Air Pollution

Air quality in Delhi this August worse than that of last year: CPCB (The

Indian Express: 20170817)

http://indianexpress.com/article/cities/delhi/delhis-air-quality-this-august-has-been-worse-

than-that-of-last-year-cpcb-4800180/

According to a report prepared by CPCB in March last year, the cities of Varanasi and

Faridabad are the most polluted in winters, with the air quality index regularly showing the

severely polluted warning sign. Delhi is at number three, as per the report.

Delhi and surrounding areas see the best air quality in the months of July and August because

of the rain.

Study finds ultrafine particulate matter in Delhi’s lush green Lutyens’ areaStudy finds

ultrafine particulate matter in Delhi’s lush green Lutyens’ area

Punjab has no role, Delhi air pollution due to Diwali, says PPCB chiefPunjab has no role,

Delhi air pollution due to Diwali, says PPCB chief

Air quality in Delhi: high temperature spikes ozone, pollution higher than in April ‘15Air

quality in Delhi: high temperature spikes ozone, pollution higher than in April ‘15

Delhi’s air quality has suffered more in the first two weeks of August as compared to the

same time last year, data collated by the Central Pollution Control Board (CPCB) shows.

Moreover, Delhi is the second most polluted city among the neighbouring ones including

Gurgaon, Faridabad, Agra and Ghaziabad.

However, Ghaziabad, where air quality monitoring was started only this year, is the most

polluted with an average air quality of 126.7 as compared to Delhi’s 112.

DAILY NEWS BULLETINLEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE DayThursday 20170817

Delhi and surrounding areas see the best air quality in the months of July and August because

of the rain.

According to a report prepared by CPCB in March last year, the cities of Varanasi and

Faridabad are the most polluted in winters, with the air quality index regularly showing the

severely polluted warning sign. Delhi is at number three, as per the report.

In monsoon months, however, the pollution in these cities goes down considerably. Delhi,

though, still sees higher pollution as compared to the others.

Rainfall has the capability to dissolve several pollutants and wash away particulate matter

and dust and that is one of the reasons behind lower air pollution levels.

Higher pollution levels

A comparison of CPCB data from August this year and August last year in Delhi, Gurgaon,

Faridabad and Agra shows that while pollution levels have increased in the first three cities,

Agra is the only one that has managed to buck the trend.

In 2016, Gurgaon was the least polluted with an average AQI of 54.1. It has grown to 63.5

between August 1 and August 15 this year. Agra, in 2016, recorded an average AQI of 79.5.

This time, however, the value is 56.6.

Delhi and Ghaziabad did not see a single good air quality day (where AQI value is below or

equal to 50) in the 15 days. Agra saw six such days, Gurgaon saw two and Faridabad one.

According to officials at CPCB, Delhi’s pollution levels could be a result of two things —

thick concentration of vehicles and better air quality monitoring.

“Emission from vehicles is not washed away very easily by rains. And in a high-density area

like Delhi there are very few areas that act as a sink for air pollution. Also, the quality and

network of air quality monitoring is much better in Delhi as compared to in other areas. Most

of these places only have one or two stations. In Delhi, there are around 20 stations managed

by different agencies,” said a senior official. The emergence of Ghaziabad as a high-pollution

zone does not surprise experts.

“Small industries , many of them illegal, and brick kilns, generate a lot of pollutants in the

area. Construction dust is also a major factor,” said the CPCB official.

Knee implant prices

After cardiac stents, Centre slashes knee implant prices (Hindustan Times:

20170817)

http://www.hindustantimes.com/health/after-cardiac-stents-centre-slashes-knee-implant-

prices-could-be-upto-20-cheaper/story-3Utyyns70vtwFRyCi5ZcNI.html

As per estimates, the move could result in savings of Rs 1,500 crore annually to patients

requiring knee replacement surgery.

The price of commonly used cromium cobalt knee implants is fixed at Rs 54, 720 and

dominates about 80% of the market.

The price of commonly used cromium cobalt knee implants is fixed at Rs 54, 720 and

dominates about 80% of the market.(Shutterstock)

A day after PM Narendra Modi announced in his Independence day speech that prices of

knee surgery would be brought down, country’s drug price regulator — National

Pharmaceutical Pricing Authority (NPPA) fixed the selling price of knee implants from Rs

54,000 to Rs 1.14 lakh, nearly 70% lower than most surgeries currently cost. Goods and

Services Tax will be extra.

The price for the commonly used cromium cobalt knee implants that rules about 80% of the

market share is fixed at Rs 54,720, which is currently available for between Rs 1 lakh and Rs

1.5 lakh.

Titanium alloy which comes close second will now cost Rs 67, 110 that was available for

about Rs 2 lakh – Rs 2.5 lakh.

NPPA, in a detailed order, has created different slabs based on the implant material and the

part of knee that needs replacement.

Cancer patients needing an implant have been provided major relief, with costs for

specialised implants slashed to Rs 1,13,950 from the current over Rs 5 lakh and above.

As per estimates, the move could result in savings of Rs 1,500 crore annually to patients

requiring knee replacement surgery.

“It is noticed that orthopedic-knee implants are having unjustified, unreasonable and

irrational high trade margins leading to their exorbitant prices which affects the out of pocket

expenses of patients and lakhs of patients are not able to pay for arthroplasty procedures…

the estimates of such patients requiring arthroplasty intervention, both diagnosed and

undiagnosed, is about 1.5 to 2 crores out of which only about 1 lakh plus well off patients are

in a position to pay for it every year,” an excerpt from the order reads.

“After cardiac stents, we have now decided to bring knee implants under price control,” said

Ananth Kumar, minister for chemicals and fertilizer, which NPPA comes under.

“Government will take stringent action against hospitals, importers, retailers if they charge in

excess of the MRP.”

The industry insiders though agree there was a need to rationalize implant prices, however,

there is also skepticism about how much patients will benefit ultimately.

“The implant price, as I see it, will be cheaper by just about 20-25%. There wasn’t a loot

going on as it was made out to be, even though there was a need to regulate prices,” said Dr

Amit Nath Misra, senior orthopaedic surgeon, Apollo Hospital.

A certain section believes, hospitals will find ways to maintain the profit margin.

“Bringing down the cost of the implant may not necessarily mean the cost of procedure will

also come down. Knee replacement procedure isn’t all about the implant cost there are other

costs involved that may go up to maintain a certain profit margin,” said a senior orthopaedic

surgeon at a government hospital.

Swine flu

Gujarat swine flu toll touches 220 (The Hindu: 20170817)

http://www.thehindu.com/news/national/other-states/gujarat-swine-flu-toll-touches-

220/article19504436.ece

As per the Gujarat health department figures, 2,095 cases of swine flu were reported this

year.

12 deaths reported in one day

With 12 deaths (six from Ahmedabad) and 212 new cases (including 91 from Ahmedabad, 31

from Vadodara, and 15 from Surat) reported on Wednesday, H1N1, commonly known as

swine flu, has become an epidemic in Gujarat.

As per the State’s health department figures, 2,095 cases were reported this year, with 220

deaths; 746 have been cured and 1129 are under treatment.

Increasing mortality and spread of the H1N1 virus has forced the authorities to launch

emergency measures including setting up a dedicated helpline and a statewide awareness

campaign.

Meanwhile, the Gujarat High Court on Wednesday slammed the authorities for “failing to

contain the spread” of the virus.

After a review meeting, Shanker Chaudhary, Health Minister, said, “More than 15,000 staff

members of the health department and civic bodies are working round the clock not only to

ensure treatment to patients but also contain the spread of viral flu.”

Jayanti Ravi, Health Commissioner, advised anyone with symptoms like cold, sore throat,

fever and body ache to immediately go to private or government-run medical centre; all

government hospitals are equipped to tackle the illness, she said. The High Court, slammed

the authorities, reacting to a Public Interest Litigation petition, which asked for a court-

appointed committee to inspect and report on “the sorry state of affairs and callous and

negligent attitude on the part of the respondent authorities which has given rise to outbreak of

vector and mosquito borne diseases.”

Appearing for the petitioner, lawyer K.R. Koshti sought the court’s direction to provide

compensation to the victims of swine flu, malaria and other mosquito-borne diseases in the

State.

Health System

On rural India’s health systems: the health checklist (The Hindu:

20170817)

http://www.thehindu.com/opinion/editorial/the-health-checklist/article19504473.ece

Equity in access to doctors, diagnostics and medicines for rural India must be a priority

The frail nature of rural India’s health systems and the extraordinary patient load on a few

referral hospitals have become even more evident from the crisis at the Baba Raghav Das

Medical College in Gorakhpur. The institution has come under the spotlight after reports

emerged of the death of several children over a short period, although epidemics and a high

mortality level are chronic features here. Medical infrastructure in several surrounding

districts and even neighbouring States is so weak that a large number of very sick patients are

sent to such apex hospitals as a last resort. The dysfunctional aspects of the system are

evident from the Comptroller and Auditor General’s report on reproductive and child health

under the National Rural Health Mission for the year ended March 2016. Even if the audit

objections on financial administration were to be ignored, the picture that emerges in several

States is one of inability to absorb the funds allocated, shortage of staff at primary health

centres (PHCs), community health centres (CHCs) and district hospitals, lack of essential

medicines, broken-down equipment and unfilled doctor vacancies. In the case of Uttar

Pradesh, the CAG found that about 50% of the PHCs it audited did not have a doctor, while

13 States had significant levels of vacancies. Basic facilities in the form of health sub-centres,

PHCs and CHCs met only half the need in Bihar, Jharkhand, Sikkim, Uttarakhand and West

Bengal, putting pressure on a handful of referral institutions such as the Gorakhpur hospital.

Templates for an upgraded rural health system have long been finalised and the Indian Public

Health Standards were issued in 2007 and 2012, covering facilities from health sub-centres

upwards. The Centre has set ambitious health goals for 2020 and is in the process of deciding

the financial outlay for various targets under the National Health Mission, including

reduction of the infant mortality rate to 30 per 1,000 live births, from the recent estimate of

40. This will require sustained investment and monitoring, and ensuring that the prescribed

standard of access to a health facility with the requisite medical and nursing resources within

a 3-km radius is achieved on priority. Such a commitment is vital for scaling up reproductive

and child health care to achieve a sharp reduction in India’s deplorable infant and maternal

mortality levels, besides preventing the spread of infectious diseases across States. It is

imperative for the government to recognise the limitations of a market-led mechanism, as the

NITI Aayog has pointed out in its action agenda for 2020, in providing for a pure public good

such as health. We need to move to a single- payer system with cost controls that make

efficient strategic purchase of health care from private and public facilities possible. Bringing

equity in access to doctors, diagnostics and medicines for the rural population has to be a

priority for the National Health Mission.

Healthcare

The private route (The Hindu: 20170817)

http://www.thehindu.com/todays-paper/tp-opinion/the-private-route/article19505840.ece

We need to find ways to make market-based health care more affordable

NITI Aayog’s recent proposal for the partial privatisation of district-level government

hospitals has been criticised for commercialising health care. Under the proposal, private

hospitals will be allowed to bid for 30-year leases that give them control over portions of

government hospitals dedicated to treating non-communicable diseases. Critics argue that

private hospitals focussed on profits will do no good to the poor who can’t pay for their

services, so the government must step in to provide free health care.

Affordability is indeed the major issue preventing poor Indians from getting proper health

care. Free health care provided by the government, however, is not the real solution to the

problem. Governments often have very little incentive to provide quality health care to many

citizens. This is because, in politics, it is the interests of powerful groups that get the most

leverage. The poor, for various reasons related to electoral politics, often get left out of the

race to influence their governments. For instance, politicians have very little incentive to care

about the needs of an individual voter since the impact of a single vote on the election result

is essentially minuscule. In the marketplace, on the other hand, private hospitals have huge

monetary incentives to proactively cater to the demands of their customers. Each consumer’s

currency note holds equal weight to a private hospital that seeks profit. This makes market-

based health care a fundamentally superior way to deliver health services to the poor.

An issue of ‘how to’

The focus then should be on how to make market-based health care more affordable. The

standard assumption in this regard is that for-profit health care works against the interests of

the poor by making health care more expensive. So various regulations aimed mostly at

reducing the profits of health-care investors and lowering the costs to consumers are imposed

on investors. Unfortunately, these regulations, by denying investors the opportunity to make

profits by providing health care, actually end up making health care more unaffordable. An

investor facing a swathe of regulations capping his returns, for instance, has very little

incentive to set up hospitals, produce life-saving drugs, or invest in medical education. This,

in fact, works against the interests of the poor by reducing the supply of health care and

increasing its price. The only real way to make health care affordable then is to increase its

supply sufficiently, which in turn will lead to lower prices. This can only be achieved when

health care is deregulated and investors are allowed to seek profits in an honest manner. In

fact, this is how any good or service gets cheaper over time. As more investments are made

into a sector in search of profits, the increased supply leads to lower prices for consumers and

lower returns for investors.

Sadly, the thinking that health care is too essential to be left to the market has prevented the

health-care market from working like any other. It is no wonder then that goods such as cell

phones and cars, which are considered luxuries and thus left to the market, have become

affordable to a larger population over time. At the same time, health care has largely

remained unaffordable to the vast majority of people.

Acute Encephalitis Syndrome

15%-29% AES fatality rate at BRD Hospital (The Hindu: 20170817)

http://www.thehindu.com/data/15-29-aes-fatality-rate-at-brd-hospital-in-

gorakhpur/article19504343.ece

About 20 AES child deaths are recorded daily, officials say

Deaths of Acute Encephalitis Syndrome (AES) patients at Gorakhpur’s Baba Raghav Das

Medical College, which serves as the only referral hospital for most people in a region racked

by the infection, have been between 15% and 29% of all cases over a span of eight years,

official records accessed by The Hindu show.

Data from 2007 till 2014 shows that the case fatality rate has been an average of 21% over

eight years, which is not considered alarming for the area. Caused by the Japanese

encephalitis virus, scrub typhus or other bacterial, viral or fungal infections, the number of

cases of AES has been high for many years now.

According to official records, a total of 2,424 cases of AES were recorded in 2007. Of these,

510 patients or 21.03% died. The number of cases fluctuated over the next few years. A total

of 2,195 cases and 457 deaths or 20.82% CFR was recorded in 2008. The cases increased to

2,663 in 2009, with 517 deaths or 19.39% CFR. In 2010, the cases shot up to 3,307, while the

number of deaths was lower at 514, making the CFR the lowest in eight years — 15.56%. A

total of 3,308 cases and 625 deaths, and a CFR of 18.82%, were recorded in 2011. The

number of cases dropped in 2012, with 2,517 total AES cases and 521 deaths, which was

20.69% CFR.

‘20 deaths every day’

Though these figures pertain to all wards and units of the medical college, a senior paediatric

doctor at the hospital said about 85% of the cases would be children. The mortality rate of

children, particularly encephalitis patients, at the medical college has been at the centre of a

scandal, after 60 children died in a span of five days starting August 7. About 30 of the deaths

occurred within 48 hours. According to officials at the medical college, 20 deaths are

recorded every day on an average.

Five doctors at the medical college that The Hindu spoke to said that the number of deaths of

encephalitis patients, especially children, had hovered around 20% of all patients in the past

few years. According to a senior paediatric doctor, the children who end up at BRD Medical

College are usually in a very serious condition when they reach.

Sleeping

Insufficient sleep raises type 2 diabetes risk in children (Medical News

Today: 20170817)

http://www.medicalnewstoday.com/articles/318991.php

Child sleeping with clock

New research investigates the link between sleep duration and risk markers for type 2

diabetes in children.

Could as little as 1 hour of sleep influence children's risk of developing type 2 diabetes? A

new study suggests so.

In the United States, 1 in 3 people are estimated to develop type 2 diabetes at one point in

their lifetime.

The disease affects men and women of all ages, but according to the latest data from the

Centers for Disease Control and Prevention (CDC), over 5,000 young people are diagnosed

with type 2 diabetes every year.

Researchers from St. George's, University of London in the United Kingdom set out to

examine the potential link between sleep duration and type 2 diabetes risk in children.

The team was led by St. George's professor Christopher G. Owen, and the findings were

published in the journal Pediatrics.

As the authors of the new research explain, the possible associations between the length of

sleep and the risk markers for type 2 diabetes have not been sufficiently studied.

Studying sleep duration and diabetes risk

Prof. Owen and colleagues examined 4,525 multiethnic children aged between 9 and 10

years, all of whom were living in the U.K.

They took the children's body measurements, including height, weight, blood pressure, and

bioimpedance - a measure of how well the body resists electric current, which gives insights

into body composition.

The researchers took blood samples and tested the children's predisposition to type 2 diabetes

using a plasma glucose test.

Binge drinking in teens may raise women's blood glucose in later life

Binge drinking in teens may raise women's blood glucose in later life

A new study shows that drinking large amounts of alcohol during teenage years may raise the

risk of high blood sugar in adulthood.

The scientists also tested the children's levels of lipids, insulin, and the hemoglobin HbA1c,

among others.

Insulin is the hormone that regulates blood sugar. An imbalance in the body's lipids - or body

fat - is thought to be involved in cardiovascular complications for people with type 2

diabetes. Finally, HbA1c has been shown to be a marker of such lipid impairment.

Sleep duration was calculated using the information provided by the children. They reported

on the time they typically go to bed and the time they wake up on a school day. The

researchers confirmed this information in a subgroup of children, using an accelerometer-

based sleep tracker.

Prof. Owen and team fed the body measurements, as well as the cardiovascular and type 2

diabetes risk markers, into multilevel linear regression models, adjusting for possible

confounders such as sex, age, ethnicity, socioeconomic background, and the effect their

schools might have on the results.

Just 1 hour less of sleep raises risk

Overall, the children slept for 10.5 hours per night, on average. The study found no

associations with cardiovascular risk factors, such as the hemoglobin HbA1c.

However, the study did find that the shorter the sleep duration, the higher the children's levels

of body fat - an association previous studies have also highlighted.

Additionally, the research uncovered a similar inverse correlation between sleep duration and

insulin levels, insulin resistance, and blood sugar levels.

In fact, just 1 hour of less sleep significantly increased type 2 diabetes risk factors, such as

blood sugar and insulin resistance.

"The finding of an inverse association between sleep duration and T2D [type 2 diabetes] risk

markers in childhood is novel," the authors conclude. "Intervention studies are needed to

establish the causality of these associations, which could provide a simple strategy for early

T2D prevention."

Prof. Owen and colleagues also add that increasing the mean sleep length during the weekday

by as little as 30 minutes could lead to a decrease in body mass index (BMI) of 0.1 kilograms

per square meter and a decrease in insulin resistance.

"These findings suggest increasing sleep duration could offer a simple approach to reducing

levels of body fat and type 2 diabetes risk from early life [...]. Potential benefits associated

with increased sleep in childhood may have implications for health in adulthood."

Prof. Cristopher G. Owen

The CDC recommend that children between 6 and 12 years old should get anywhere between

9 and 12 hours of sleep every night.

Mental Diseases

ȡ  ͧ Ȣ ȡǐ ɉसे Ǔ ȯ Ʌ  ¢ नया एप (Dainik Jagran: 20170817)

http://epaper.jagran.com/ePaperArticle/17-aug-2017-edition-National-page_14-1707-19479-

262.html

Û Ǘ Ȩ[, आइएएनएस : ȡ  ͧ Ȣ ȡǐ ɉ से अब आसानी से Ǔ ȡ जा सकेगा। \ ȯǐ ȧ

Ȱ£ ȡǓ ɉने ऐसा è ȡ[ Ȫ एप ͪ  ͧ ͩ ȡहै, िजससे ȡ  ͧ Ȫ ɉपर नजर रखी जा सकेगी।

इससे समय रहते Ȣ ȡǐ ɉको Ǔ Ȳǒğ ͩ ȡजा सकेगा। 1 Ȫ ȡ[j Ȳने एप के दरू-दराज के ¢ ȯğɉ

Ʌरहने वाले अधेड़ और बड़ी ` Ĩ के Ȫ ɉके ͧ f Ï ȡȡफायदेमंद   ȡǒ होने ȧ` à Ȣ जताई है।

ͪ ȯ£ ɉने बताया ͩ पहले è ȡ[ Ȫ ^è ȯ ȡ करने वाले गंभीर ȡ  ͧ Ȣ ȡȣसे Ē  ͧ Ȫ ɉ

ȧ Ȣ ȧ Ǿ ɉका पता लगाया गया और उसके Ǖ ȡǒ एप ͪ  ͧ ͩ ȡगया। इस एप के

ǐ ȯ ȣ ɉको तीन ¡ ȣ ȯ Ʌदस   ğɉसे गुजरना होता है। 1^  Ʌतनाव और Ȣ ȡȣ के ɉ,

दवाओं के ^è ȯ ȡ का ȣ ȡ, दवाओं के Ǖǽ Ȫ ] Ǒ के बारे Ʌ ȡ ȡȣजुटाई जाती है। इस एप

को तीसरे ¢ ɮȡȡǓ Ȳǒğ ͩ ȡजाता है। ͩ   Ȣभी तरह ȧ  è ȡआने पर ȯ ȣ ȯͫ  ͧ के

ǐ ȯइलाज मुहैया कराया जाता है। यह एप भारत जैसे ͪ ȡ  Ȣ ȯ ɉके ͧ f Ï ȡȡफायदेमंद

  ȡǒ हो सकता है, जहां èȡèØ   Ǖͪ ȡf ȲǕǽè ¡ ȣȲ¡ ɇ@Û Ǘ Ȩ[, आइएएनएस : ȡ  ͧ

Ȣ ȡǐ ɉसे अब आसानी से Ǔ ȡजा सकेगा। \ ȯǐ ȧȰ£ ȡǓ ɉने ऐसा è ȡ[ Ȫ एप ͪ  ͧ

ͩ ȡ है, िजससे ȡ  ͧ Ȫ ɉपर नजर रखी जा सकेगी। इससे समय रहते Ȣ ȡǐ ɉको Ǔ Ȳǒğ

ͩ ȡजा सकेगा। 1 Ȫ ȡ[j Ȳने एप के दरू-दराज के ¢ ȯğɉ Ʌरहने वाले अधेड़ और बड़ी ` Ĩ के Ȫ ɉ

के ͧ f Ï ȡȡफायदेमंद   ȡǒ होने ȧ` à Ȣ जताई है। ͪ ȯ£ ɉने बताया ͩ पहले è ȡ[ Ȫ

^è ȯ ȡ करने वाले गंभीर ȡ  ͧ Ȣ ȡȣसे Ē  ͧ Ȫ ɉ ȧ Ȣ ȧ Ǿ ɉका पता लगाया

गया और उसके Ǖ ȡǒ एप ͪ  ͧ ͩ ȡगया। इस एप के ǐ ȯ ȣ ɉको तीन ¡ ȣ ȯ Ʌदस

  ğɉसे गुजरना होता है। 1^  Ʌतनाव और Ȣ ȡȣके ɉ, दवाओं के ^è ȯ ȡ का ȣ ȡ, दवाओं

के Ǖǽ Ȫ ] Ǒ के बारे Ʌ ȡ ȡȣजुटाई जाती है। इस एप को तीसरे ¢ ɮȡȡǓ Ȳǒğ ͩ ȡ

जाता है। ͩ   Ȣभी तरह ȧ  è ȡआने पर ȯ ȣ ȯͫ  ͧ के ǐ ȯइलाज मुहैया कराया जाता है।

यह एप भारत जैसे ͪ ȡ  Ȣ ȯ ɉ के ͧ f Ï ȡȡफायदेमंद   ȡǒ हो सकता है, जहां èȡèØ

  Ǖͪ ȡf ȲǕǽè ¡ ȣȲ¡ ɇ@

Bone Surgery(Hindustan: 20170817)

http://epaper.livehindustan.com/story.aspx?id=2150891&boxid=97723264&ed_date=2017-08-

17&ed_code=1&ed_page=18

TB Medicine (Hindustan: 20170817)

http://epaper.livehindustan.com/story.aspx?id=2150891&boxid=97718566&ed_date=2017-08-

17&ed_code=1&ed_page=18

Knee implants

Prices of knee implants cut sharply (The Tribune: 20170817)

http://www.tribuneindia.com/news/nation/prices-of-knee-implants-cut-sharply/453042.html

Six months after reducing the prices of coronary stents, the government today cracked down

on exorbitantly priced knee implants, fixing their ceiling prices in a major financial relief to

patients.

The National Pharmaceutical Pricing Authority (NPPA), the Centre’s drug pricing wing, in

an order today capped the prices of most widely used knee implants (cobalt-chromium) at Rs

54,720 as against the previous MRP of Rs 1.58 lakh.

The second category of implants (titanium, oxidised zirconium), currently priced at Rs 2.49

lakh, cannot be sold for more than Rs 76,600 now. The cost reduction works out to be around

69 per cent, as it does for the high flexibility implants now capped at a price of Rs 56,490

against the old MRP of Rs 1.81 lakh.

(Follow The Tribune on Facebook; and Twitter @thetribunechd)

Revision implants, used in a more complicated form of orthopaedic surgery, will not cost

more than Rs 1,13,950. The previous price was Rs 2,76,869.

With around 1.5 lakh annual orthopaedic knee implants in India, patients are expected to save

Rs 1,500 crore.

“By 2020, osteoarthritis will be the fourth largest cause of immobility in the world. India has

1.2-1.5 crore orthopaedic patients who require implant surgeries. Most of those diagnosed are

not able to afford the operation. The government is reforming this by putting a ceiling from

today,” Minister of Chemicals and Fertilisers Ananth Kumar said today.

For specialised implants for cancer and tumours, the NPPA has fixed the ceiling at Rs

1,13,950, taking away the cost-fixing discretion from hospitals and surgeons.

The government said complaints of overcharging would be monitored directly and the

overcharged amount would have to be returned with 18 per cent interest, if proven right.

Knee implants

Knee implants to cost up to 69% less as govt caps prices (The Times of

India: 20170817)

http://epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=Knee-implants-to-

cost-up-to-69-less-17082017001014

Acting swiftly on PM Narendra Modi's Independence Day promise to take steps to rein in

healthcare costs, the government on Wednesday said it is placing knee implants under price

control.

The government has slashed the prices of knee implants by between 59% and 69%, using a

special provision in the drug pricing law that enables it to intervene in “extraordinary

circumstances“ in public interest. The move is expected to benefit over three crore arthritis

patients in India needing knee replacement surgery .

Official sources said hip implants and intraocular lenses are the next items likely to attract the

attention of the regulatory scanner.

TOI was the first to report -in its edition of August 5, 2017 -that a price cap on orthopaedic

knee implants was imminent following an analysis by the price regulator that showed

manufacturers, distributors and hospitals were earning up to 450% trade mar SC hears its 1st

City to get 20 more air Mughalsarai gins on widely used devices.

The standard, widely used cobalt chromium in knee replacement surgery will now cost Rs

54,720 as against an earlier MRP of Rs 1,58,324. Similarly , the price of implants of special

metals like titanium and oxidised zirconium have been slashed by almost 70%, to Rs 76,600

from Rs 2.49 lakh. In case of revision knee replacement, which is usually done if the primary

replacement fails, prices of implants have been cut by 59%. The government said there was

“unjustified, unreasonable and irrational“ profiteering and trade margins on these devices.

The high costs make treat ment unaffordable for many who need arthroplasty procedures. The

regulator national pharmaceutical pricing authority finds that it is urgently necessary to act in

public interest and has fixed and notified ceiling prices of orthopaedic knee implants for knee

replacement systems, the order issued by the department of pharmaceuticals said.

“The government will not be a mute spectator to illegal and unethical profiteering,“

chemicals and fertilisers minister Ananth Kumar said. He added the government would take

stringent action against hospitals, importers and retailers if they charged in excess of the

MRP fixed by the government.

According to government estimates, the price regulation of knee implants alone will lead to a

saving of about Rs 1,500 crore annually for patients.The new prices come into effect

immediately and will also apply to all available stocks for sale in trade channels. A price cap

on implants is expected to benefit millions of patients with orthopaedic problems. Industry

data, which experts say does not fully capture the picture, shows over three crore arthritic

patients in India in need of knee replacement surgery.

Swine flu

Swine flu: No morning prayer in NCR schools (The Times of India:

20170817)

http://epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=Swine-flu-No-

morning-prayer-in-NCR-schools-17082017005018

The fatal epidemic continues to be on the rise with over 695 cases of swine flu reported

across the state. The state UP principal Secretary (Health) has issued directions for both

private and government schools to discontinue the practice of morning assembly in schools.

Two deaths have been reported in Ghaziabad due to swine flu.

“A direction from UP principal Secretary (health) has been issued to DMs stating schools to

discontinue the practice of morning assembly in view of rising s in the state,“ said G K

Mishra, district malaria officer. “We have just received the directive which we intend to

circulate in all schools,“ added Mishra.

The administration is taking precautionary steps to contain the outbreak with a rapid response

team of a physician, epidemiologist, pathologist and a lab technician in place. “Whenever

swine flu cases are reported, rapid action team sanitizes the targeted area.The patients and

their family members are administered Tamiflu“ said Mishra. “We have also reserved 10

isolation wards in government hospitals for the swine flu patient “ added Mishra. In addition

to this 24hour toll-free number has been made available where any information on swine flu

could be sought from.

Meanwhile, in Noida, the GB Nagar health department has issued 'verbal instructions' to

private as well as government schools asking them to stop the morning assemblies. “We

received the order on August 9 and have started issuing verbal directions to all the schools to

stop the morning assemblies.We are doing this through the nodal teachers appointed for

awareness about the vector born diseases,“ Gautam Budh Nagar Chief Medical Officer

(CMO) Anurag Bhargava told TOI.

“The teachers should examine the students and if any of the students are found to be ill, they

should be instructed to stay at home for at least seven days,“ reads the order.However, the

schools in the area claim, they are yet to receive any orders. “We are yet to receive any

instruction. Since the disease has not become endemic, it is not logical to stop the school

assemblies,“ Asha Prabhakar, Principal, Bal Bharati Public School, Sector 21, told TOI.

Generic medicines

Centre plans to sell generic medicines at fuel stations (The Times of India:

20170817)

http://epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=Centre-plans-to-sell-

generic-medicines-at-fuel-17082017016040

But Shortage Of Qualified Pharmacists Posing Problems

The government is working on opening `Jan Aushadhi' (generic medicines) stores at petrol

pumps belonging to staterun fuel retailers across the country with a view to make cheap drugs

accessible to masses, Union oil minister Dharmendra Pradhan said on Wednesday .

“Oil marketing companies are bringing an ecosystem of non-fuel retail business at petrol

pumps through tieups. The Jan Aushadhi stores under the department of pharmaceuticals in

the chemicals & fertilizers ministry will also be opened at the outlets in the future,“ Pradhan

said after the fuel retailers inked MoU with Energy Efficiency Services Ltd for selling

energy-efficient appliances and LED bulbs

But shortage of qualified pharmacists have emerged as a problem. Under law, drug stores

need to have qualified pharmacists. While most of the private drug stores list such

pharmacists, they are seldom present. “As government entity , we can't do that,“ a person

familiar with inter-government discussions told TOI. But the officials were hopeful of finding

a way and said it will al so open job opportunities.

EESL is a company promoted by state-run power utilities. It is spearheading the

government's flagship `Ujala' scheme to replace all incandescent and CFL bulbs in the

country with LED lamps by 2019.

Pradhan said the IT ministry's `Common Service Centre' concept is also being explored to

offer government services such as issuing PAN and E-Aadhaar cards, utility bill payments,

banking solutions and agriservices at the pumps.

Power, coal and renewable energy minister Piyush Goyal said the MoU was an example of

how the Narendra Modi government worked as a single unit.

Under the tie-up with IndianOil, Hindustan Petroleum and Bharat Petroleum, EESL will

leverage the network of their 55,000 petrol pumps, which have a daily footfall of 3.5 crore, to

sell LED bulbs and other energy efficient appliances.

“It is worth noting that two important ministries have come together to realise the Prime

Minister's vision of every citizen having access to energy efficient appliances. The marketing

network of the three oil marketing companies is unparalleled and this tie-up will only

accelerate and scale up the distribution of energy efficient appliances across the length and

breadth of the country ,“ he said.

EESL will make the entire upfront investment for ensuring availability of the products at the

outlets and no upfront capital cost will be borne by the oil marketing companies, barring

manpower and space. EESL will pay 10% to the outlets on sale. The consumer can purchase

high-quality 9W LED bulbs for Rs 70, 20W LED tubelight for Rs 220 and five-star rated

ceiling fan for Rs 1,200.

Air PollutionKnee implant pricesSwine fluHealth SystemHealthcareAcute Encephalitis SyndromeSleepingMental DiseasesBone SurgeryTB Medicine KneeSwine FluGeneric Medicines