in the state. Despite attempts at mediation, protests continued through 13 June, finally resulting in the Chief Minister issuing an ultimatum to the protesting doctors, which was eventually defied by the protesting doctors who wanted the government to meet their demands for security and a public apology from the Chief Minister.

Life expectancy and Vital Statistics
1.               Life expectancy in India has increased from 49.7 years in 1970-75 to 68.7 years in 2012-16, as per the National Health Profile 2019. For the same period, the life expectancy for females is 70.2 years and 67.4 years for males.

2.               HIV virus now can be made untraceable undetectable and an HIV positive person will be able to live a normal married life on daily uninterrupted treatment

Major Campaigns
1.               Fit India Movement by Ministry of Sports GOI
2.               Perfect Health Mela by Heart Care Foundation of India

1.               The downfall in the economy was a major issue in 2019.

2.               In 2019Fortis Healthcare announced that it has completed the acquisition of RHT Health Trust (RHT) assets for an enterprise value of Rs 4,650 crores.

3.               Rs 5,800 cr Medanta-Manipal deal falls through as sides disagree over valuation

Medical  Update
1.               For patients with heart failure and low heart pumping function with persistent symptoms and an elevated serum natriuretic peptide level on optimal pharmacologic and device therapy a new ray of hope came for better due to availability  of  a new drug dapagliflozin

2.               In patients with type 2 diabetes with kidney involvement (urine albumin excretion >300 mg per day and eGFR >30) the incorporation of an SGLT-2 inhibitor into the patient's glucose-lowering regimen has been shown to improve the diabetics complications.

3.               We expect in 2020 all patients with an LDL-C >100 mg/dL and a greater than 10 percent risk of a cardiovascular disease event within 10 years, will be put on statins. Also, All patients with  cardiovascular disease independent of the baseline low density lipoprotein cholesterol (LDL-C) level they will be put on lifelong high-intensity statin therapy (atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg) rather than moderate intensity statin or no LDL-C lowering therapy.

Ayushman Bharat
As on 2nd December 19590 hospitals empanelled, 6800774 patients benefitted via admissions and  11.46.69,820 cards issued


Dr Rajan Sharma took over as the National President 

New Drugs introduced in India in 2019
1.     Fenspiride hydrochloride film coated extended release tablet 80 mg and Fenspiride hydrochloride bulk for allergic asthma

2.     Bilastine tablets 20 mg and Bilastine Bulk for urticaria

3.     Iguratimod film coated tablets 25mg and Iguratimod Bulk for rheumatoid arthritis

4.     Fingolimod Capsules 0.5mg and Fingolimod hydrochloridebulk for multiple sclerosis

5.     Remogliflozin etabonate bulk and Remogliflozin etabonate film coated tablets 100 mg for diabetes

6.     Concentrate of Proteolytic enzyme enriched in Bromelain topical gel for eschar

7.     Menotrophin injection 600 IU/ml, 1 ml & 2 ml multi dose vial (Highly purified) for infertility

8.     Rifapentine 150mg film coated tablet for TB

9.     FDC of Bictegravir, Emtricitabine and Tenofovir alafenamide 50mg/200mg/25mg tablets for HIV

10.  Levomilnacipran ER capsules 20mg/40mg/80mg/120mg for depression

11.  Bosutinib bulk and Bosutinib tablets 100mg, 400mg, 5600 mg for cancer

12.  Algard HWS-256 (didecyl dimethyl ammonium chloride 10.14% w/w + n-Alkyl dimethyl benzyl ammonium chloride 6.76% w/w as disinfectant

13.  Algard - R-82 (octyldecyl dimethyl ammonium chloride 6.510 w/w + Dioctyl dimethyl ammonium chloride 2.604% w/w + Didecyl dimethyl ammonium chloride 3.906% w/w + Alkyl dimethyl benzyl ammonium chloride 8.680% w/w as disinfectant

14.  Safinamide methane sulphonate bulk drug and Safinamide tablets 50, 100mg for Parkinson disease for Parkinson disease

15.  Droxidopa bulk drug and Droxidopa capsules 200mg/300mg for postural hypotension

16.  Acalabrutinib 100mg capsules for multiple myeloma

17.  Abemaciclib 50mg, 100mg, 150mg and 200mg film coated tablets for breast cancer

18.  Ripasudil hydrochloride hydrate bulk drug and Ripasudil Eye drops 0.4% w/v for glaucome

19.  Diperoxochloric acid concentrate and Diperoxochloric acid topical solution for diabetic neuropathy ulcers

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