Updates in Medicine

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• Four weeks of triple or quadruple combination therapy using new drugs for hepatitis C virus (HCV) results in only limited cure rates in patients with early-stage liver fibrosis, according to a study published online November 23 in the Annals of Internal Medicine.

• The US Food and Drug Administration (FDA) has declined approval of the New Drug Application for an intranasal naloxone spray for the emergency treatment of known or suspected opioid overdose.

• A pilot study in Frontiers in Neurology reports that although performing direct funduscopy during a patient’s initial assessment is considered a “basic competency,” most clinicians did not perform the eye exam, potentially missing “valuable clinical information”.

• The US FDA has repurposed a 45-year-old vaccine against anthrax for postexposure protection. It added a new indication to prevent anthrax after suspected or confirmed exposure to Bacillus anthracis in individuals aged 18-65 years. The vaccine should be given in conjunction with recommended antibiotic treatment. Anthrax vaccine adsorbed (BioThrax, Emergency BioDefense Operations) was approved in 1970 to prevent the disease in individuals at high risk for exposure.

• Results of a multicenter prospective study in JAMA Surgery show that patients with acute complicated appendicitis who received 5 days of postoperative antibiotic treatment after laparoscopic appendectomy surgery did not have a reduction in infectious complications relative to patients receiving only 3 days of postoperative antibiotic treatment (Snapshot Appendicitis Collaborative Study Group).

• In rheumatoid arthritis patients who fail to achieve an adequate response to their first anti-tumor necrosis factor (TNF) agent, a non-TNF targeted biologic provides significantly better disease control than a second anti-TNF agent (Rotation of Anti-TNF or Change of Class of Biologic trial) (American College of Rheumatology 2015 Annual Meeting).

OPINION ON REGISTERED PHARMACIST Pharmacy Practice Regulations, 2015

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According to Regulation 2(b) of the Pharmacy Practice Regulations, 2015,‘Practice of Pharmacy’ means: –

i. Interpretation, evaluation and implementation of medical orders; dispensing of prescriptions, drug orders ;

ii. Participation in drug and device selection, drug administration, drug regimen reviews and drug or drug related research,

iii. Provisions of patient counseling and the provision of those acts or services necessary to provide pharmaceutical care in all areas of patient care including primary care; and

iv. Responsibility for Compounding and labeling of drugs and devices (except labeling by a manufacturer, repacker or distributor of non-prescription drugs and commercially packaged legend drugs and devices) proper and safe storage of drugs and devices and maintenance of proper records for them.

According to Regulation 2(h) of the Pharmacy Practice Regulations, 2015, ‘Pharmacy Practitioner’ means an individual (Community Pharmacist/ Hospital Pharmacist/ Clinical Pharmacist/ Drug information Pharmacist) currently licensed, registered or otherwise authorized under the Act to counsel or otherwise and administer drugs in the course of professional practice.

According to Regulation 2(i) of the Pharmacy Practice Regulations, 2015, Registered Pharmacist means a person whose name is for the time being entered in the register of the State in which he is for the time being residing or carrying on his profession or business of pharmacy under the Pharmacy Act, 1948.

According to Regulation 2(j) of the Pharmacy Practice Regulations, 2015, ‘prescription’ means a written or electronic direction from a Registered Medical Practitioner or other properly licensed practitioners such as Dentist, Veterinarian, etc. to a Pharmacist to compound and dispense a specific type and quantity of preparation or prefabricated drug to a patient.

According to Regulation 3.3 of the Pharmacy Practice Regulations, 2015, ‘Displaying name of owner and registered pharmacist’:

(a) Name of the owner of pharmacy business shall be displayed at or near the main entrance of each premises in which the business is carried on.

(b) Name of the registered pharmacist along with his registration number and qualification along with his/her photograph shall be displayed adjacent to the area where dispensing is carried on in the pharmacy. Registered pharmacist shall also comply with a dress code of being dressed formally and wearing clean white overall (coat/apron)with a badge displaying the name and registration number.

(c) Registered pharmacists shall display as suffix to their names only recognized pharmacy qualification / degrees or such certificates/diplomas and memberships / honours which confer professional knowledge or recognizes any exemplary qualification/achievements.

According to Regulation 4.1 ‘Character of registered pharmacist’:

(a) The prime object of the pharmacy profession is to render service to humanity; reward or financial gain is a subordinate consideration. Who- so-ever chooses his profession, assumes the obligation to conduct himself in accordance with its ideals. A registered pharmacist should be an upright man, instructed in the art of medicines. He shall keep himself pure in character and be diligent in caring for the sick; he should be modest, sober, patient, prompt in discharging his duty without anxiety; conducting himself with propriety in his profession and in all the actions of his life.

(b) A person having qualification in any other system of pharmacy is not allowed to practice modern system of pharmacy in any form.

(c) A registered pharmacist shall uphold the dignity and honour of his profession.

NCERT to change the objectionable clauses in Social Science Textbook for Class 7, Social and Political Life-II

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Sub: WP(C) No.8706/2015 titled “Indian Medical Association vs. Union of India & Anr (NCERT)” pending before Hon’ble Delhi High Court, New Delhi.

The captioned matter was listed today before Hon’ble Mr Justice Rajiv Shakdhar. The Ld. counsel for NCERT handed over the proposed changes recommended by the Complaints Committee set up by NCERT, in the Chapter-2 of Text Book “Social & Political Life-II” prescribed for the students of Class-VII, in compliance with the order dated 11.09.2015 by Hon’ble Court.

The copy of the proposed changes are attached herewith. We are directed to take instructions from IMA on the said changes and now the matter is re-notified for 14.12.2015 to apprise the Hon’ble Court about the stand of IMA on the proposed changes made by NCERT. Kindly do the needful.
Thanks and regards,
Contact Details:
Rahul Gupta & Associates

Social Science Textbook for Class 7, Social and Political Life-II Chapter-2: Role of the Government in Health Report of the changes (pages 22, 23, 24, 26, 29 and 122)

Page 22: (storyboard)
Last paragraph, last line: “ He prescribed…. Replace “lots of” with some,

Page 23: (Last panel in the storyboard)

Existing
Revised
My hospital was nice, but they gave me too many medicine and the whole thing cost more than Rs. 3,500/-
My hospital was nice, but they gave me many medicines and the whole thing cost quite a lot
That much! My treatment cost just Rs. 150/-
Oh! My treatment did not cost much

Page 24: (Change the sequence of the questions in the left column)

1. Where do you go when you are ill? Are there any problems that you face? Write a paragraph based on your experience

2. What problems did Aman face in the government hospital? How do you think the hospital can work in a better manner? Discuss

3. Why did Ranjan have to spend so much money? Give reasons.

4. What problems do we face in private hospitals? Discuss.

Page 26: Delete the following word in the paragraph beginning with “In India…..

“As these services are run for profit”

Existing
Revised
“In order to earn more money, these private services encourage practices that are incorrect. At times cheaper methods, though available, are not used. For example, it is common to find doctor5s prescribing unnecessary medicines, injections or saline bottles when tablets or simple medicine can suffice” (45 words)
Some private services indulge in unethical or unfair practices to earn more money. At times inexpensive alternatives, though available, may not be used. For example, some medical practitioners are found to prescribe superfluous medicines, injections or saline when simple medications may suffice (42 words)

The following box and the question are to be included in the left column on page 26.
The Medical Council of India’s code of Medical Ethics states: “Every physician should, as far as possible, prescribe drugs with generic names and he/she shall ensure that there is a rational prescription and use of drugs.”

How can healthcare be made more affordable? Discuss.
Page 29: Replace the existing table with a new table

Facility
Affordability
Availability
Quality
Private
Public

Glossary: Include the following terms:
Ethics: Moral principles that influence a person’s behavior
Generic names: These are Chemical names of the drugs. They help in identifying the ingredients. They are globally recognized. For example, acetyl salicylic acid is the generic name of Aspirin

Page 122: (References): Include the following:
• Medical Council of India,
http://mciindia.org/Rules-and-Regulation/Ethics%20Regulations-2002.pdf

• Supreme court of India, Paschim Banga Khet Mazdoor Samity & Ors. Vs State of West Bengal and Anr. (Hakim Seikh case, date of judgement: 6 May, 1996,
http://judis.nic.in/supremecourt/imgs1.aspx?fiename=15597)

• World Health Organization, Essential medicine and health products,
http://www.who.int/medicines/services/inn/en

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