Thursday, 15 February 2018

Medical education

It is a public service, not a commercial venture
INDIA, the world’s largest democracy with 130 crore inhabitants, has only a little over 10.41
lakh registered doctors. Out of which, only 8.33 lakh doctors are actually available for active
service. It is a grim situation, especially for the ambitious ‘Ayushman Bharat’ project of the
Modi government. Earlier this month, the government promised quality healthcare services to
all citizens, including the poor, through the Rs 5 lakh per family insurance scheme. A well intentioned
announcement may, however, remain a distant dream, in want of well-trained
human resources. India would require doubling the number of doctors by 2022 to provide
basic healthcare to its citizens.

Amidst this challenging scenario, the government’s intent to raise the number of MBBS seats
in the country to 85,525 by March 2021 appears insignificant. This target is too small
considering the currently available MBBS seats of 67,352. India needs to double the number
of MBBS seats by expanding the existing institutions and by opening new medical colleges.
This will require huge investments in infrastructure, human capital, latest equipment and
modern technology. Scarcity of faculty is the immediate challenge. Teaching in India is not
much valued and is considered less remunerative, compared to huge investments in medical
education, both in terms of time and money. Bright medical graduates and trained doctors
prefer to settle abroad where they get better recognition and higher salaries.

It seems that the National Medical Commission Bill, which is being enacted to reform
medical education and practice, does not address this basic issue. Allowing private colleges
to charge capitation fee at will for their 60 per cent seats would aggravate the problem of
brain drain. Under the burden of education loan, the medical graduates would be guided by
better returns on their investments rather than the Hippocratic Oath or the call of duty. A
democratic country like India, where the majority is poor, cannot afford to rely on
unregulated private health and education institutions. There are several examples of
overcharging by them. The principle of laissez-faire should be confined to commercial
ventures. Instead, the government should prompt corporates to invest their CSR funds in
creating charitable medical institutions.

Source: The Tribune

Thursday, 4 January 2018

Sugar coma’ can slow down your brain, warns study

Consuming certain sugars can drastically diminish your cognitive performance, a study has
discovered. Previous studies have explored the positive impact ingesting glucose can have on
your brain, namely improving your memory. However, the consumption of other sugars, such
as fructose and sucrose, can have an adverse effect.

Researchers from the University of Otago in New Zealand decided to examine how common
sugars affected the abilities of 49 people to perform cognitive tasks. Three common dietary
sugars were tested against a placebo sweetener, sucralose.

The participants each took part in simple response time, arithmetic and Stroop interference
tests. The study concluded that the participants who ingested glucose and sucrose performed
worse in the tasks in comparison to those who ingested fructose and the placebo.

One of the study’s authors, Mei Peng, a lecturer in sensory science in the Department of Food
Science at the University of Otago, discussed the way in which consuming sugar can affect
you on a daily basis. “I am fascinated by how our senses influence our behaviour and affect
our everyday lives,” Peng told ‘PsyPost’.

“In particular, how sugar consumption might change the way our brains work.”
“Our study suggests that the ‘sugar coma’— with regards to glucose— is indeed
Thinkstock a real phenomenon, where levels of attention seem to decline after consumption of glucose containing sugar.”

In 2016, the National Diet and Nutrition Survey announced that consumption of sugary soft
drinks by children aged four to 10 was on the decline. However, last year Public Health
England unveiled new guidelines to reduce the quantity of sugar that people in the UK
consume in their diets. 

Source: The Times of India

Tuesday, 28 November 2017

WHO: 10% of drugs sold in developing world dubious

Two WHO reports released on Tuesday estimated that roughly 10.5% of medicines being sold in Low and Middle Income countries (LMIC) could be substandard or falsified.

Hence, they concluded, the size of the dubious drugs market in these countries at about $30 billion. However experts slammed the basis for these estimates and said they were grossly exaggerated.

While substandard medicines have been a matter of concern in many countries, several member states are expressing concern with the findings, especially the estimation of prevalence of substandard and falsified medical products in Low and Middle Income countries using an “unscientific methodology”, said a statement issued by Third World Network (TWN), a transnational alternative policy group aimed at strengthening cooperation among countries of the Global South.

Of the two reports, one was on the cases reported to the WHO’s Global Surveillance and Monitoring System (GSMS) for dubious drugs launched in July 2013.

The cases reported between 2013 and 2016 were categorised under various heads such as “falsified”, “suspected falsified”, “substandard”, “diverted”, “stolen” and “unlicensed” medical products.

However, after the World Health Assembly decided in 2016 to categorise compromised medicines as “substandard” and “falsified” and adopted working definitions for the same, the Global Surveillance and Monitoring System cases appear to have been automatically categorised as one of these two, said Third World Network.

Source: The Times of India.

Wednesday, 15 November 2017

FDA approves first digital pill that tracks patients

For the first time, the Food and Drug Administration has approved a digital pill — a medication embedded with a sensor that can tell doctors whether, and when, patients take their medicine.

The approval, announced on Monday, marks a significant advance in the growing field of digital devices designed to monitor medicine-taking and to address the expensive, longstanding problem that millions of patients do not take drugs as prescribed.

Experts estimate that socalled nonadherence or noncompliance to medication costs about $100 billion a year, much of it because patients get sicker and need additional treatment or hospitalisation.

“When patients don’t adhere to lifestyle or medications... there are really substantive consequences that are bad for the patient and very costly,” said Dr William Shrank, chief medical officer of the health plan division at the University of Pittsburgh Medical Center.

Patients who agree to take the digital medication, a version of the antipsychotic Abilify, can sign consent forms allowing their doctors and up to four other people to receive electronic data showing the date and time pills are ingested.

A smartphone app will let them block recipients anytime they change their mind. Although voluntary, the technology is still likely to prompt questions about privacy and whether patients might feel pressure to take medication. A controversial use might be requiring digital medicine as a condition for parole. Abilify is an arguably unusual choice for the first sensor-embedded medicine. It is prescribed to people with schizophrenia and bipolar disorder and, in conjunction with an antidepressant, depressive disorder. Symptoms of schizophrenia and related disorders can include paranoia and delusions, so some doctors and patients wonder how widely digital Abilify will be accepted.

The newly approved pill, called Abilify MyCite, is a collaboration between Abilify’s manufacturer, Otsuka, and Proteus Digital Health, a California company that created the sensor.

The sensor, containing copper, magnesium and silicon (safe ingredients found in foods), generates an electrical signal when splashed by stomach fluid said Andrew Thompson, Proteus’s president and chief executive.Dr Jeffrey Lieberman, chairman of psychiatry at Columbia University and New York-Presbyterian Hospital, said many psychiatrists would likely want to try digital Abilify. But he noted it has only been approved to track doses, and has not yet been shown to improve adherence.

Proteus has spent years bringing its sensor to commercial use, raising about $400 million from investors, including Novartis and Medtronic, Thompson said. Until now, the sensor could not be embedded in pills, but pharmacies could be commissioned to place it in a capsule along with another medication. In 2016, the encapsulated sensor started being used outside of clinical trials, but commercial use is still limited, Thompson said.

Nine health systems in six states have begun prescribing it with medications for conditions including hypertension and hepatitis C, the company said, adding that it has been found to improve adherence in patients with uncontrolled hypertension and others. How patients will view Abilify MyCite is still unclear.
Source: The Times of India