No online sale of medicines till norms in place, says HC

Agencies
December 18, 2018

New Delhi, Dec 18: The Delhi High Court on Tuesday said its stay on sale of drugs and prescription medicines by online pharmacies will continue till rules are framed to regulate such entities.

A bench of Chief Justice Rajendra Menon and Justice V K Rao said that "once the rules come into play, you (online pharmacies) can start selling it (medicines). Problem is that today there are no rules regulating it".

The observations by the bench were made while hearing the applications moved by some online pharmacies seeking to be impleaded in the matter.

The pharmacies urged the court to remove the prohibition on online sale of drugs, saying they held licences and no medicines were sold illegally.

They also contended that even prescription drugs were sold only if there was a valid prescription from a doctor.

The applications for impleadment were filed in a PIL by Zaheer Ahmed seeking a ban on "illegal" sale of drugs and medicines online.

During the hearing, the petitioner informed the bench that the Madras High Court on Monday had banned online sale of medicines till the Union Health Ministry and the Central Drugs Standard Control Organisation (CDSCO) notified the proposed Drugs and Cosmetics Amendment Rules, 2018 in the gazette at the earliest by January 31.

The Madras High Court, however, kept the operation of its order in abeyance till December 20, to enable the online pharmacies to challenge the decision.

On being informed of the development, the Delhi High Court listed the matter for hearing on December 20.

In his petition, Ahmed has said that the online illegal sale of medicines would lead to a drug epidemic, drug abuse and mis-utilisation of habit forming and addictive drugs.

It has claimed that the Ministry of Health, CDSCO and an expert committee appointed by the drug consultative committee have already concluded that the online sale of medicines was in contravention of the provisions of Drugs and Cosmetics Act, 1940 and the other allied laws.

Still lakhs of drugs are being sold on the Internet every day, it has said, adding that some of the drugs/ medicines contain narcotic and psychotropic substance and some can cause antibiotic resistant-bacteria which is a threat not only to the patient but to the humanity at large.

"It is a matter of public knowledge that e-commerce websites have been caught on numerous occasions of selling fake products. Unlike consumer items, drugs are extremely potent substances and consuming wrong dose or fake medicine can have fatal consequences on the patient," it said.

The petition said that as of now there is no mechanism to control the sale of medicines on the Internet and this puts health and lives of people at a high risk and affects their right to a safe and healthy life under Article 21 of the Constitution.

"Online pharmacies are operating without a drug licence and cannot be regulated in the present regime. Unregulated and unlicensed sale of medicines will increase risk of spurious, misbranded and sub-standard drugs being sold," the plea has said.

The plea has sought direction to the authorities to take action against the entities distributing, selling or exhibiting drugs on the internet.

It has also sought direction for constitution of an expert committee to find out the total number of websites which are distributing and selling the drugs in the country and to impose a ban on the online sale and purchase of medicines.

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Agencies
June 29,2020

Washington DC, Jun 29: Young children with narrow retinal artery diameters were more likely to develop higher blood pressure, and children with higher blood pressure levels were more likely to develop retinal microvascular impairment during early childhood, according to a new study.

The first study to show this connection in children was published today in Hypertension, an American Heart Association journal.

High blood pressure, the main risk factor for the development of cardiovascular disease (CVD), can manifest as early as childhood, and the prevalence of high blood pressure among children continues to rise. In previous studies, analysis of blood vessels in the retina has shown promise as a predictor of CVD risk among adults. In the study titled, "Retinal Vessel Diameters and Blood Pressure Progression in Children," researchers sought to predict the development of high blood pressure in children over four years based on retinal blood vessel measurements.

"Hypertension continues as the main risk factor for the development of cardiovascular diseases and mortality," says Henner Hanssen, M.D., the study's lead author and a professor in the department of sport, exercise and health at the University of Basel in Switzerland. 

"Primary prevention strategies are needed to focus on screening retinal microvascular health and blood pressure in young children in order to identify those at increased risk of developing hypertension. The earlier we can provide treatment and implement lifestyle changes to reduce hypertension, the greater the benefit for these children."

Researchers screened 262 children ages six to eight from 26 schools in Basel, Switzerland, in 2014, for baseline blood pressure and retinal arterial measurements. Both measures were taken again in 2018. Blood pressure measurements at both baseline and follow-up were performed in a sitting position after a minimum of five minutes of rest and were categorized based on the American Academy of Pediatrics' blood pressure guidelines. These guidelines utilize the same measurements as the American Heart Association/American College of Cardiology 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.

Results from the analysis indicate: children with narrower retinal vessel diameters at baseline developed higher systolic blood pressure at follow-up; retinal vessel diameters could explain 29 -31 per cent of the changes in systolic blood pressure progression between 2014 and 2018; children with higher blood pressure levels at baseline developed significantly narrower arteriolar diameters at follow-up, depending on weight and cardiorespiratory fitness; and initial blood pressure measures explained 66-69 per cent of the change in retinal arteriolar diameter from baseline to follow-up.

"Early childhood assessments of retinal microvascular health and blood pressure monitoring can improve cardiovascular risk classification. Timely primary prevention strategies for children at risk of developing hypertension could potentially counteract its growing burden among both children and adults," said Hanssen.

Researchers noted limitations of their study include that they could not confirm blood pressure measurements over a single 24-hour period, so they would not account for "white coat" hypertension, a condition where patients have high blood pressure readings when measured in a medical setting.

Developmental stage including puberty status of each child was not accounted for in the study, as well as genetic factors or birth weight - variables that could impact blood pressure development and microvascular health.

In addition, reference values for appropriate retinal vessel diameters in children do not currently exist, so future studies are needed to determine age-related normal values during childhood.

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Agencies
February 6,2020

Researchers have found the rates of lung cancer are higher in young women than men.

The study, published in the journal Pediatrics, examined lung cancer rates in young adults in 40 countries across five continents and uncovered a trend of higher lung cancer rates in women compared with men in recent years.

The emerging trend was widespread, affecting countries across varied geographic locations and income levels.

The changes appeared to be driven by a rising rate of adenocarcinoma lung cancer among women, said the study researchers from University of Calgary in Canada.

Lung cancer rates have been higher among men than women because men started smoking in large numbers earlier and smoked at higher rates; however, recent studies have reported converging lung cancer incidence rates between sexes.

Among men, age specific lung cancer incidence rates generally decreased in all countries, while in women the rates varied across countries with the trends in most countries stable or declining, albeit at a slower pace compared to those in men.

For the findings, lung and bronchial cancer cases between 30-64 age group from 1993-2012 were extracted from cancer incidence in five continents.

The study found the higher emerging rates of lung cancer in young women compared to young men.

According to the researchers, future studies are needed to identify reasons for the elevated incidence of lung cancer among young women.

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Agencies
June 10,2020

Early treatment with the antiviral drug remdesivir has been found to reduce viral load and prevent lung disease in macaques infected with SARS-CoV-2 that causes COVID-19, according to a study.

The findings, published in the journal Nature on Tuesday, support the early use of remdesivir treatment in patients with COVID-19 to prevent progression to pneumonia.

Researchers from the National Institutes of Health in the US noted that remdesivir has broad antiviral activity and has been shown to be effective against infections with SARS-CoV and MERS-CoV in animal models.

The drug is being tested in human clinical trials for the treatment of COVID-19, they said.

Researcher Emmie de Wit and colleagues investigated the effects of remdesivir treatment in rhesus macaques, a recently established model of SARS-CoV-2 infection.

Two sets of six macaques were inoculated with SARS-CoV-2.

One group was treated with remdesivir 12 hours later -- close to the peak of virus reproduction in the lungs -- and these macaques received treatment every 24 hours until six days after inoculation.

In contrast to the control group, the researchers found that macaques that received remdesivir did not show signs of respiratory disease, and had reduced damage to the lungs.

Viral loads in the lower respiratory tract were also reduced in the treated animals; viral levels were around 100 times lower in the lower-respiratory tract of remdesivir-treated macaques 12 hours after the first dose, they said.

The researchers said that infectious virus could no longer be detected in the treatment group three days after initial infection, but was still detectable in four out of six control animals.

Despite this virus reduction in the lower respiratory tract, no reduction in virus shedding was observed, which indicates that clinical improvement may not equate to a lack of infectiousness, they said.

Dosing of remdesivir in the rhesus macaques is equivalent to that used in humans, the researchers noted.

They cautioned that it is difficult to directly translate the timing of treatment used in corresponding disease stages in humans, because rhesus macaques normally develop only mild disease.

However, researchers said the results indicate that remdesivir treatment of COVID-19 should be initiated as early as possible to achieve the maximum treatment effect.

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