வியாழன், 25 ஆகஸ்ட், 2016

NEWS COMMENTS

WAR FOR WATER

In future if there would be a war it must be a war for water.Water can exist without lives but lives cannot exist without water.

Water is mismanaged by us.This comment is based on the latest news in The Hindu Magazine 'Cauvery Row:Karnataka Chief Call For An All Party Meeting'

Water disputes between TN and Karnataka is not similar to other interstates water disputes in the country.Internationally there are water disputes between countries but some how they are managed or solved successfully by the respective countries by mutual cooperation or by solution by the International Court.

Internationally there were well known disputes for water and have been solved by the intervension of IC such as Nile Disputes between Egypt and Sudan,Tigris and Euphratus Disputes between Turkey,Syria and Iraq.

All the above disputes were solved by the court successfully on a basical theory that The Course of Rivers and water bodies should not be subjected into diversion or misdirections.They should be kept on their own natural course of directions without any disterbance from any side.They are the nature's gift.Each and every lives has the right to enjoy it.

The above norm is more suitable and should be implimented in India also.All states should be stricly advised that water is a common body and does not belongs to any state.

To ensure this the Center has to take the step to organize Cauvery River Management Authority and the Cauvery River water Distribution Regulating body wihout politics.

Tamilnadu similar to Karnataka must unite beyond the politics in this issue.
The Full News

Cauvery row: Karnataka CM calls all-party meeting on Saturday

A delegation of TN farmers’ leaders met Siddaramaiah seeking Cauvery water on humanitarian grounds, in Bengaluru on Thursday. Photo: Special arrangement

A delegation of TN farmers’ leaders meet Siddaramaiah, seek water release on humanitarian grounds

With Tamil Nadu moving the Supreme Court seeking release of Cauvery water, water-starved Karnataka, which is facing deficient rainfall in the catchment area, has called an all-party meeting on Saturday in Bengaluru to decide the next course of action.

Karnataka Water Resources Minister M.B. Patil told reporters here on Thursday that the all-party meeting convened by Chief Minister Siddaramaiah would also take stock of the grim water storage situation in the reservoirs in the Cauvery basin and the problems being faced by farmers of the State due to deficient rainfall.

The proposed meeting would be attended by MPs from the State, including three Union Ministers and ministers in-charge of the districts in Cauvery basin, Mr. Patil said.

Referring to the seriousness of the situation due to poor storage in the reservoirs in Cauvery basin, the minister said: "We need the water stored in the dams in Cauvery basin for drinking purpose and have strictly instructed our farmers not to take up cultivation of water-intensive crops. But Tamil Nadu is actually seeking water for irrigation purposes."

"We will convince the Supreme Court, the Centre and the Cauvery Monitoring Committee about the deficient rainfall and poor storage position in Karnataka’s dams," he added.

Referring to Tamil Nadu’s contention that there was a deficit of 22.934 tmcft of water to be released by it, Mr. Patil said as per Karnataka’s official records, the shortfall was only 12 tmcft. Tamil Nadu has filed an application before the Supreme Court seeking direction to Karnataka to release 50.052 tmcft of water.

Meanwhile, a delegation of representatives from all the farmers’ associations in Tamil Nadu met Mr. Siddaramaiah on Thursday and appealed to him to release Cauvery water to their Samba crop on humanitarian grounds. After hearing their plea, Mr. Siddaramaiah told them about the grim storage position in Karnataka and said it would be difficult to release water given the present scenario. He assured them of releasing water in the coming days if there was good rainfall in the catchment areas.

The Chief Minister requested the farmers’ leaders from the neighbouring state to understand the position of Karnataka, which was finding it difficult to provide even drinking water.

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NEWS UPDATES-TOOMUCH BRAIN ACTIVITY LEADS TO COGNITIVE,MEMORY AND ATTENTION DEFECTS

OVER BRAIN ACTIVITY DEFECTS

A recent research has proved that too much neuronal stimulant activities especially in the attention and memory regions of the brain leads to attention deficits,age related cognitive and memory defecits and Alzheimer's Syndrome.

The research was conducted by Dr Tobias Bast in the School of Psychology at the University Of Nottingham and published in the academic journal Cerebral Cortex.

The Central Nervous System including the Brain is the main controller of all our body's physical and mental activities.

Our brain is composed of many neurons which interact with each other by means various stimulatory and inhibitory neurotransmitters.

Gamma Amino Butyric Acid is the major inhibitory neurotransmitter which control the neurons from over stimulation by the other stimulant transmitters.

If this control has been last there will be an erratic inhibition,which results in neuronal over activities.This over activities leads to neuronal tiredness.If this happen in the hippocampus area of the brain then there will be cognitive,memory,and attention defects,Alzheimer Disease,and schizophrenia.

The Full News

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Neurons in the brain interact by sending each other chemical messages, so-called neurotransmitters. Gamma-aminobutyric acid (GABA) is the most common inhibitory neurotransmitter, which is important to restrain neural activity, preventing neurons from getting too trigger-happy and from firing too much or responding to irrelevant stimuli.

Researchers led by Dr Tobias Bast in the School of Psychology at The University of Nottingham have found that faulty inhibitory neurotransmission and abnormally increased activity in the hippocampus impairs our memory and attention.

Their latest research - "Hippocampal neural disinhibition causes attentional and memory deficits" - published in the academic journal Cerebral Cortex, has implications for understanding cognitive deficits in a variety of brain disorders, including schizophrenia, age-related cognitive decline and Alzheimer's, and for the treatment of cognitive deficits.

The hippocampus - a part of the brain that sits within our temporal lobes - plays a major role in our everyday memory of events and of where and when they happen - for example remembering where we parked our car before going shopping.

This research has shown that a lack of restraint in the neural firing within the hippocampus disrupts hippocampus-dependent memory; in addition, such aberrant neuron firing within the hippocampus also disrupted attention - a cognitive function that does not normally require the hippocampus.

Increased activity can be more detrimental than reduced activity

Dr Bast, said: "Our research carried out in rats highlights the importance of GABAergic inhibition within the hippocampus for memory performance and for attention. The finding that faulty inhibition disrupts memory suggests that memory depends on well-balanced neural activity within the hippocampus, with both too much and too little causing impairments. This is an important finding because traditionally, memory impairments have mainly been associated with reduced activity or lesions of the hippocampus.

"Our second important finding is that faulty inhibition leading to increased neural activity within the hippocampus disrupts attention, a cognitive function that does not normally require the hippocampus, but depends on the prefrontal cortex. This probably reflects that there are very strong neuronal connections between hippocampus and prefrontal cortex. Our finding suggests that aberrant hippocampal activity has a knock-on effect on the prefrontal cortex, thereby disrupting attention.

"Overall, our new findings show that increased activity of a brain region, due to faulty inhibitory neurotransmission, can be more detrimental to cognitive function than reduced activity or a lesion. Increased activity within a brain region can disrupt not only the function of the region itself - in this case hippocampus-dependent memory - but also the function of other regions to which it is connected - in this case prefrontal cortex-dependent attention."

Adding to existing research finding

Dr Bast's research is motivated by recent clinical findings that patients in early stages of schizophrenia, age-related cognitive decline and Alzheimer's show faulty inhibition and increased activity within the hippocampus. The new study, where inhibition in the hippocampus of rats was disrupted before the animals took part in tests of attention and memory, revealed that such faulty inhibition and aberrant activity within the hippocampus causes the type of memory and attentional impairments seen in patients.

This research adds to the team's recent findings, where they found that attention was disrupted by faulty inhibition and increased activity within the prefrontal cortex, a brain region important for attention.

Dr Bast, said: "Overall, these findings highlight that higher brain functions, such as attention and memory, depend on well-balanced neural activity within the underlying brain regions."

Potential target for new treatments

This research has important implications for treating cognitive impairments.

The findings show that simply 'boosting' the activity of the key memory and attention centres in the brain (the hippocampus and prefrontal cortex), which has been a long-standing strategy for cognitive enhancement, will not necessarily improve memory and attention, but can actually impair these functions. What's important is to re-balance activity within these regions.

Dr Bast, said: "One emerging idea is that early stages of cognitive disorders, such as schizophrenia and age-related cognitive decline and Alzheimer's, are characterised by faulty inhibition and too much activity; this excess neural activity leads then to neuronal damage and the reduced brain activity characterizing later stages of these disorders. So, rebalancing aberrant activity early on may not only restore attention and memory, but also prevent further decline.

"We have new studies on the way where we aim to identify medicines that might be able to re-balance neural activity within hippocampus and prefrontal cortex and to restore memory and attention."

புதன், 24 ஆகஸ்ட், 2016

NEWS UPDATES-BOOK READING INCREASES LIFE EXPECTANCY

BOOK READING-LONG LIFE

There is a good news for book worms.A recent research has proved that book readers live longer than non readers.They live an average of about 2 years longer than non book readers.A news study published on the magazine Social Study And Medicine

The Full News:-

Bookworms May Have Better Life Expectancy

Ryan Marotta, Assistant Editor

Published Online: Tuesday, August 9, 2016

“A reader lives a thousand lives before he dies,” mused a character in George R.R. Martin’s A Song of Ice and Fire series.

Although life expectancy in Martin’s fantasy franchise is infamously low, a recent study has good news for bookworms in the real world: readers may live an average of about 2 years longer.

The study published in Social Science & Medicine evaluated data on the reading patterns of 3635 patients 50 years and older. The participants were separated into one of 3 groups: those who read for 3.5 hours or more each week, those who read for up to 3.5 hours each week, and those who didn’t read at all.

Over a 12-year follow-up period, 27% of readers and 33% of nonreaders passed away. After accounting for factors such as gender, race, and education, the research team determined that participants who read for up to 3.5 hour a week were 17% less likely to die than those who didn’t read at all, while more avid readers were 23% less likely to die than no-readers.

“When readers were compared to nonreaders at 80% mortality (the time it takes 20% of a group to die), non-book readers lived 85 months (7.08 years), whereas book readers lived 108 months (9.00 years) after baseline,” the study authors wrote. “Thus, reading books provided a 23-month survival advantage.”

The researchers noted that books were more strongly linked to longevity than newspapers or magazines. They also suggested that book reading engages higher cognitive processes and promotes empathy, social perception, and emotional intelligence, all of which can lead to improved survival.

The study authors acknowledged that further research is needed to uncover any further health benefits offered by reading, as well as to establish differences between fiction and non-fiction or various genres. They also expressed interest in better understanding the health effects of e-books and audiobooks, which are more likely to be read in a nonsedentary manner. Fortunately, bibliophiles can offset the risks associated with long periods of sitting by supplementing their daily reading with an hour of physical activity.

Pointing to previous studies in which participants 65 years and older were found to spend more than 4 hours a day watching television, the researchers ultimately encouraged patients, especially older ones, to consider spending their leisure time behind a book rather than in front of a TV.

“The benefits of reading books include a longer life in which to read them,” the study authors concluded. “The robustness of our findings suggests that reading books may not only introduce some interesting ideas and characters; it may also give more years of reading.”

ஞாயிறு, 21 ஆகஸ்ட், 2016

NEWS BITS

1.Chemotherapy for Cancer Leads to Cognitive Deficits:-

Long term chemotherapy for cancers produce long term cognitive defects.

Many post menopausal women who underwent chemotherapeutic treatments for their breast cancers have complained of long term cognitive decline after he treatments.

The researches ask how long these deficits will lost.

But the treatments are improved life expectancy and mostly increase the survival rate.But the patients complained often about the suffer from loss of memory,loss of concentration,and inability to do multi tasks.

The condition is dubbed as 'Chemo Brain' or 'Chemo Fog'.

A news report publishes on 9th Aug 2016 by Newman this condition affects nearly about 17 to 50% of female breast cancer survivors.

A study conducted at University of Illinois and published in the journal of Behavioral Brain Research,set out to investigate the effects of chemo brain over a long periods of time.

Anthracycline based chemotherapy causes worse on verbal memory tasks.

வெள்ளி, 19 ஆகஸ்ட், 2016

KIDNEY DISEASE AND THE DOSAGE ADJUSTMENTS

DOSAGE ADJUSTMENTS IN CKD

Many drugs are prescribed by doctors for various disease to the patients for treatments.The general rule is there should be a special care to be taken by the doctors to old and Chronic Kidney Disease (CKD) patients who's kidneys are very weak and functionless respectively.

Kidneys are one of the major organs eliminating the unwanted materials from the body and regulating the amount of bioavailability and plasma concentration of a drug.A diseased kidney which last its power of excretion may cause over accumulation of certain drugs in our blood and body fluids which results in toxicity.

A diseased kidney may over eliminate certain drugs which causes insufficient bioavailability and under plasma concentration which result in poor or nill therapeutic effect at the given dosage.

Hence dosage adjustments are necessary by accurate technical assessments by the doctors.

The following news study is more informative for you.
The following medications require dosage adjutments in CKD
1.Allopurinol
2.Lithium
3.Acyclovir
4.Amantadine
5.Fexofenadine
6.Gabapentin
7.Metoclopramide
8.Ranitidine
Antimicrobials that require dosage adjustments in CKD
1.Cephalexin
2.Amoxicillin
3.Cefuroxime
4.Ciprofloxacin
5.Clarithromycin
6.Levofloxacin
7.Nitrofurantoin
8.Piperacillin
9.Tetracyclin
10.Trimethoprim+sulphamethoxazole

The News:-

Medications Requiring Renal Dosage Adjustments

Published Online: Wednesday, August 17, 2016

Chronic kidney disease (CKD) and renal dysfunction can alter medications’ renal elimination and lead to subtherapeutic or supratherapeutic drug concentrations, which may decrease efficacy or increase toxicity.

Using the Cockroft-Gault equation or the Modification of Diet in Renal Disease (MDRD) to estimate creatinine clearance (CrCl) helps provide the appropriate dosage of renally-excreted medications.¹ Because elderly patients tend to have poor renal function, it’s important to take CrCl into consideration when dosing medications that follow renal elimination.

Renal damage can alter clearance of active drug metabolites, potentially causing accumulation.² Altered renal function can also affect dosing intervals of renally-eliminated medications.

The following medications require renal dosage adjustments^3,4:

Allopurinol (Zyloprim)
Lithium (Lithobid)
Acyclovir (Valtrex)
Amantadine (Symmetrel)
Fexofenadine (Allegra)
Gabapentin (Neurontin)
Metoclopramide (Reglan)
Ranitidine (Zantac)
Rivaroxaban (Xarelto)
Fesoterodine (Toviaz)

*List isn’t conclusive of all renally-dosed medications

Some common antimicrobials requiring renal dosing include³:

Cephalexin (Keflex)
Amoxicillin (Amoxil)
Cefuroxime (Ceftin)
Ciprofloxacin (Cipro)
Clarithromycin (Biaxin)
Levofloxacin (Levaquin)
Nitrofurantoin (Macrobid)
Piperacillin/Tazobactam (Zosyn)
Tetracycline (Sumycin)
Trimethoprim/Sulfamethoxazole (Bactrim)

*List isn’t conclusive of all renally-dosed medications

Roughly half of adults 30 to 64 years old are expected to develop CKD in their lifetime.⁵ In patients with a glomerular filtration rate (GFR) <60 m="" min="" ml="" sup="">2

, MDRD is considered superior to the Cockroft-Gault equation in estimating GFR to help determine dosing adjustments.¹

CKD patients will require dosage adjustments for certain medications, including antihypertensives, hypoglycemic agents, analgesics, statins. Staging of CKD is dependent on the patient’s GFR results.

Diuretics
Thiazide diuretics are considered first-line treatment for patients with uncomplicated hypertension and CKD (only if S_cr <2 .5="" crcl="" dl="" mg="" or="">30 mL/min). Loop diuretics are also commonly used to treat uncomplicated hypertension in CKD patients, but potassium-sparing diuretics should be avoided because the mechanism through which they work (excreting extra fluids and retaining potassium) is detrimental to the health of these patients.¹

Antihypertensives
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are first-line antihypertensives used in patients with type 1 or 2 diabetes and early CKD.¹Beta-blockers that are hydrophilic (including atenolol, bisoprolol, and nadolol) require dosing adjustments in CKD patients.

Hypoglycemic Agents
A renally-excreted hypoglycemic agent like metformin isn’t recommended if S_cr is >1.5 mg/dL in men or >1.4 mg/dL in women. It’s important to monitor CKD patients on metformin closely for lactic acidosis development. Sulfonylureas like chlorpropamide and glyburide should be avoided in patients with stage 3 to 5 CKD,¹ as their use increases hypoglycemia risk.

Analgesics
Metabolites of morphine, tramadol, and codeine can accumulate in CKD patients, leading to respiratory adverse effects. Dosage reduction is recommended for morphine and codeine in patients with CrCl <50 accumulation="" and="" be="" br="" can="" cause="" ckd="" concentrations="" dosing="" for="" harm.="" in="" intervals="" lead="" may="" metabolite="" min.="" ml="" modified="" need="" opioids="" patients.="" severe="" supratherapeutic="" to="">
Statins
Statin therapy for dyslipidemia is commonly used in CKD patients. Atorvastatin and pravastatin have no dose adjustment recommendation in these patients,⁶ but rosuvastatin, simvastatin, and lovastatin do have dose adjustment recommendations dependent on CKD severity. Fluvastatin should be used with caution in CKD patients.

Taking renal function into consideration when necessary can help ensure optimal therapy. Considering CrCl and GFR may prevent unnecessary adverse effects from medications that require renal dosage adjustments.

References
1. Munar MY, et al. Drug dosing adjustments in patients with chronic kidney disease. American Academy of Fam Physicians. aafp.org/afp/2007/0515/p1487.pdf. Accessed August 10, 2016.
2. Doogue MP, et al. Drug dosing in renal disease. Clin Biochem. 2011;32:69-73.
3. Renal dosing - database. GlobalRPh. globalrph.com/index_renal.htm. Accessed August 13, 2016.
4. Renal dosage adjustment guidelines for antimicrobials. Nebraska Medicine. nebraskamed.com/app_files/pdf/careers/education-programs/asp/antimicrobial-renal-dosing-guidelines.pdf. Updated March 2013. Accessed August 10, 2016.
5. CDC. Chronic kidney disease (CKD) surveillance system. nccd.cdc.gov/ckd/. Updated June 23, 2016. Accessed August 13, 2016.
6. Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease. National Kidney Foundation. kidney.org/professionals/KDOQI/guideline_diabetes. Accessed August 13, 2016.

சனி, 13 ஆகஸ்ட், 2016

NEWS COMMENT-ISHA YOGA AND THEOLOGY

IS YOGA SHOWS GOD?

This is based on a news that a woman moved the Madras High Court alleiging the illegal detention of her two daughters in the Isha Yoga Foundation at it's Coimbatore Ashram.

But the court dismissed her plea on the basis of a receipt of statements directly from the concerned daughters of the woman saying that they are staying at the Yoga Center in Coimbatore at their own will and volition.The statements were taken from the women ananymously but that ananymous report which contain the statements "we are not under any illegal detention,we are staying at our own will" was from the Principal District Judge of Coimpatore as per the direction of the MHC.

It was not clear that who visited the daughters at the IYC to take the statements.

It is ambiguous that why this long and unbeleivable procedure of taking self declaring statements from one concerned end to other concerned end through various hands yet the case is put on habeas corpus plea.

Our Jurisdiction and Court systems are frequently influenced by corruption and bureaucracy.Hippocratic and corrupted Justice System.

Irresponsible and meaning less rejection of a valuable plea by the parents who have the right to see their daughter at the spot,the court and not by visit to the IYC.

It is right time to think by every women that Home is the best place to stay.

It is not advisable for women to stay in another place whether it is a Musjid or Church or Temple without the concern of their parents or their spouces.

The Power of God spreads over every where else in the earth including your house.Women's physiques are not similar to Men's.They have many complications.It is not safe for them bodily and mentally to stay with strangers.

Court has to order to bring the concerned women to MHC with the help of police and get their statements in a free atmosphere.

The News From The Hindu (13-08-2016)

Madras HC dismisses plea against Isha Yoga Centre

Court gives liberty to parents to meet their daughters in the Foundation, without causing any disturbance to the peaceful atmosphere of the centre.

A day after a woman moved the Madras High Court, alleging illegal detention of her daughters in the Isha Yoga Foundation, Coimbatore, the court on Friday dismissed her plea, relying on the statements received from the women confirming that they are staying at the centre on their own volition.

A Division Bench of Justices S. Nagamuthu and V. Bharathidasan however, gave liberty to the parents to meet their daughters in the Foundation, without causing any disturbance to the peaceful atmosphere of the centre and with due intimation to the management.

When the habeas corpus plea of Sathyajothi came up for hearing, the government advocate submitted the report of the Coimbatore Principal District Judge (PDJ) as directed by the High Court on Thursday. After perusing the report, which included the statements of Geetha, and Latha, the Bench said, “The PDJ has categorically mentioned in his report that there is no truth in the allegation and that the detenues are staying at the Foundation on their own will.”

Noting that as of now no material is on record to believe that they are under illegal detention in the Isha Yoga Centre, the Bench said, “Prima facie, we are satisfied that they are staying on their own wish, and hence no relief can be granted as prayed in the petition.”

According to the petitioner, Geetha (34) and Latha (31), who now go by the names ''Maa Mathi'' and ''Maa Mayu'' have been forced to stay in the yoga centre against their will.

Geetha was a former employee of Sheffield Hallam University, England. After her marriage broke up in 2008, she started attending yoga classes organised by Isha foundation.

Later Latha also joined the Foundation and both became full-time workers in 2013. The petitioner alleged that the management of the Foundation, after coming to know about the financial status of their daughters, had exerted influence and pressure on them to enrol as full-time workers.

Claiming that she was not allowed to contact or meet her daughters for over a year, the petitioner prayed for a direction to the police officers concerned to produce the women before the court.

Keywords: Isha Yoga

View comments (10)Post Comment

‘No compulsion behind our stay at yoga centre’August 4, 2016

HC orders inquiry into alleged captivity of two women in Isha Yoga Centre

வெள்ளி, 12 ஆகஸ்ட், 2016

NEWS UPDAE-MEDICAL COMPANIES GAMBLES AND OUR HEALTH IS AT RISK

CORRUPT COMPANIES-OUR HEALTH IS AT RISK

Read the following news from Indian Express patiently if you are really interested in your health.Full news has been copied and pasted below with he full report given by the Singapore Arbitration Tribunal.

The important point is the drug company Ranbaxy was sold to a Japanese company Daiichi.At the time of transaction when it was sold and upto now they coveniently hidden the fact that the company has duped the drug control departments in about 40 countries to get quick approval of some 200 formulations including formulations for AIDS.

When Daiichi came to this fact in the latest development the Ranbaxy ex-owner Mr.Malvender Singh who sold the company cleverfully replied that it is a matter of malpractice by some employees and not by Ranbaxy and is conspired by Pfizer.

Now who ever they conspired against whom it does not matter to us but we the public and our health is under serious danger and conspiracy.

The center of the matter is they gave fraud and duped reports about their formulations in about 40 countries to get quick approvals.Their aim is only to make billions and trillions by putting public health at risk.

Now one kitten has come out but we do not know how many kittens are still in hide.

These big big drug companies like pfizer they have a number of cases against them in USA.

The medical profession has been purely commercialised.Highly bueuarocratic.

The Forensic Law clearly states that high risk medicines,such as sedative,norcotics and those which may affect the normal physiology of the body should not be dispensed on the counter as OTC.

But drug companies are freely advertice their products which are prescription medicines in the newspapers and magazines with attractive images and descriptions which may encourages a person to go for self medication without caution as the advertisement does not mention about its side effects.

Paracetamol a commonly used for fever and headache has liver effects on over usage.How many people knows this.Aspirin if use frequently to a child may precipitate serious Rye's Syndrom in which the baby become gray in colour with serious complications.

Tetracyclines should not be given to a child in growing age as it will affect bone growth.

Please be care with drugs and drug companies.

Should bury data, said Ranbaxy chief when R&D head revealed fudge: Tribunal order

7 / 33

The Indian Express

deepak patel 9 hours ago

On October 14, 2004, Rajinder Kumar, head of R&D, presented the Self Assessment Report (SAR) to the company’s science committee detailing how the pharma giant had “falsified data” for more than 200 drugs to obtain quick regulatory approvals from authorities in over 40 countries.
Present in the room were chairman Tejendra Khanna; Malvinder Singh, then president of pharmaceuticals and Ranbaxy’s owner; Brian Tempest, Chief Executive Officer (CEO); and top executives.
Khanna, according to Tempest who recalled that meeting at the Singapore arbitration tribunal, “said something to the effect that ‘Ranbaxy should just bury the data.” As reported Thursday, the order implicates the Ranbaxy top brass in a range of alleged irregularities.
Apparently frustrated at how the top management had responded to his findings, Kumar resigned the next day. Seven months later, in a letter to the management, he put on record some of the responses at the meeting: One board member (said): “Can we bury the data.” Falsification of data, said another senior Ranbaxy executive, only happened with few products and everyone did it.
Chairman Khanna quit the board three years later and was appointed by the UPA government as Lieutenant Governor of Delhi.
Significantly, the minutes of this crucial science committee meeting — circulated internally — made no mention of the SAR or of any board member’s response to the document.
In his letter on April 20, 2005, Kumar expressed his disappointment with the Ranbaxy management and, referring to the October 14 meeting, said that he had presented a plan to resolve the SAR issues.
READ | How Ranbaxy ‘buried info on fraud, duped its owners’

When contacted by The Indian Express, Khanna said: “The statement supposedly attributed to me by Dr Brian Tempest is completely denied. I always stood for complete and unfailing compliance with all regulatory requirements and emphasised that Ranbaxy should maintain an impeccable and zero tolerance record in such matters. In my Chairman’s messages which can be seen from published Annual Reports of the Company, there were unequivocal exhortations to maintain highest standards of quality assurance and regulatory compliance”.
Tempest did not reply to an emailed query from The Indian Express.
The tribunal fined Malvinder Singh and his brother Shivinder Singh Rs 3,500 crore for defrauding Daiichi Sankyo by “deliberately” withholding information about the SAR and its significance from the Japanese pharma company. Daiichi had purchased a majority stake in Ranbaxy from the Singh brothers and for Rs 19,804 crore on November, 2008.
The tribunal noted that SAR, which was forwarded to the US Food and Drug Administration by Kumar’s principal assistant Dinesh Thakur in 2005, was the basis of investigations by USFDA and the US Department of Justice. It culminated with Ranbaxy, under Daiichi, paying $500 m to the DOJ in 2013.
RECOMMENDED | Terrible… put patients at risk: Ranbaxy’s own expert Richard Cooper on Ranbaxy
Internal emails exchanged between Tsutomu Une, Ranbaxy Board chairman and Daiichi Sankyo’s points person in India, and Daiichi’s consultant Dick Van Duyne also reinforce the tribunal’s indictment.
On November 19, 2009, according to the tribunal, well over a year after Daiichi acquired Ranbaxy, Une commented that the DOJ had a “smoking gun” (a reference to the SAR) that could have, according to his diary entry for that day, created a “high possibility of a criminal penalty”.
In due course, this and Une’s other diary entries had a central role in the indictment.
Une’s email to Daiichi’s consultant Duyne noted that “the bad thing is the involvement of top management in the current compliance issues are identified”. He also recorded that he had come to know that Ranbaxy “management wanted the evidence destroyed”.
Van Duyne wanted to know who was this “top” management. Une replied: “The in-house email communications before 2006 has been provided by the whisperer...and DOJ found out that R’s (Ranbaxy’s) auditor as well as outside auditor cautioned to the Board members the issues which are exactly the same reasons as those relevant to the AIP (Application Integrity Policy).”
The FDA had invoked AIP which effectively suspended all new or pending applications or supplemental applications for drug approval against Ranbaxy on February, 2009.
Une added: “Furthermore, Dr Tempest and MS (an apparent reference to Malvinder Singh) ordered to break all the documents relating to the issues.This is the reason why the cases could be criminal even (though) no patients was (sic) harmed by the products. Also this is why FDA insists the issues caused by the corporate culture.”
RHC Holding, where Malvinder and Shivinder Singh are the promoters, was asked specifically by The Indian Express about this statement of Une talking about Malvinder Singh asking to “break (discarding) the documents.” The company replied: “The matter is sub judice and we cannot offer any comment in view of the confidentiality requirements.” Une, who is still with Daiichi Sankyo, did not respond to queries from The Indian Express.

Consider the salient points made in the arbitration order:
# SAR listed more than 200 drugs, including antiretroviral drugs for AIDS patients, where Ranbaxy is alleged to have used fabricated data to get approvals from authorities of more than 40 countries.
# Daiichi did not have a clue about SAR because Ranbaxy top brass withheld the report and its significance. The top brass named in the tribunal’s order include former owner and CEO Malvinder Singh, former COO Atul Sobti (who became CEO after Singh left the company in May 2009), former executive director of regulatory affairs Abha Pant, Ranbaxy’s General Counsel and senior Vice President of Global Intellectual Property Jay Deshmukh and his successor Lavesh Samtani. (Malvinder Singh’s brother Shivinder Singh was a non-executive director and was said to be not involved in the day to day affairs)
# Even Sanjeev Puri, Malvinder Singh’s then personal attorney, and V K Kaul, Malvinder Singh’s close family friend who was Ranbaxy’s independent director until late 2008, were also well aware of the SAR’s significance. Both were in touch with Daiichi Sankyo though the entire duration of the sale process and the subsequent handholding phase but did not reveal anything about it to the new owners.
# Had it not been for the SAR, the fine for Ranbaxy’s alleged violations of Current Good Manufacturing Practice (cGMP) violations, would not have been beyond $100 million — the cGMP regulations for drugs and biological products stipulate certain minimum requirements that must be met for the methods, facilities, and controls used in manufacturing, processing and packaging.
# That Daiichi was unaware of the fraud is evident in the fact that even after it took control of the Ranbaxy board in December 2008, Malvinder Singh was allowed to continue as the CEO till May 2009. That’s the year Daiichi forced him to step down for “incompetence”, rather than “dishonesty”. It was only in November 2009, that Daiichi came to know of SAR and its significance, and its impact on the US regulatory investigations on the company.
# In deal talks in 2007-08, Malvinder Singh and his team told Daiichi, in “carefully crafted language,” that the DOJ investigations were merely a “fishing expedition.” That it could only implicate some employees and not Ranbaxy, that it was a conspiracy initiated by its competitor Pfizer. These were not “honest answers.” And Malvinder Singh and his team knew that these were not accurate and “which they knew would provide the claimant with the comfort to enter the share purchase and share subscription agreement.”
Malvinder Singh’s stance changed during the arbitration hearing: he first claimed that he “did not know” about the SAR but later claimed that he did not regard the SAR as important to the ongoing FDA and DOJ investigations and therefore there was no reason to mention it to Daiichi. “His adherence to his position at the hearing undermined his overall credibility in the eyes of the tribunal and leads it to conclude that he must have taken a conscious decision not to inform Daiichi”, the tribunal said.
Ironically, midway through the Singapore tribunal hearing, the Singh brothers said that documents disclosed to Daiichi Sankyo before the signing of share purchase deal — which happened in June, 2008 — had given them enough “cause” to be concerned that Ranbaxy was a “corrupt’ organisation. Therefore, the brothers claimed that despite the assurance of Malvinder Singh and his team, Daiichi Sankyo ought to have been aware of such “corrupt” concerns but had decided to ignore them and proceed with the acquisition.
Tearing this apart, the tribunal made it clear that it “is not an attractive argument for the Singh brothers to make, especially in circumstances where they simultaneously have argued that no false representation were made”.
The Indian Express contacted key players indicted in the Singapore order
“The matter is sub judice and we cannot offer any comment in view of the confidentiality requirements.” The brothers have a majority shareholding in RHC Holding, a private limited company with assets of over Rs 10,000 crore. Listed companies such as Fortis Healthcare and Religare, and unlisted companies including SRL Diagnostics and Fortis Healthworld, are controlled through RHC Holding.
Jay Deshmukh, who was Ranbaxy’s then General Counsel: “Everything I did or did not do in dealing with Daiichi Sankyo (DS) at the time of the merger was pursuant to the express instructions of Malvinder Singh (who I reported to) — I objected to those instructions at the time, but felt I had no choice. I urged the management and Mr Singh to remedy the problems and to tell DS (Daiichi Sankyo) the truth, but he refused. Since leaving Ranbaxy, I have done everything in my power to remedy the situation.” Deshmukh is in Washington as partner at a California-based law firm.
Abha Pant resigned in 2011 as Vice President, Regulatory Affairs. “I am not aware of what is written in the tribunal and would not comment on anything till I see what you are referring to you.”
Rajinder Kumar, who was the Head, Research and Development, Ranbaxy in 2004, did not reply to the emailed queries. Kumar resigned a day after he presented the SAR to the Ranbaxy management on October 15, 2004. Kumar currently is President and chief medical officer of Vitas Pharma. He works from the company’s British office.
Mails sent to Daiichi Sankyo did not elicit a response. Atul Sobti, who resigned as the CEO of Ranbaxy in August 2010, did not respond to the emailed queries. Lavesh Samtani, who became Ranbaxy’s de facto General Counsel once Deshmukh left the company in March, 2009, did not respond to the emailed queries. He is currently the General Counsel and Executive Vice-President (Business Development) of New Jersey based pharma company BionPharma. The newspaper could not get in touch with V K Kaul and Sanjeev Puri.

புதன், 10 ஆகஸ்ட், 2016

Antimicrobial resistance: clear and present danger

NEWS FROM THE HINDU

Antimicrobial resistance: clear and present danger:

After years of doing little to tackle the silent but potentially deadly proliferation of antibiotic-resistant bacteria in India, all hell broke loose in 2008, when New Delhi was tacked onto the name New Delhi Metallo Beta-lactamase-1(NDM-1) an enzyme make virulant antibiotic resistant strains discovered in New Delhi in 2008.The bug is highly resistant to all beta lactamase antibiotics such as Penicillins,and cephalosporins.

Only after the detection of the New Delhi Metallo-beta-lactamase-1 super bug, India sat up to the danger of anti-microbial resistance within its boundaries, and is beginning to understand the disastrous societal consequences of rendering certain life-saving drugs impotent. Photo: Special Arrangement

India awoke late to risks of antibiotic overuse and is scrambling to contain the surge in drug resistance.

The New Delhi Metallo-beta-lactamase-1 was an enzyme that rendered bacteria resistant to a broad spectrum of antibiotics. A strain of the NDM1 had crossed the shores and spread resistance in the U.K. as well.

Despite its outrage over being associated with a resistant bug the nation sat up to the danger of anti-microbial resistance within its boundaries, and is beginning to understand the disastrous societal consequences of rendering certain life-saving drugs impotent.

Prior to the detection of the NDM, isolated calls for regulating antibiotics use were being made by doctors in surgeries and those manning Intensive Care Units.

It was in 2011 that the Union government came up with a National Policy for Containment of Antimicrobial Resistance in India, seeking to reverse what seemed to be spiralling healthcare concern.

The policy makes no bones about recognising the real threat: “Antimicrobial resistance in pathogens causing important communicable diseases has become a matter of great public health concern globally including our country. Resistance has emerged even to newer, more potent antimicrobial agents like carbapenems.”

A March 2016 paper on ‘Antibiotic Resistance in India: Drivers and Opportunities for Action’ in PLOS Medicine makes a convincing case for action against resistance: “Antibiotic resistance is a global public health threat, but nowhere is it as stark as in India. The crude infectious disease mortality rate in India today is 416.75 per 100,000 persons… twice the rate in the U.S. (200) when antibiotics were introduced.”

Among the key factors responsible are the widespread use and availability of practically all the antimicrobials across the counter, increasing and wanton use of antibiotics in livestock production, inappropriate doses, and irrational use of antibiotics in hospitals.

Attempts have begun to regulate at least the human consumption of antibiotics: there are now guidelines for appropriate antibiotics usage which have revised Schedule H drugs to make over-the-counter availability of certain antibiotics nearly impossible.

Stringent enforcement of drugs control, making the dispensing of some antibiotics over the counter punishable, is the need of the hour.

Comment

Antibiotics are wonderful medicines to give relief from various infections.But they should be handled very carefully.They should be prescribed only by professionals.In many developed countries and some countries in the third world such as in UAE (Abudhabi) antibiotics have been already labelled as 'only by prescription' medications.Abudhabi has a well designated and highly controlled medical authority known as Health Authority of Abu Dhabi (HAAD)

In these countries antibiotics are semi controlled and should be kept in separate racks away from the OTC medicines.Pharmacists are not allowed to dispense antibiotics.

Doctors are also not advised to overscribe any antibiotic as resistance may develop and put the patient in danger.

Before prescribing antibiotics to a patient the patient should be thoroughly consulted about his past history of tolerance for antibiotics.Patients should submit all the details of his past history and treatments to the present doctor.

Remember any drug can produce unwanted side effects if they were over used.Because a drug is a substance which would yield the desired effect by affecting or changing the physiology of your body.

Similarly antibiotics also they give the required releif by affecting many physiological aspects of your body.For example chloromycetin a old fashioned drug used to treat salmonella typhi,an organism that causes typhoid fever,was killing not only the organism but kills everything else that crosses infront of it including your red blood cells.Hence the drug is mostly withdrawn from use.

Antibiotics are safe if used with care.

But in India especially in Tamilnadu a peculiar state of bureaucracy and corruption with a recorded mal practices of nearly 10 years dispensing of expired medicines, antibiotics are vehemently misused and over prescribed in pharmacies,clinics and even in I/Care of big hospitals.

Recently a lady doctor was arrested in Tamil nadu as she has impersonated with a dead person's mark sheet to get a medical seat.We do no know still how many of such fraud doctors are practicing in the state unnoticed.

General precautions of Antibiotic Use:

1.Be sure that you are not allergic to the antibiotic.

2.After you start the course of antibiotics please complete the full course as per your doctor's prescription.Do not stop it in the middle of the course even if you get complete relief.Bacterias are very clever and become silent and calm at the middle of the course but when you stop the medication they become more strong and virulence by a process of mutation and resist the antibiotic.

3.Take the medicines in time.

4.Many antibiotics are effective in empty stomach but may be unfriendly to the stomach.In that case take it 1 hour before food or 2 hours after food.

செவ்வாய், 9 ஆகஸ்ட், 2016

News Comments-A DUPED DOCTOR

A DUPED DOCTOR

A news from TOI 9-8-16:-

Impersonation: Suspended woman doctor's bail plea rejected

PTI | Aug 9, 2016, 08.42 PM IST

Chennai, Aug 8 () The Madras High Court today dismissed anticipatory bail plea of a woman doctor, suspended on charges of impersonating a deceased SC woman to get her medical seat, and directed police to probe the matter on a war-footing, saying the alleged offence is dangerous to society at large.
Justice S Vaidyanathan dismissed the bail petition of Archana Ramachandran, who apprehended arrest in connection with the case, observing that she had lived a dead woman's life in letter and spirit.

Comment:-

A very interesting case of a Doctor got a medical seat by impersonating with the marksheets and certificates of a deceased S/C girl.

The practice is clearly showing that how much the degree of bureaucracy and fraudulence are deeply rooted in our Government official systems.

Anybody can do anything else.Even it is doubtful that she also got her Doctor degree in this way only.Because she cannot use her original mark sheets which are worthless to get an MBBS seat for her.Hence she used another person's mark sheet.

This fraud lady doctor basically had very poor wisdom,and hence poor marks in her school education.Hence she could not be a bright student during her MBBS education.

Hence it is very dangerous to allow such type of worthless medical professionals to practice as a doctor