1-Oct-2019: Government plans penicillin revival to fight rheumatic fever
In a bid to fight drug resistance and tackle rheumatic heart disease, the Government of India is planning a revival of penicillin, one of the oldest antibiotics known to man. Not many organisms have developed resistance to it yet.
Penicillin went out of production in India because of unrealistic price control. The government is now planning to procure penicillin centrally for three years and give it to all children between 5-15 years who have a sore throat, at least once. The drug will be dispensed through primary health centres or administered by ASHAs.
A committee has been formed with officials from the department of health research to finalise the contours of the plan to tackle rheumatic fever and heart disease burden and revive penicillin.
Health ministry officials are exploring various options including talking to the National Pharmaceutical Pricing Authority to take it off the price control list. Also, to kickstart production, they are looking at procuring the medicine centrally — enough stock for three years so that manufacturers are encouraged to restart production.
Penicillin, discovered in 1928, is still the first line antibiotic in many western countries, but it gradually went out of the Indian market even though some of its more expensive derivatives continue to be prescribed.
Population-based studies indicate the prevalence of rheumatic heart disease in India to be about 2/1000 population. However, surveys conducted in school children in the age group of 5-16 years by ICMR gives overall prevalence of 6/1000. Rheumatic fever is endemic in India and remains one of the major causes of cardiovascular disease, accounting for nearly 25-45% of acquired heart disease. Not all sore throats go on to become rheumatic fever with severe joint pain or affect the heart in a disease that eventually leaves no option but to replace the heart valves — a condition known as rheumatic heart disease. However, doctors say, it is better to give an antibiotic dose and nip the possibility in the bud.
Penicillin is one of the oldest antibiotics and in many western countries still remains the first antibiotic. Yet in India it has almost gone out of the market because of price control. The prices were kept so low that manufacturers stopped making the drug. On the other hand, India has a high burden of rheumatic fever and rheumatic heart disease — the latter often goes undiagnosed and leads to many maternal deaths at the time of childbirth. The first presentation often is a sore throat, so we are looking at giving a course of penicillin to all children between 5-15 years once.
21-Jun-2019: A medicated nail enamel to help fight infection
A fungus, Trichophyton rubrum, causes painful infection of toe and fingernails. Prevalent in coastal regions and wet work zones, the infection known as Onychomycosis accounts for about half of all nail diseases. It causes brittleness, discolouration and disfigurement of nails.
The disease needs prolonged treatment with both oral medication and application of ointments, which are both expensive and have side effects.
Researchers from the Delhi-based Hamdard Institute of Medical Sciences and Research have now developed a novel translucent nail lacquer fortified with an antifungal drug to treat onychomycosis. The drug-infused, quick-drying polymer can be easily applied like nail polish.
This nail lacquer has shown promising results in delivering the antifungal drug for extended durations indicating its potential use as a topical application and effective remedy to treat onychomycosis.
The antifungal Bilayer Nail Lacquer (BNL) reduces the need for frequent drug application, improves cosmetic appearance and yields fruitful therapeutic outcomes. It overcomes problems associated with conventional formulations and offers a novel drug delivery platform for the successful treatment of onychomycosis.
The researchers used readily available and approved antifungal drug Luliconazole and incorporated it into the matrix of a polymer. The drug was mixed with an organic solvent by using a magnetic stirrer. To this solution, film-forming polymers, plasticisers, humectants, and permeation enhancers were added sequentially to obtain the polymer. The drug-laden, water compatible polymer was obtained after evaporating the solvent.
Following a similar process, a drug-free, waterproof polymer was fabricated as the protective coat. The X-ray diffraction analysis of the formulation showed smaller crystalline area compared to that of the pure drug, indicating its efficacy.
To conduct nail permeation studies, researchers tested the polymer on bovine hooves, as their outer structure is similar to that of the human nails. The tests revealed that the lacquer had an extensive nail plate coverage with high adhesion of the polymer. Over 24 hours, 75% of the drug was released to the nail exhibiting its ability for prolonged drug delivery. The lacquer was also tested in animals for skin-safety and tolerability and found to be within the tolerable limits.
The researchers are now looking for industry collaboration to develop their innovation into a pharmaceutical product.
4-Jun-2019: India's deadly Nipah virus resurfaces in Kerala
A 23-year-old student has contracted the lethal Nipah virus which resulted in 17 deaths in southern India last year. The virus, which has no known vaccine, is an infectious disease that can cause an inflammation of the brain, according to the World Health Organization. As a result, it is on the institution's "priority pathogen" list alongside Ebola.
Despite four other people showing Nipah-like symptoms, There is no need for panic. The contagious virus can be caught from bats or pigs and takes its name from Sungai Nipah, the Malaysian settlement where it was first identified.
There was an initial outbreak of the disease, which killed in excess of 100 people across Malaysia and Singapore, in the late 1990s. In an attempt to prevent infections spreading, approximately one million pigs were terminated, drastically affecting the Malaysian pig farming industry.
It has a mortality rate of 70 per cent and its symptoms include fever, headaches, convulsions and difficulties in breathing.