Tag: The Medicine Box

Understanding Digestive Health: Insights from gastroenterology expert Dr Amit Maydeo

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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The human gut, often likened to Pandora’s Box or the Magician’s Box, stands as one of the most captivating organ systems in our bodies. Dr Amit Maydeo, a renowned expert in gastroenterology, sheds light on the intricacies of the gut and its pivotal role in maintaining overall health.

The gut, Dr Maydeo emphasises, is not merely a singular entity but a sophisticated network comprising 14 distinct organs. These organs, akin to an orchestra, harmonise their functions under the guidance of the brain and nervous system, ensuring seamless digestion and absorption of nutrients.

Central to the gut’s functionality is its vast microbial community, housing over 30 trillion bacteria of diverse species. Dr Maydeo underscores the significance of maintaining a delicate balance between beneficial and harmful bacteria to support optimal digestive health.

However, imbalances in the gut ecosystem can arise from various factors, including diet, lifestyle, and environmental influences. Dr Maydeo highlights that acidity, a common digestive issue among Indians, often stems from wrong food choices, irregular eating patterns, and stress.

Acidity, if unresolved, warrants medical attention, particularly if accompanied by symptoms like tightness in the stomach or frequent reflux. Dr Maydeo suggests endoscopic examinations to diagnose underlying digestive issues, including inflammation or infections like H. pylori.

Moreover, Dr Maydeo warns that chronic acidity could signal early-stage stomach or oesophagal cancers, underscoring the importance of timely medical intervention.

Moving beyond acidity, Dr Maydeo addresses other prevalent digestive concerns such as constipation, especially among children. He emphasises the role of dietary habits, including the consumption of fibre-rich foods and the establishment of regular bowel routines, in alleviating this condition.

Discussing gastrointestinal cancers, Dr Maydeo highlights risk factors such as tobacco use and dietary habits high in non-vegetarian foods. He advocates for preventive measures like increased intake of vegetables, fruits, and fibre to mitigate the risk of colon cancer.

While there’s no specific preventive testing for digestive diseases, Dr Maydeo recommends screenings like colonoscopies for early detection of abnormalities, especially in individuals with a family history of cancer or high non-vegetarian consumption.

Also Read: Merck drug for rare form of high blood pressure gets US nod

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Medicine Box — Is one glass of wine a day good for health?

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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The Republic of Ireland is set to introduce health warning labels on alcohol products. While the new regulation will not come into place until 2026, it is important to highlight that Ireland is the first country to warn against alcohol consumption.

Labelling will warn consumers about the risks of drinking alcohol, provide information about the calories it contains and the amount of alcohol present in the drink. The warning will include dangers of drinking during pregnancy and cancer risks associated with alcohol consumption.

It’s important to note that India is one of the fastest growing markets for alcohol, the health repercussions of which we should watch. As of 2020, the size was estimated at $52.5 billion is expected to grow close to seven percent on CAGR basis by 2023. The number of people consuming alcohol increased from around 22 crore in 2015 to nearly 30 crore in 2018 and is projected to rise to close to 40 crore by 2030.

Also Read: No safe limit of alcohol consumption for health: WHO study

So, back to the health warnings on alcohol products – it brings up the question on how harmful is alcohol? There are different viewpoints on it.

For example, the World Health Organization (WHO) in its report published earlier this year looks to bust the view that one glass of red wine a day is good for the heart. According to the WHO, no level of alcohol consumption is safe for health, no matter how expensive or well distilled it is. Even light or moderate consumption, according to the WHO, is considered a risk.

WHO describes alcohol as a toxic, psychoactive and dependence producing substance. It, in fact, joins the ranks of tobacco and radiation as being a Grade 1 carcinogen or cancer causing substance, according to the International Agency for Research on Cancer. Other diseases linked to alcohol consumption include heart disease, nerve damage, and mental health issues such as depression and dementia and not to mention liver damage, the organ which is used to flush out alcohol from the body.

So is there any safe amount? WHO doesn’t think there is any safe level. The risk starts from the first drop. Hence, according to the health agency, the less you drink the safer it is. Several experts, however, are of the opinion that the amount of alcohol one drinks is important and not the kind of alcohol. Yes, once in a while a little too much alcohol won’t have lasting damage but the problem arises if one drinks either consistently. For example, two drinks a day consistently increases the risk of liver damage or is one drinks heavily regularly. Drinking heavily regularly is defined as around more than four drinks a day or 14-15 a week for men or more than three drinks a day for women or 7-8 per week.

Also Read: Tips and tricks to pair Indian food with wine, beer and cocktails

So the answer it seems lies somewhere in the middle. Mayo Clinic, for example, says if you are a light to moderate drinker and healthy otherwise, you can continue to do so but only if done responsibly. The important point to remember is that any amount of alcohol can cause liver damage but the level of damage may vary based on factors such as amount, frequency along with factors such as underlying conditions

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

India is an exciting opportunity for us, says Amneal Pharma

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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Amneal Pharmaceuticals is a company that specializes in developing and manufacturing high-quality generic and specialty pharmaceuticals. Recently, the President and Co-CEO, Chirag Patel, spoke to CNBC-TV18 about the challenges and opportunities facing the pharmaceutical industry.

Patel also spoke about the opportunities in the Indian market, which he sees as a big market that will grow substantially in all aspects.

“India is a big market, we believe that India will be growing substantially beyond imagination in all aspects as India’s economy is doing so well and will continue to do so well and we are very happy about it,” he said.

He noted that awareness for patients is increasing in India, and that there is a growing need for innovation in areas like rare diseases, which impact 9 percent of the population.

“The insurance coverage awareness for patients providers is increasing and that will drive tremendous growth in India in upcoming years,” he said.

“India is an exciting opportunity for us,” he added.

Also Read | Data integrity, difference in regulatory standards and more — Takeaways from BioAsia compliance panel

Amneal Pharmaceuticals, founded by two Indian origin brothers Chirag Patel and Chintu Patel in 2002, with over $2 billion in sales, is the third largest affordable medicine player in the US market currently. The company, which gets majority of its business from the US currently, says that price pressure is in low double digits and is not sustainable.

Patel noted that this level of price pressure – 10-12 percent price pressure in the US alone – is not sustainable in the long term, and that companies need to keep investing in manufacturing and quality infrastructure to remain competitive.

However, Patel also highlighted that these savings are not going to the patient, and that the industry needs to find new ways to create value for patients.

One way that Amneal is doing this is by focusing on specialty products and injectable drugs, which are seeing a faster pace of growth.

Also Read | Research firm pegs Indian pharma market’s growth at 2.3% in January — oncology, derma segments see growth

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Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

3 Mins Read

Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

The Medicine Box | India’s love with topical steroids

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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How often have you been told by a friend, family member or even your beautician to apply a certain medicated cream for your acne or say a mild rash? Have you used a steroid-based cream for longer than prescribed or even at your own discretion if say the skin irritation returns? Or have you wondered why your friend is using a cream containing the steroid betamethasone to lighten her skin?

Today, besides antibiotics, another set of drugs in India are being used irrationally — these are topical corticosteroids which are basically creams, ointments or skin products that contain steroids. Topical steroids have been in use for six decades in the country and comprise over 80 percent of the total dermatology product sales in the country. They are effective in providing almost immediate relief in autoimmune, inflammatory and other dermatological conditions. But the problem arises with the unrestricted access of topical corticosteroids resulting in overuse, misuse and abuse.

Today, studies indicate around 10 out of a 100 people in the country buy topical steroids because a dermatologist told them to. Over four out of 10 people buy topical steroids on their own or without a prescription. 20 percent buy them because they are recommended by their friend, family member or neighbor and over 8 percent buy it because their beautician told them.

Today, over 95 percent of the patients who buy topical steroids in the country are unaware of their adverse effects and most of them, in some studies 100 percent, don’t know how often and how much to of the cream to use either. A dermatologist and head of department at a public hospital in Mumbai points out a 25 percent rise in patients who have misused steroid creams in just the last 4-5 years.

Also Read: The Medicine Box | Here’s why hospitals are bullish on the prospect of medical tourism

Topical steroids are misused in India due to the same reason antibiotics are misused in the country. The lack of enforcement of prescriptions, that is,  you can buy the drug like an over the counter product. Dermatologists also point out that high potency creams are recommended by general practitioners and even pediatricians without knowing what the consequences are. For example, even small doses of high potency steroids can result in systemic absorption with children and elderly being more susceptible to it.

Also, one must be wondering why beauticians are recommending steroid creams? This is linked to an important issue of topical prescription drugs being used as fairness creams. Today, over 50 percent of topical steroids bought without a prescription are used mainly to lighten skin as they reduce melanin the natural skin pigmentation present in the body. Majority of the users are women between the ages of 10-29 years, and the most used drug is Betamethasone. Dermatologists point out that they have seen cases of women applying clobetasol one of the strongest steroid creams available as a fairness cream for over 25 years. We in India are also guilty of using other harmful substances such as hydroquinone as skin lighteners which in fact has been banned from use in cosmetics in several geographies such as Japan, UK and Europe due to its risk to human health.

Steroid creams are used mainly for symptomatic relief with the underlying pathological issue remaining unresolved and many a times continuing to aggravate. Doctors point out that this is especially the case in fungal infections where long-term usage of steroid based fungal creams can in fact worsen conditions

Also using steroid creams is a vicious cycle in fact doctors say it is addictive. For example, stopping prolonged use of steroid creams can result in almost immediate side effects such as itchy rashes, redness. Patients then tend to reuse the drug to control these side effects which then leads to inability to wean off it. Long term side effects range from thinning of the skin, redness, acne, lesions, puffiness, consistent burning, discoloration to more severe skin issues for example Tinea a group of diseases caused by fungus or weight gain, hormone fluctuation due to systemic absorption of creams.

So what needs to be done? Experts say the government needs to make prescriptions necessary for dispensing these medications. In 2016, the government did ban certain fixed dose combinations creams containing steroids and in 2018 the government banned over the counter sale of 14 steroid-laden fairness creams they need to do more. Experts say there is a need to consistently relook and monitor the combination creams and fairness products available and prevent the sale of the drugs without prescriptions. Lastly, one of the other measures include awareness within the doctor community and among patients and especially the people who self-medicate.

Also Read: The Medicine Box | Top hospital heads on growth drivers for preventive and predictive health space

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

3 Mins Read

Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

The Medicine Box | Here’s why hospitals are bullish on the prospect of medical tourism

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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[wealthdesk shortname=”Apollo Hospital” isinid=”INE437A01024″ bseid=”508869″ nseid=”APOLLOHOSP” sector=”Hospitals & Medical Services” exchange=”nse”]

Hospitals are bullish on the prospect of medical value travel or medical tourism. Initiatives such as ‘Heal In India’ by the government will add impetus as it is expected to increase transparency. Indian hospitals have the advantage of not only clinical skills and cost but softer skills such as proficiency in English. Here is what the top hospital heads of Medanta, Fortis and Apollo Hospitals had to say on medical value tourism.

While speaking to CNBC-TV18’s Ekta Batra, Dr Naresh Trehan, Chairman and MD of Medanta said before COVID-19, around 12 percent patients were international. However, it fell to 3-4 percent and now rising again.

He further added that medical tourism recovery is much faster. The biggest bottleneck has been visas — pending visas have been issued. There are around 140 visas waiting in Iraq to come.

Also Read: Apollo Hospitals targeting occupancy level of 70%, says Suneeta Reddy

According to him, government schemes have helped trigger medical tourism and India has a huge future when it comes to the same, adding that India has the highest level of care across all specialities. India provides quality, cost effective services and is more universal in English versus other countries. India has a good image and is improving, he said.

Meanwhile, Dr Ashutosh Raghuvanshi, MD and CEO of Fortis Healthcare, said medical tourism is around 10 percent of sales. He expects it to rise to 12-15 percent in the next 1.5 to 2 years.

According to him, Heal In India will bring transparency in interactions. However, one of the challenges is general infrastructure in healthcare.

While Apollo Hospitals’ MD Suneeta Reddy said medical value tourism should be around 7 percent of sales in FY23E (estimated). According to her, medical value tourism on absolute basis has risen 19 percent from 2020 and the potential for medical value tourism can go to 20 percent of sales.

Apollo Hospitals will be a big player in Medical tourism due to its locations, she said.

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

The Medicine Box | Top hospital heads on growth drivers for preventive and predictive health space

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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One of the trends emerging post COVID-19 in healthcare is preventive health — predictive health, personalised medicine across specialties from diabetes to oncology as areas of focus.

In this CNBC-TV18’s special series The Medicine Box, Dr Naresh Trehan, Chairman & MD at Medanta; and Suneeta Reddy, Managing Director of Apollo Hospitals decode the segment and possible growth drivers for preventive health space post COVID-19.

While giving the larger picture for Apollo Hospitals, Reddy said, “You will see Apollo as a network which has hospitals which has primary care touch points as well as the pharmacy.”

She said her vision is that for the consumer the facility complete the entire healthcare offering. 360 degree offering, “but we are not transactional, we are pro-active, because we also want to look after their health even in the preventive healthcare space and the next segment of growth will come from preventive healthcare space.”

She added that by next year, preventive healthcare will be around Rs 500 crore of sales from Rs 300 crore.

Dr Trehan said preventive healthcare is growing but at the same time Medanta is leading the way in predictive health.

Predictive health is a field of medicine that entails predicting the probability of disease and instituting preventive measures in order to either prevent the disease altogether or significantly decrease its impact on the patient.

“When a person comes to you on family history, we can now predict chances of disease and be more precise. Predictive health can prevent diabetes with knowledge and can prevent disease with personalised medicine,” Dr Trehan said.

However, he added that predictive health is a work in progress.

Many wellness centre has predictive health. He is a believer in Ayurveda and his focus is on integrated wellness.

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

The Medicine Box | Have healthcare norms changed post COVID-19?

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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What has changed after COVID-19 in healthcare? Consumers are more conscious and aware about their health and there is greater insurance penetration. In this CNBC-TV18 special series, The Medicine Box, Dr Naresh Trehan, Chairman and MD at Medanta; Dr Ashutosh Raghuvanshi, MD and CEO, Fortis Healthcare; and Suneeta Reddy, Managing Director of Apollo Hospitals, share the key post-pandemic trends they spotted in the healthcare sector.

Dr Trehan said that during the devastating Delta wave, people with co-morbidities were the most vulnerable. And this led to more people seeking preventive care post-COVID-19.

Also Read: Dr Naresh Trehan explains why 20-25% margin is ideal in healthcare sector

Raghuvanshi also noted that more and more people in India are now getting health insurance because of increasing awareness of how healthcare costs can be devastating for a family.

COVID-19 has taught people that things can change quickly, he said.

Also Read: Fortis Healthcare expects occupancies to grow as international patients rise above pre-pandemic level

The Apollo Hospitals stock has risen nearly 25 percent in the last six months, though it has fallen 10 percent during the past year.

In November, broking firm UBS said that it believed that the market will be surprised by Apollo Hospitals’ success on multiple fronts. Therefore, it upgraded the shares of the hospital chain to a ‘buy’ from ‘neutral’ earlier. The firm also raised its price target on Apollo Hospitals to Rs 5,600.

Speaking to CNBC-TV18, Reddy said that people are more conscious and there is greater insurance penetration post COVID-19.

Also Read: Apollo Hospitals targeting occupancy level of 70%, says Suneeta Reddy

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Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

3 Mins Read

Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

The Medicine Box | How are hospitals dealing with spurious drugs?

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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Spurious drugs are a concern for hospitals with hospitals undertaking procurement directly from distributors and random testing to prevent it.

In this CNBC-TV18 special series, ‘The Medicine Box‘, Dr. Naresh Trehan, Chairman & MD at Medanta; Dr Ashutosh Raghuvanshi, MD & CEO, Fortis Healthcare and Suneeta Reddy, Managing Director of Apollo Hospitals talk about the concern around spurious drugs and means to tackle them.

Dr Raghuvanshi said this is a grave concern and needs to be taken care of. “For the hospitals themselves to be sure that nothing breaks in the supply chain, is rather difficult. The only thing we can do and what we try to do all the time is that we have very reputed distributors only. Then from time to time, we do some random testing as well. But still things can go under the radar,” he said.

He added that spurious drugs have to be prevented by authorities. “If it is coming directly from the company, usually we feel more secure. So, then the responsibility lies with the company and generally the reputed companies which we deal with, they make sure that it is taken care of,” he said.

Read Here: Fortis Healthcare expects occupancies to grow as international patients rise above pre-pandemic level

Suneeta Reddy said the company started the pharmacy chain because they were conscious of spurious and outdated drugs. “If you look at the way that our purchasing is done, there is a very strict guideline, and which is why most of the time even our generics that we sell, we have been very, very careful in quality testing. We don’t, in fact, sell the largest amount of generics as yet, like the others too, because we are very very careful on quality,” she said.

Meanwhile, Dr Trehan believes that the distribution system in not the culprit.  “We buy straight from the companies, who we know are reputed. They have a stake like we have a stake. So if you see what a brand means to a person. A well-established brand just tells you one thing that mostly their products will be standardized,” he said.

Also Read: Apollo Hospitals targeting occupancy level of 70%, says Suneeta Reddy

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

The Medicine Box: Eye care market

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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Today, three out of 10 people in the world who are blind are expected to be from India and as many as eight out of 10 people go blind in the country due untreated cataract, which is a treatable condition. Similarly, over 1.2 crore people in India suffer from glaucoma, again a condition that can be managed. However, of them, 12.5 percent are losing their eyesight.

Today, more than 90 percent glaucoma cases remain diagnosed in the country and around 50 lakh surgeries are needed to clear the backlog of blindness and visual impairment due to cataract.

The eye care industry, which includes services such as cataract, glaucoma, retina and squint, is valued around USD 1.4 billion in India. In fact, the Indian eye care market is categorised by a few of the larger pan-India hospitals, corporate enjoying 5-6 percent market share, followed by a long tail, which is basically a large number of regional or smaller eye care players such as specialised hospitals, led by solo practices of doctors.

Interestingly some of these solo practices too have seen a recent surge for example Dr Agarwal of Dr Agarwal’s Eye Care or Dr Singhvi of ASG Hospitals.

Also Read: The Medicine Box: Epilepsy — All you need to know

Earlier this year, Dr Agarwal’s Healthcare, the promoter group of Dr Agarwal Eye Care, raised over Rs 1,000 crore from TPG and Temasek. The latest was a private company ASG Eye Hospitals, which runs over 50 eye care hospitals, raising Rs 1,500 crore from private equity (PE) funds General Atlantic and Kedaara Capital.

CNBC-TV18 spoke to Dr Singhvi of ASG and Akash Sachdev of Foundation Holdings, a homegrown PE firm that is an existing investor in ASG, to find out more about their business and the potential of the eye care industry.

According to ASG, the eye care industry in fact has seen a recent surge in demand post COVID-19 as the need for electives normalised and there was more awareness about health conditions. Dr Singhvi of ASG, which looks to partner or buy out the top 2 to 3 eye care practices in every micro market, in fact saw growth triple from the pre-COVID-19 levels of 15-20 percent.

The company has raised funds for their partnership model and is looking at 15 more such partnerships or mergers and acquisitions across the country. The range or size of their acquisitions of smaller regional eye care practices can range from Rs 25-Rs 30 crore to Rs 200-300 crore. While the company looks to institutionalise the doctors practice that they acquire, there is always a fear of how one maintains quality, especially in a service as delicate as eye care.

Lastly, the company believes there will be more fund raising and consolidation in the industry and that an IPO will be a journey it is looking at, eventually expanding into South East Asia. And while they have made inroads into north and central India, their eyes are now set on expanding in the South.

Also Read: The Medicine Box: India and brain strokes

Elon Musk forms several ‘X Holdings’ companies to fund potential Twitter buyout

3 Mins Read

Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow