Category Archives: MISC

Stem Cells – Are they a magic bullet?

When the name stem cell rings in our ears, more conmen incidences runs through our thoughts. The science behind it has been over shadowed by the multi-crore businesses surrounding it applications. From the banking of umbilical cord stem cells to autologous transplant into the needed tissue its application has got widened pretty much since its entry into the scientific market. Not to forget the incidences of “60 minutes” show of CBS television, USA tracking down conmen offering stem cell therapy for a dearly price 6 years ago. But science have travelled a long way. From utilizing the embryonic stem cells to almost not using it nowadays we have got way advanced in this field. Let me give you some basic insights about stem cells here in this blog.

Stem cells are considered a blank slate, which can transform into any tissue depending upon the organ’s requirement. The potency and viability of stem cell are proven to decline as we age. Due to this, the repairing process declines too. So when we talk about autologous vs allogenic stem cell transplant (discussed later in this blog), this concept takes the center stage.

Types of stem cells:

ESCs are pluripotent whereas ASCs are multipotent. But many researches have stated that ASCs are pluripotent. This misunderstanding is a result of accepting in-vitro differentiation data that were generated by using non-physiological conditions and non-specific cell markers (These markers are used to track SCs once transplanted into the human body. Difficulties faced are fluorescence emitted by markers mimics auto-fluorescence by human tissue cells, markers can leak out and can stain normal tissue, harsh treatment required for tracking. These can give false positive results).

While we have so called ‘cures’ for many ailments, they address only the symptoms and not the disease per se. So patients have to bear the grunt of the disease. Stem cells are a promising option which address the underlying pathology of the disease rather than just resolving the symptoms. It helps in augmenting or accelerating the body’s natural regenerative capacity.

Does it sounds like a magic bullet? Now the main problem is that we are not able to utilize the full potential of stem cells. We either fail in the in-vivo differentiation process or being not able to produce a clinically significant regeneration. There is no uniformity in the understanding of stem cell behavior. Different researchers give their hypothesis for stem cell behavior. For example, few consider autologous stem cell transplant is better than allogenic as there is no immunogenicity as long we use MSCs (as they lack MHC-II). Whereas the ones who do allogenic transplant (stem cells obtained from human fetal waste tissues like umbilical cord or placenta after getting consent from the mother) claim that these stem cells taken from the fetal tissues retain the maximum potency and viability. The immunogenicity is addressed by removing the antigenic property by processing of these tissues prior to the transplant. This debate will be never-ending until the near future which will give us an answer!

We can see the sprouting of multiple stem cell treatment centers and storage banks within last few years. For the storage of the stem cells these banks charge around 50 thousand to 2 lac rupees till 26 years of the child age with an offer of additional two years free of cost. They even offer EMI options. The parents get paranoid by the proposals of the banking executives, that the storing of stem cells can be help full for the child and the sibling in case of blood cancers, storage disorders etc., in the future. But none of them actually know the whereabouts of the tissue storage facility and the quality control procedure. Imagine that these stem cells are stored in a facility where there is no proper maintenance of temperature and purity which could seriously compromise the viability of those cells. And what guarantee the client get that these companies will return their stem cells or even respond to them when they are in need of those cells after 26+2 years? The sense of fear of illness drives us towards these banking facilities. These stem cell banks lure their prospective clients with excellent web designs and trained executives who with their sugar coated tongue convince their clients. I am not trying to imply that that it’s not useful, but there exists a cloud of uncertainty surrounding their functioning.

With my research over stem cell applications in India, I found its use mostly in infertility, anti-aging, non-healing ulcers, critical limb ischemia (CLI) and in many orthopedic (non-union, ligament tears, OA, resorptive bone diseases etc.) and dental diseases (oral submucosal fibrosis, tooth regeneration etc.). Many other diseases like cerebral palsy, retinitis pigmentosa, cardiomyopathy and erectile dysfunction are being tried. As you can observe one thing from the above diseases that they don’t have any curative treatment options. So people’s desperation drives them to a better treatment. And I would say it’s their luck and sometimes their effort which takes them to an appropriate treatment center or doctor.

These practicing doctors are skeptical about publishing their results. Reason, many don’t know its scientific background. They purchase from the vendors who supplies it in the name of “product for research” (legal loop hole to evade convictions). Few don’t have the inclination and time to publish their research as they fall in to the category of “busy practioners” who openly proclaim their inability to publish their results due to time constraints. Few even claim that the journal rejects their manuscripts quoting their products as mere fibroblasts and sometimes they even say the West suppress Indians. I don’t argue about the genuinity of the their treatment here but because of this, stem cell therapy done in the private clinics remains a clandestine treatment option to the eyes of the actual researchers. Many research institutes in India like PGIMER-Chandigarh, AIIMS-New Delhi, Stem cell center for Advanced Research – Govt. Stanley Hospital Chennai  and many private hospitals namely Aravind Eye hospitals – Madurai, Narayan Health City – Bangalore provide commercial stem cell treatment options with concomitant research in that filed.

First DCGI approved stem cell trials and product is from a private company named Stempeutics. Their one of the product Stempeucel has got limited marketing license for CLI and have completed phase 2 trial for OA and diabetic foot ulcer. They along with School of Regenerative Medicine (SORM), Manipal University offer MSC and PhD courses on Regenerative medicine.

With regenerative medical and surgical procedures pacing up in developments for various cosmetic & therapeutic applications, stem cells therapies are finding its role, either scientifically or clandestinely, in varieties of unproven disorders with a miraculous promise of complete cure.

In lieu of having a negative notion on stem cell therapies, let’s have a discussion with the experts in the field of stem cell research and treatment. Multidisciplinary Research Unit of Dhanalakshmi Srinivasan Medical College, Perambalur is organising an one day National Symposium on Regenerative Medicine on June 3rd, 2017. I am being the organising secretary for the event, have invited speakers who are having more than a decade of experience in stem cell research and Treatment.

Opening talk will be by Dr. V.R Ravi, Consultant Orthopedician & the Director of Mother Cell Regenerative Centre (MCRC), Trichy. He is also the secretary of Indian Stem Cell Study Group (ISCSG). His talk will be followed by Dr.Sankaranarayanan’s lecture, who is Dental Surgeon and the Director of MCRC, Trichy. He is one of the pioneers in dental pulp stem cell (DPSC) research and have given successful results for patients with oral submuscosal fibrosis using DPSC. He also received the Best Innovator Award at the International Stem Cell Conclave on May 2017 organised by Antiaging Foundation, India in New Delhi. Myself, Dr.Natesh Prabhu, Assistant Professor in Pharmacology, DSMCH and Diabetic & Sexual Medicine Consultant at Manipal Specialty Clinic, Trichy will be giving a talk on Role of Stem cells in erectile dysfunction (ED) and Infertility. With an increasing incidence of diabetes induced ED and the high failure rate of PDE5 inhibitors (Viagra, Cialis, Tazzle) in these patients, stem cell therapy has shown to offer a promising restoration of erection for them. All these are in research stage and approved therapies are yet to hit the market. But this can’t be a reason to withhold a promising treatment option of autologous stem cell injection in the cavernous sinusoids of the penis. Various preclinical and few clinical studies (mostly abroad) have been done to support this claim. I will be explaining about ED and various treatment options in a different blog. My talk will be followed by the key note lecture from Dr.Rosy Vennila whose is the professor & Head of Microbiology department at Govt. Stanley Medical College, Chennai. She is the principal investigator of the Stem Cell Centre for Advanced Research which is the only government research body (supported by ICMR funding) to undergo stem cell research, on hepatocytes specifically, in Tamilnadu. Then we have three speakers from Bengaluru. Dr.(Lt.Col)Pawan Kumar Gupta, a hemato-pathologist and Vice President of Medical Affairs, Stempeutics Research Pvt. Ltd. Dr.Prathip Kumar, a consultant hematologist for Narayana Hrudayala Tissue bank and Stem cell Research centre at Narayana Health City. And Dr. Debasish Das who has done his postdoctoral research on stem cells at Karolinska Medical Nobel Institute, Stockholm and working as the Head of Stem cell Research Lab at Narayana Nethralaya. Final talk will be from our in-house oncologist Dr.Arun Seshachalam who is also the consultant oncologists from GVN hospital, Trichy. He is currently affiliated with many oncology trials  at GVN hospital and you can find his interviews to various channels like Sun TV on YouTube. And the last session is for the delegates to interact with our speakers during the panel discussion and clarify any of their doubts on stem cell research and treatment.

So don’t miss out on this humongous opportunity to learn about stem cells directly from the experts and clarify the enigmatic idea of whether the stem cells are really a magic bullet!

We have applied for 2 credit hours from Tamilnadu Medical Council

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Antibiogram for Dengue? Sounds weird?

 

Some antibiotics have antiviral properties as well! Doxy inhibits viral replication in dengue.
Ref:
1) http://www.ncbi.nlm.nih.gov/pubmed/24142271

2) http://www.ncbi.nlm.nih.gov/pubmed/25858261

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The FDC battel continues

The NewDelhi government has moved the Supreme Court in defense of the ban it imposed earlier this year on hundreds of fixed dose combination drugs that it alleged to be irrational, unsafe for patients and lacking scientific validation. Armed with approvals from state regulatory agencies and, in certain cases, the central drug regulator, scores of drug makers countered the decision in courts. Read more here.

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Fetus in Fetu | “Long lost twin”. Literally

TOI reported a rare case of Fetus in Fetu. I was really shocked to read this “3.5kg fetus removed from one-year-old girl in Tamil Nadu: A one-year-old girl from Erode was found seemingly ‘pregnant’ due to a condition called fetus-in-fetu by doctors”.

Fetus in fetu (FIF) is a rare congenital anomaly. It is a condition in which malformed and parasitic fetus is located in the body of its twin. The anomaly was first defined in early nineteenth century by Meckel.  Despite its prevalence among infants and children, there have been reports of cases in which the anomaly had remained asymptomatic until later ages. This rare congenital anomaly, which was reported around 100 times since its first definition in the nineteenth century, has been discussed with respect to its prognosis and treatment in the light of the relevant literature

Read more about it here.

 

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Photo-Immunotherapy | NIH

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Workshop on Research Methodology |21-23,July, 2016 | KIMS, Kancheepuram

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Supporting info on Statins usage |”Statin-Taking Patients With LDL-C of 70–100 mg/dL at Decreased Risk of MACE” #Update

As the controversies regarding the Statin usage grow day by day, Clalit Research Institute, Tel Aviv_Israel has done a population-based study of more than 31,000 statin-taking adults in Israel who had stable ischemic heart disease showed no significant differences in major adverse cardiac events (MACE) between those with LDL-C levels that were between 70 and 100 mg/dL after 1 year of treatment and those with LDL-C <70 mg/dL. However, there was a significantly lower risk for MACE in those with LDL-C of 70 to 100 mg/dL vs those with LDL-C levels of 100 to 130 mg/dL (P<0.001).

Although the European Society of Cardiology (ESC) currently recommends that long-term statin treatment for patients with CAD should target LDL-C levels less than 70 mg/dL, new research suggests that the optimal level is actually a bit higher

Read more about it here.

 

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Happy Doctors Day | “Do we need to celebrate it?”

Happy Doctors Day

I woke up to this  message from our IMPA Clinical Pharmacology group which made made me to feel weird. I don’t know why it made me to feel so! Then there were bunch of similar messages from various groups, friends and family. Then i started to reply all with this deep thought in my mind: “What have we done to celebrate this Doctor’s day?”

The picture above is Dr.Mohit Naredi, President of Junior Doctors Association-Indore, resident of MYHospital, Indore who was grievously injured after patient’s kin attack him with drip stand. This happened last year.

Clinicians treat and save patients. But for a para-clinical faculty, teaching and training the future doctors are the paramount responsibility vested upon them. If the budding doctors are not taught the basics well, they are definitely going to fumble in therapeutics which eventually leads to poor understanding of patient’s situation. Foundation is most important and teaching needs passion and commitment towards making the students to learn the medical subjects in a enjoyable way. Above all, As quoted by , every doctor needs compassion towards their patients.

Clinicians treat and save patients. But for a para-clinical faculty, teaching and training the future doctors are the paramount responsibility vested upon them. If the budding doctors are not taught the basics well, they are definitely going to fumble in therapeutics which eventually leads to poor understanding of patient’s situation. Foundation is most important and teaching needs passion and commitment towards making the students to learn the medical subjects in a enjoyable way. Above all, As quoted by Dr.B.M.Hegde, every doctor needs compassion towards their patients.

Various countries celebrate Doctor’s day for various reasons and in India, it was established by the Government of India in 1991 to commemorate the birth of Dr. Bidhan Chandra Roy, a renowned physician, freedom fighter and the first chief minister of West Bengal. Read about his contributions here.


“National doctors day celebration has been marked as the day of respect for entire professional doctors who have made their great efforts in saving the life of patients. Doctors day means a whole day which has been dedicated to the medical profession especially for doctors and physicians to commemorate their efforts and roles. It is a day to say them vote of thanks for their love, affection and priceless care of their patients. Sometimes people get stuck in the wrong hand of irresponsible and unprofessional doctors which becomes the reason of public violence and protests against those doctors. This awareness campaign is the great way of attracting all the doctors and physicians at one place to bring them at one track of responsibility towards the life saving medical profession.”


“National doctors day is being celebrated for years by the government and non-government healthcare organizations in order to get familiar with the doctors contributions. Staff of the healthcare organizations organizes variety of events and activities for the campaign celebration. “Rotary Club of the North Calcutta and North East Calcutta Social & Welfare Organization” organizes big event every year for the grand celebration of the doctors day.

A discussion program is organized to discuss about the various aspects of medical profession such as health check-up, cure, prevention, diagnosis, proper treatment of the disease and so many. Rotational medical services by the doctors are also promoted and encouraged in the community for better and healthy social development. Free medical checkup camps are organized at many health centers and public places by the health care organizations to promote quality medical services without cost among common public.

General screening test camps are also organized to assess the health status, health counseling, health nutrition talks and chronic diseases awareness among poor people and senior citizens. Free blood test, random blood sugar test, ECG, EEG, blood pressure checkup and etc activities are organized to aware people about the priceless roles of doctors in everyone lives.

Some of the activities at the schools and colleges level are also organized for encouraging more youth students toward the dedicated medical profession. Discussion on the medical topics, quiz competitions, sports activities, availing scientific tools to students for the creative knowledge, implementing new and effective educational strategies for making the medical profession strong and more responsible.”


“On the 1st of July, the patients greet their doctors by distributing greeting cards, appreciation cards, Ecards, giving them bunch of flowers or bouquets, greeting messages through the mails and etc. Special meetings, party and dinner are organized at the health centers, hospitals, nursing homes or at homes by the doctors in order to commemorate importance of day and contributions of doctors towards medical profession.”


Now watch this video:

This is just one of the many incidences happening recently in India. With a situation prevailing like this,  the question, everyone has to ponder about is: “Do i need to celebrate Doctor’s day?”

Protest Against Assault on Doctors at Stanley Medical College, Chennai

Protest Against Assault on Doctors at Stanley Medical College, Chennai

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Improving ADR reporting habit

ADR reporting: Adverse Drug reactions are inevitable outcome of drug therapy. We can’t avoid it but we can try to mitigate it by expecting or predicting it based on the previous documented reports. Uppsala Monitoring Centre (UMC) in Sweden_WHO initiative, have provided certain guidelines and facilities to voluntarily report ADR by any health care faculty. In few countries, it is even done by patients themselves. But India lags behind reporting ADR even after setting up of National Coordination Centre by Pharmacovigilance Program of India (NCC-PvPI). The nodal body is Indian Pharmacopoeia Commision (IPC) at Ghaziabad which comes under the purview of Ministry of Health and Family Welfare, Govt. of India and works in collaboration with CDSCO, India.

Reason:

  • Being complacent
  • Lack of awareness
  • Lack of responsibility
  • Lack of sustained motivation by the nodal bodies
  • Lack of facilities

Indians have this “Chalta Hai” attitude for lot of things. If not all, many have. We just crib over lack of change but we never take steps to be a part of the movement which will bring change. Just being complacent for anything which happens to us.

This combined with lack of awareness and responsibility of such happenings do more harm than good. Many practitioners outrightly project reporting ADR is a responsibility of nurses or interns or Department of Pharmacology! Unless they intimate about an ADR, no signal can be detected! I have seen lame scenarios like physicians laughing over the reporting habit by just saying that “We will make sure ADR doesn’t happen in our wards”. Nothing more to be said. Period.

Lack of motivation by nodal bodies plays a big role in denting the reporting habits among the health care professionals. Starting PvPI program doesn’t ensue successful reporting. Previously there were many confusions like where to report, whom to contact for queries. But now IPC website mentions everything about reporting. Still just mentioning doesn’t give full flexibility in reporting. Many AMC (ADR Monitoring Centres) don’t have VigiFlow, a web-based Individual Case Safety Report (ICSR) management system that is specially designed for use by national centres in the WHO Programme for International Drug Monitoring. It is provided free of cost by WHO to report ADRs directly to UMC and to IPC. Login authorisation leads to uploading of ADRs. Many centers applied in vain and still waiting for any response from PvPI/IPC. Lack of these prime facilities still create a huge dent in reporting practices.

In many medical colleges, post graduate students walk through all the wards in the hospital to check for any ADRs, even after sensitising the practitioners and staff nurses towards reporting ADR. This “ADR collection” happens in this way even after:

  • Providing the contact numbers of the staffs of Department of Pharmacology
  • Providing the duty rosters with contact numbers of the duty PGs of department of Pharmacology
  • Providing ADR drop boxes at every wards
  • Sensitizing the clinicians at the weekly clinical meetings

So this lead to a scenario of frustration and lack of interest among the ADR “collectors”. Sometime later the whole habit of reporting vanished only to reappear when it’s mandatory requirement for some “regulatory purpose”.

As we all have become app savvy, Dr. Sachin Kuchya, Associate Professor of Pharmacology, NSCB Medical College, Jabalpur conceptualised and developed an android app, named ADR Reporting. Later he was invited by IPC / PvPI to give a presentation on the same which lead to the authorisation of the app by IPC as an official reporting app for ADRs. But a lack of clarity in the authorisation documents keeps the usage of the App under abeyance by many AMCs.

As quoted by him:

“Let me share something very relevant,this app has been my brainchild and I have invested close to (INR) 1.80 lakh plus, towards its development and updation (updating). With the help of NCC Pvpi, I could connect all the 179 AMC’s recognized till may 15, (2016) & also I could dedicate the app to the nation. Now, I don’t have money. What I wish henceforth that NCC Pvpi should take it forward. Develop even a better version, which works across all platforms, is user friendly. But again I wish to assure you all that it’s still the best way to report ADRs, let’s continue with the same. With the app based data, at least the reporter is verifiable, the paper based has everything questionable. Feel free to use the app and spread the same. Best wishes, however if you all need some assistance I am always their. Thanks and Regards.”

IMPAS.in appreciates Dr.Sachin Kuchya’s effort in developing and dedicating this app. We have few suggestions to improve the reporting habit through an app, either by this ADR Reporting app or by any third party app authorised by the Indian government. ( Note: Many Big Pharma have their own ADR reporting app developed for their own purpose and also a paid version for third party use)

  • Release the official authorisation document of the app by IPC in their website
  • Gov. of India should invite the cellular companies, as a part of their Corporate Social Responsibility (CSR) to provide free data usage for these apps which will promote the usage and reporting irrespective of the reporters data balance.
  • Go a level up and provide a smart phone, with inbuilt  authorised app for ADR reporting, used only for this purpose. Keep this in all the wards of the hospital. If it is made as a mandatory requirement for MCI recognition, all the colleges will be obliged to have this

But this app reporting is not the only solution. We as a healthcare faculty should have a moral responsibility of reporting any ADR. Even it’s a trifle reaction like itching or sneezing, it has to be reported as the severity varies between patients. and the responsibility of reporting has to be extended from the hands of department of Pharmacology to the clinical departments.

Recently we saw a spurt in the promotional activities of ADR reporting by NCC\PvPI. They have also started a WhatsApp group for discussion and promotional activities for ADR reporting. Send a request to #7042343309 to join the group.

India is moving towards a healthy ADR reporting practices. But this movement is in a snail pace. It needs to be speeded up and let’s all work towards it!

Also, recently IPC has initiated Hemovigilance program of India (HvPI) as an important tool for improving safe blood transfusion practices in a country. It is a set of surveillance procedures covering the whole transfusion chain from  the collection of blood and its components to the follow-up of its recipients intended to collect and assess information on unexpected or undesirable effects resulting from the therapeutic use of labile blood products and to prevent their occurrence and recurrence. In this program the blood banks has to be registered under HvPI and after which a username / password is provided to report the adverse events in the portal provided within the webpage. Click here to view HemoVigil. There is also a similar portal named DonorVigil.

IPC have also started Materiovigilance Programme of India (MvPI) to monitor the safety of medical devices in the country.

Useful Links:

ADR Reporting App: https://play.google.com/store/apps/details?id=sADRReporting.sADRReporting

ADR reporting form: http://www.cdsco.nic.in/writereaddata/ADR%20form%20PvPI.pdf

Medicinal Side Effects Reporting form_ENGLISH: (also available in major regional languages)  http://ipc.nic.in/writereaddata/mainlinkFile/File262.pdf

Transfusion Reaction Reporting Form: http://nib.gov.in/Haemovigilance/TRRF_Form.pdf

Also, check out this article written by Ashish Jain and Ravneet Kaur on “Hemovigilance and blood safety”, published in Asian Journal of Transfusion Science. Read this article hereJain A, Kaur R. Hemovigilance and blood safety. Asian Journal of Transfusion Science. 2012;6(2):137-138. doi:10.4103/0973-6247.98911.

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Active strain of wild poliovirus was detected in a water sample collected from a drain in Hyderabad | The virus emerges after 5 years.

Even with the “SWITCH” campaign going around…Poliovirus is back again… Sad!

Read about the news here.

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National Treatment Guidelines for Antimicrobial Use in Infectious Diseases!

Get it here

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Dr.kartar Lalvani | Singh is King: Even at 84 | Founder – Chairman of Vitabiotics

After years of slow and steady growth, Dr Kartar Lalvani has turned Vitabiotics into a market leader. Read what he told about his journey to success!

When Dr Kartar Lalvani founded Vitabiotics in London in 1971, it was the UK’s only specialist vitamin supplement company. Today, the company produces a range of well-known brands, including Wellwoman and Omega-H3, which treat everything from mouth ulcers to menopause. The global Vitabiotics Group turns over about US$371m a year and is driven by Lalvani and his son, Tej. But it wasn’t always plain sailing for the enthusiastic and modest Sikh businessman. Indeed, the company’s roots were in adversity.

Lalvani was born in Karachi in 1931. His father was a successful pharmacist and the family lived comfortably. But in 1947, the partition of India forced them to flee to Bombay, where they had to start their lives over from nothing. Lalvani recalls it as a devastating period in his life. Aged just 16, he had to leave his secure, contented life and move to an unknown city more than 500 miles away.

In retrospect, he says that this period of turmoil was the making of him. “Without partition, perhaps my brothers and I would not have been so entrepreneurial,” he says. “But because we witnessed my father losing everything, it made us determined that such a thing would not happen to us.” This fear of failure is what drove him on in the early days and it still does, despite Vitabiotics’ current success and his own personal wealth.

In the end, Lalvani followed in his father’s footsteps and studied pharmaceutical science in London, Germany and India. But it took more than a good knowledge of the subject to succeed in the pharmaceutical sector. It was the way he applied himself to his studies, to research and then to setting up and growing the business that really made the difference.

Lalvani arrived in London in April 1956 at the end of one of the coldest winters on record. He threw himself into his studies and completed a postgraduate degree in pharmacy at King’s College London. Then came a doctorate in medical chemistry at Bonn University in West Germany.

No pain, no gain But it was a personal issue that led Lalvani into business. At that time, he suffered from mouth ulcers and had failed to find a treatment on the market that worked for him. They might alleviate the immediate pain, but they didn’t cure the problem.

So, using a combination of vitamin C and powder taken from a diarrhea tablet, Lalvani managed to treat his condition successfully. The product, called Oralcer, would be the first in his new business’s pipeline. By then, it was 1971 — and it was also where the hard work started.

There were not many young Sikh entrepreneurs in London in the 1970s, and Lalvani found it difficult to get his ulcer treatment on the shelves of the larger high-street chemists, such as Boots. He then approached the UK’s larger pharmaceutical companies, hoping to license his formula, but they too chose not to work with him.

So convinced was he that his product worked that he set up his own company, Vitabiotics. Having spent all his savings on patenting the product, however, there wasn’t enough money to launch it with much fanfare. So he began to visit individual pharmacies personally. While this approach also proved fruitless — he only managed to sell £5 worth of Oralcer — Lalvani learned a valuable lesson about getting knocked back and having answers for any questions or concerns that were thrown at him.

Perhaps just as important as Lalvani’s persistence and determination was the degree to which he was prepared to make sacrifices. He worked harder and offered a better level of service than anyone else — and learned to live on a meager budget. “I was always overworked,” he says, “but happily overworked. I’d work 17 hours a day but be happy doing it.”

This was just as well as, in addition to trying to get Oralcer to market, Lalvani was working on his next product, a multivitamin called Omega H-3. He had also taken on his first employee and was taking his first steps into marketing and PR activity. It was with Omega H-3 that Lalvani got his first big break — but it didn’t come through UK sales.

Family fortunes:
With Vitabiotics turning over hundreds of million dollars a year and Kartar Lalvani himself said to be worth £100m, you might think that would be enough success for one family. But business obviously runs in its blood. Lalvani’s brothers, Gulu and Partap, founded Binatone, which imports and distributes consumer electronics. In the 1980s, they opened offices in Spain, Japan, South Korea, Hong Kong, India, Nigeria and Taiwan. In 1989 the company was divided, with Gulu (now Chairman of Binatone Electronics International) retaining the European and Hong Kong businesses and Partap (now Chairman of Binatone Industries) retaining the group’s businesses in Eastern Europe, Africa and South Asia. Their sister, Bina, after whom Binatone was named, is a successful fashion designer in India. Kartar’s daughter is studying for a law degree and his niece, Divia Lalvani, co-owns the successful London restaurant Zuma. Kartar’s other son, Ajit, is a professor at Imperial College, London, and a leading tuberculosis specialist. In October, the Royal College of Physicians honored his research into the development of new tools for treatment and control of TB with the prestigious Weber- Parkes Trust Medal. He has developed a new test that is, according to the judges, “the first significant advance on the century-old tuberculin skin-prick test and is significantly faster and more accurate”.
Lalvani’s brothers, Gulu and Partap (see box), were also forging entrepreneurial careers. Partap was working in Nigeria, so Lalvani tried Omega H-3 there and it was a success. It was the impetus Vitabiotics needed.

But just when the time seemed right to expand, Lalvani hit a stumbling block common to all entrepreneurs: access to finance. Developing pharmaceutical products and setting up a new business isn’t cheap, but the banks wouldn’t lend to him. In fact, despite having had an account with the same bank since 1957, it wouldn’t give him a loan. While this frustrated the rate at which Vitabiotics could grow, Lalvani says the experience forced him to focus, concentrate on value for money and approach expansion and investment with caution.

Today, Vitabiotics exports to more than 100 countries and has 20 UK brands, eight of which are number one in their markets. It employs 2,200 people and has factories and offices in six countries Lalvani may have struggled to find funding at first, but turnover is now about US$371m a year, with UK sales making up about 25% of that total.

These days, Lalvani works in partnership with his son Tej. The pair, along with Vitabiotics’ Vice President and Marketing Director Robert Taylor, plan the future growth strategy of the company.

While Tej accepts that it is very much his father’s company, both father and son see the relationship as positive and say they have no difficulties separating business and family life. And both hasten to add that it wasn’t a case of Tej being given a senior position at Vitabiotics just because his father was the founder.

“I started out driving forklift trucks in a warehouse,” says Tej. “But I wanted to do it that way — it is important to understand how all the different parts of the business operate and to see how important each part is.”
Without borders stats:
As Lalvani prefers to be based in the UK, it’s down to Tej to lead the global business development of Vitabiotics. It’s a busy period in the firm’s history: it is building a new factory in Egypt, acquiring a manufacturing plant in Indonesia and looking to significantly expand its US presence. “We look at the demographics of a country, the economic fundamentals, and generally start in a new territory by working with a distributor and going from there,” says Tej. “If sales are strong.

Read more about him and vitabiotics here:

http://www.naturalproductsonline.co.uk/dr-kartar-lalvani-wins-maurice-hanssen-award-of-honour/

https://www.vitabiotics.com/ourhistory

https://www.asian-voice.com/Opinion/Columnists/Rani-Singh/Dr-Kartar-Lalvani-OBE-The-Vitamin-King-Making-People-Healthier

http://articles.economictimes.indiatimes.com/2013-03-24/news/37981375_1_nri-entrepreneur-indian-origin-entrepreneur-vitabiotics

http://www.telegraphindia.com/1110829/jsp/entertainment/story_14437516.jsp

Also read about his book: “The Making of India – The Untold story of British Enterprise”
https://books.google.co.in/books/about/The_Making_of_India.html?id=Q3_IsgEACAAJ&redir_esc=y

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Heartless human…Literally!

This is phenomenal!!
Great feat! Now the question here is wat kind of anticoagulants will be given for this patient? Check out this video.

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Streaming Full Movie The Fate of the Furious (2017) English Full Episodes Online Free Download

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Quality : HD
Title : The Fate of the Furious.
Director : F. Gary Gray
Release : April 12, 2017
Language : en.
Runtime : 136 min
Genre : Action, Crime, Thriller.

Synopsis :
‘The Fate of the Furious’ is a movie genre Action, Crime, Thriller, was released in April 12, 2017. F. Gary Gray was directed this movie and starring by Vin Diesel. This movie tell story about When a mysterious woman seduces Dom into the world of crime and a betrayal of those closest to him, the crew face trials that will test them as never before.

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Good actionable insight for Pharma Marketers post UCPMP

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Yet an another pioglitazone controversy!

The results of this large population based study indicate that pioglitazone is associated with an increased risk of bladder cancer. The absence of an association with rosiglitazone suggests that the increased risk is drug specific and not a class effect. Read about the study here.

Now let’s wait for the drug regulators action!!

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MaMaPrint | Segregating breast cancer patient for Chemotherapy

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A genomic test called “MaMaPrint”, by Agendia, segregates breast cancer patients whether they need chemotherapy or not. This is not a new approach. MaMaPrint got FDA approval on 2007. But scepticism among the practitioners kept it at bay. But now the American Association of Cancer Research endorsed its use at their recent meeting at New Orleans a couple a days back.

Read more about this news here. And read about “MaMaPrint” test here

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Know about your blister packs!!

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Cost of medical error=Death

Medical error is the third leading cause of death in the United States, after heart disease and cancer, according to findings just published in BMJ.

Similarly, a viewpoint was just published in JAMA with the title ‘Patient Safety at the Crossroads’ regarding the same concern of medical errors.

But unfortunately, there is severe dearth of such kind of data from our country….
Also check the BMJ podcast on this.

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Portable Heart in Box

Imagine a heart can be transported without stopping its beat!! Now watch this video

TransMedics Portable Heart in Box is here!!

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Watch Full Movie Online And Download Captain America: Civil War (2016)

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Quality: HD
Title : Captain America: Civil War
Release : 2016-04-27.
Language : English.
Runtime : 146 min.
Genre : Action, Science Fiction.
Stars : Chris Evans, Robert Downey Jr., Scarlett Johansson, Sebastian Stan, Anthony Mackie, Don Cheadle.

Following the events of Age of Ultron, the collective governments of the world pass an act designed to regulate all superhuman activity. This polarizes opinion amongst the Avengers, causing two factions to side with Iron Man or Captain America, which causes an epic battle between former allies.

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Update on 2013 ACCF/AHA Guideline for the Management of Heart Failure

The 2013 ACCF/AHA Guideline for the Management of Heart Failure has been updated by the American College of Cardiology/American Heart Association Task Force and Heart Failure Society of America. This focused update on new pharmacological therapy for heart failure has been based on various RCTs, that have studied the role of new drugs such as ARNI and ivabradine in patients with heart failure. The guidelines were published ahead of print in the journal Circulation, on May 20th

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Good Publishing Practices

If your are interested in publications of your research work, well here are the benefits

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Supreme Bug!

U.S. sees first case of bacteria resistant to all known antibiotics.

U.S. health officials on Thursday reported the first case in the country of a patient with an infection resistant to all known antibiotics, and expressed grave concern that the superbug could pose serious danger for routine infections if it spreads.

“We risk being in a post-antibiotic world,” said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, referring to the urinary tract infection of a 49-year-old Pennsylvania woman who had not travelled within the prior five months.

Frieden, speaking at a National Press Club luncheon in Washington, D.C., said the infection was not controlled even by colistin, an antibiotic that is reserved for use against “nightmare bacteria.”

The infection was reported Thursday in a study appearing in Antimicrobial Agents and Chemotherapy, a publication of the American Society for Microbiology. It said the superbug itself had first been infected with a tiny piece of DNA called a plasmid, which passed along a gene called mcr-1 that confers resistance to colistin.

“(This) heralds the emergence of truly pan-drug resistant bacteria,” said the study, which was conducted by the Walter Reed National Military Medical Center. “To the best of our knowledge, this is the first report of mcr-1 in the USA.”

The study said continued surveillance to determine the true frequency of the gene in the United States is critical.

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Deep Brain Stimulation (DBS) of surgically implanted system in brain!

The video is simply amazing especially to see the eyes of that patient when his tremors got mitigated!

Not all patients are be eligible for this: only patients whose tremor & Stiffness are not controlled by drugs are the most appropriate candidates.

Eligible patients and Mechanism:
FDA gave approval for three such systems consisting of either a micro-eletrode or a pacemaker like electronic device, implanted under the skull, which blocks the electrical signals from the targeted areas in the brain such as Sub-Thalamic Nucleus (STN) & Globus Pallidus interna (GPi), a lead wire connecting the implanted device to the Neurostimulator placed near the collarbone/Chest/Abdomen under the skin.

Any of ur dearones is suffering from PD? Check out these sites:
1) http://www.dbs4pd.org/

2) http://www.parkinson.org/understanding-parkinsons/treatment/surgery-treatment-options/Deep-Brain-Stimulation

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Cipla partner Stempeutics gets DCGI nod for stem cell-based product

Cipla – Stempeutics tie up | DCGI grants limited approval for manufacturing and marketing of Stempeucel-First of kind product in India-for the treatment of Critical Limb Ischemia due to Buerger’s Disease.Watch Full Movie Streaming Online and Download

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Delhi HC reserves verdict on pleas against ban on 344 FDCs

On May a total of 334 FDC were banned by the central government. But this created a big ruffle among the practitioners. The Delhi HC kept asking the government what’s the urgency in banning these FDCs?

Recently during arguments in the HC, the drug companies had contended that government has not properly implemented the powers under section 26A (power to prohibit manufacture of drugs and cosmetics in public interest) of Drugs and Cosmetics Act under which the ban was ordered. They had also argued that the ban order was passed without considering clinical data and termed as “absurd” government’s claim that it took the decision to ban FDCs on the ground that safer alternatives were available. Thus the Delhi High Court on Thursday reserved its verdict in over 450 petitions filed by drug and healthcare majors challenging the Centre’s decision to ban 344 fixed dose combination (FDC) medicines, including well known brands like Corex cough syrup, Vicks Action 500 extra and D’Cold.

  • Read about the full report about the ban here
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Syncardia-Total artificial heart for biventricular failure | Heart on a Back pack!

Stan2 Syncardia

 

 

 

 

 

Stan Larkin – The first patient in Michigan ever discharged with a SynCardia temporary total artificial heart in 2014, underwent a traditional heart transplant 1 week ago in May 2016 at the University of Michigan Frankel Cardiovascular centre. Awesome video of Stan on youtube.

Read about the artificial heart here. Also read about the full news here

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Current status of Healthcare in India: Dr.Vishal Bali

 

 

Dr.Vishal Bali says: “Healthcare needs to be made into a national agenda if India aims to provide affordable means of treatment based on new age technology to its citizens”

Read What he said to ETHealthWorld.com here.

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