Updated Guidelines on PEP

The Centers for Disease Control and Prevention (CDC) has issued new evidence-based guidelines, "Updated Guidelines for Antiretroviral Postexposure Prophylaxis after Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV — United States, 2016" that provide updated recommendations for providers regarding non-occupational post-exposure prophylaxis (nPEP) for exposure to HIV outside the healthcare setting. 

The new guidelines expand on the 2005 U.S. Department of Health and Human Services recommendations and are intended to help reduce the development of new HIV infections via effective nPEP administration to patients following a single exposure to blood, genital secretions, or other potentially infectious bodily fluids that may carry HIV. The 2016 updated guidelines include new scientific data from human and animal studies as well as information on pediatric dosing. In addition, it includes consideration of new antiretroviral drugs that were approved since the 2005 guidelines. 

66097 Tourists Arrived in August 2016 on e Tourist Visa

196.6% Growth in Tourists Arrival on e-Tourist Visa in August 2016 over the Same Period in 2015 

UK Continues to Occupy Top Slot followed by USA and China Amongst Countries Availing e-Tourist Visa Facility During August 2016 

A total of 66,097 tourists arrived in August 2016 on e-Tourist Visa as compared to 22, 286 during the month of August 2015 registering a growth of 196.6%

Commencing from 27th November 2014 e-Tourist Visa facility was available until 25th February 2016 for citizens of 113 countries arriving at 16 Airports in India. The Government of India has extended this scheme for citizens of 37 more countries w.e.f 26th February 2016 taking the tally to 150 countries. Status of achievements in respect of e-Tourist Visa availed by International tourists visiting India last year in 2015 has been surpassed in the first 06 months of the current calendar year 2016.

The following are the important highlights of e-Tourist Visa during August, 2016:-

(i) During the month of August, 2016 a total of 66,097 tourist arrived on e-Tourist Visa as compared to 22,286 during the month of August, 2015 registering a growth of 196.6%.

(ii) During January- August 2016, a total of 6,06,493 tourist arrived on e-Tourist Visa as compared to 1,69,976 during January-August 2015, registering a growth of 256.8% .

(iii) This high growth may be attributed to introduction of e-Tourist Visa for 150 countries as against the earlier coverage of 113 countries.

(iv) The percentage shares of top 10 source countries availing e-Tourist Visa facilities during August, 2016 were as follows:

UK (19.4%), USA (13.2%), China (6.7%), France (6.4%), Spain (6.1%), UAE (5.5%), Germany (4.6%), Australia (3.7%), Canada (3.5%) and Korea Republic of (2.4%).

(v) The percentage shares of top 10 ports in tourist arrivals on e-Tourist Visa during August, 2016 were as follows:

New Delhi Airport (45.30%), Mumbai Airport (21.53%), Chennai Airport (8.82%), Bengaluru Airport (7.58%), Kochi Airport (4.60%), Hyderabad Airport (3.52%), Kolkata Airport (2.07%), Amritsar Airport (2.01%), Ahmadabad Airport (1.44%) and Trivandrum Airport (1.36%).

Over 66,000 travellers arrived in India on e-tourist visa in August this year, recording a growth of about 197 percent over the same period last year. Among the countries availing e-tourist visa facility, the UK occupied the top slot, followed by the US and China, the Union Tourism Ministry said in a statement. "During the month of August, 2016 a total of 66,097 tourist arrived on e-Tourist Visa as compared to 22,286 during the month of August, 2015 registering a growth of 196.6 percent," it said. During January-August this year, a total of 6,06,493 tourist arrived on e-tourist visa as compared to 1,69,976 during the corresponding period last year, witnessing a a growth of 256.8 percent. "This high growth may be attributed to introduction of e-tourist visa for 150 countries as against the earlier coverage of 113 countries," the statement said. Launched on November 27, 2014, the facility was initially available for citizens of 113 countries arriving at 16 airports in India.It was later extended for citizens of 37 more countries. Among the top 10 source countries availing the facility in August, the UK share was maximum with 19.4 percent, followed by the US (13.2 percent), China (6.7 percent), France (6.4 percent), Spain (6.1 percent), UAE (5.5 percent). The share of Germany was 4.6 percent, while that of Australia 3.7 percent, Canada 3.5 percent and Korea 2.4 percent.

PEP treatment if given within 8 hours, can help rape victims prevent HIV contraction

The initiative to administer this treatment should be taken by the relatives of the victim and also the law enforcement agencies which usually focus mainly on the crime angle, he suggested.

Rape victims can be prevented from contracting an HIV infection if a ‘post-exposure prophylaxis’ (PEP) treatment is given to them within eight hours of the sexual assault, a medical expert has claimed.

However, the treatment, which can prove to be life-saving for victims of sexual assault, is neither mandated nor is provided in India due to lack of awareness, AIDS Society of India (ASI) President Dr Ishwar Gilada told PTI.

“In cases of rape, along with legal aid a treatment of post-exposure prophylaxis should be immediately given to sexual assault victims. This will cut down the chances of infection to 100 per cent,” Gilada said.

A proactive three-day movement for creating public awareness for the use of PEP to prevent the spread of HIV infection in victims of sexual assault started in Mumbai from Saturday, where HIV clinicians from several medical faculties deliberated on how to put the evidences into a policy and take swift action.

“In a country like India, we have to work hard to put an end to sexual assault incidents. But warding off the fear of HIV infection is very easy, if all are made aware of the treatment,” he said.

The last few years have witnessed an alarming rise in rape cases in India. According to the National Crime Records Bureau (NCRB) statistics, 36,735 rape cases were reported in the country in 2014.

“In cases of rape, along with providing immediate trauma care, precaution should also be taken to ensure that the victim does not contract sexually transmitted diseases (STD), including HIV,” he said.

“In order to alleviate the danger of HIV infection, PEP should be administered to the victims. This is a short term, inexpensive and an anti-retroviral treatment (ART) which can prove effective if started within eight hours of the rape incident,” Gilada said.

The initiative to administer this treatment should be taken by the relatives of the victim and also the law enforcement agencies which usually focus mainly on the crime angle, he suggested.

ASI is a professional non-profit organisation of medical doctors and researchers in HIV/AIDS aiming to promote and disseminate clinically-oriented medical teaching and coordinated medical management of HIV disease.

National AIDS Research Institute’s (NARI) Director In-charge and ASI’s annual national conference ASICON 2015 Co-Chairman, Dr Raman Gangakhedkar said the latest WHO guidelines on HIV make available two key recommendations that were developed during the revision process this year, one of them being administration of PEP.

“Daily use of oral post-exposure prophylaxis is recommended as a prevention choice for people at substantial risk of HIV infection as part of combination prevention approaches,” Gangakhedkar said.

“In any case of sexual assault or an accidental exposure to HIV infection, like condom rupture between two partners, this treatment would help reduce the risk by 100 per cent. More and more awareness would help to control this infection in India,” he said.

In 2013, the World Health Organisation (WHO) had issued consolidated guidelines on the ‘Use of anti-retroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach’.

Incredible India Tourism Investor’s Summit 2016 IITIS

While the ambit of the travel and tourism industry in India is looking prospective, the government is looking at attracting national and international investments to explore new opportunities and improve core infrastructure.


The Ministry of Tourism announced a three-day event called the Incredible India Tourism Investor’s Summit 2016 (IITIS) as a significant platform for the investors across the globe to explore investment opportunities available in the tourism sphere of one of the fastest growing economies. The event is scheduled to take place at Vigyan Bhawan, New Delhi, starting on 21 September. The landscape of India’s tourism sector has arguably brought a new paradigm of growth and development in creating employment, generating income and fostering entrepreneurship. However, foreign investment in the sector and branding the country as a hub of new business development keeping tourism as the key focus is yet to see remarkable development. Dr. Mahesh Sharma, the  Minister of State for Culture and Tourism, Government of India, said in a statement that the domestic tourism sector is expected to attract investments to the tune of INR 500,000 million from around 600 projects during this three-day investors’ summit.


Investment system revolutionised

To change the investment policies across industries in India, which have not always had investor-friendly business models, this summit looks at showcasing the investment ecosystem in the tourism industry and help global investors understand the investment-ready projects in the country. A recent press note from the ministry outlines that this three-day event will strive to catalyze partnership in form of B2B linkages and identify opportunities for local players to move up the value chain through technical collaboration and global partnerships.

While the ministry is also trying to project the Indian tourism industry as a lucrative investment destination for the leading investors in the global travel and tourism sector, the investors can also expect tangible projects in various states and union territories of India.

Vinod Zutshi, the Secretary at the Ministry of Tourism, explained how the tourism landscape in India is undergoing significant transformation. “The travel and tourism sector in the country presents a plethora of investment opportunities in areas of infrastructure development, both from India and overseas. With the streamlining of infrastructure in the core and tourism-related sectors through investments and partnerships between the public and private sectors, Incredible India can be catapulted amongst the most sought after destinations in the world,” Vinod said.
What to expect at the IITIS?

The tourism investment summit will have presentations from all states which have investible properties or projects, and sessions describing why India is the right market to invest at this critical juncture of global economic upswing.

There will be participations from major stakeholders, including states/UTs, with interesting projects related to the banks & financial institutions, business developers, cruise liners, domestic investors, entertainment companies, global investors, helicopter services, hoteliers, infrastructure-developers, international associations, restaurateurs, spa and yoga centres, tour and travel operators, urban developers, venture capitalist and civic amenity providers among others.

However, the highlight of the summit would be the 600 projects from across the country and from varied tourism sectors on the table of 140 investors from 70 different companies for final discussions. Complementing business discussions, there will be around 21 seminars across two days with some of the tourism industry leaders covering interesting thematic sessions on states and their tourism potential. International tourism boards from USA, UAE, Thailand, Hong Kong & Shanghai and Singapore will have their road shows alongside their Indian counterparts from Gujarat, Maharashtra and Madhya Pradesh.

Suman Billa, Joint Secretary, Ministry of Tourism, made a presentation on IITIS during a press meet in New Delhi, where he promised the summit to hold innovative panel discussions on core infrastructure for tourism, sessions on start-ups, digital India, investing in ‘Swadesh Darshan’, MICE and niche tourism products keeping a special focus on the Northeast and its development.

Health Ministry bans 344 drugs

The Health Ministry has banned 344 fixed drug combinations through a gazette notification issued over the weekend. These include several common cough syrup solutions,analgesics and antibiotic combinations, many of which are sold over the counter.

The ban, which comes into effect immediately, follows recommendations of an expert committee formed to examine the efficacy of these drug combinations. The industry though may question the basis of the ban and seek judicial intervention.

The list of banned drugs includes Nimesulide, which had been a cause of concern for long for health experts for its continued use in India despite being banned in most of the developed nations. Fixed drug combinations have mushroomed in the market as companies in their quest for newer products — and often to beat price control — mix and match ingredients into a single molecule to market them as newer remedies.

Fixed drug combinations have mushroomed in the market as companies in their quest for newer products — and often to beat price control — mix and match ingredients into a single molecule to market them as newer remedies. 

Here is the complete list of all drug combinations banned by the ministry:

* fixed dose combination of Aceclofenac + Paracetamol + Rabeprazole

* fixed dose combination of Nimesulide + Diclofenac

* fixed dose combination of Nimesulide + Cetirizine + Caffeine

* fixed dose combination of Nimesulide + Tizanidine

* fixed dose combination of Paracetamol + Cetirizine + Caffeine

* fixed dose combination of Diclofenac + Tramadol + Chlorzoxazone

* fixed dose combination of Dicyclomine + Paracetamol + Domperidone

* fixed dose combination of Nimesulide + Paracetamol dispersible tablets

* fixed dose combination of Paracetamol + Phenylephrine + Caffeine

* fixed dose combination of Diclofenac + Tramadol + Paracetamol

* fixed dose combination of Diclofenac + Paracetamol + Chlorzoxazone + Famotidine

* fixed dose combination of Naproxen + Paracetamol

* fixed dose combination of Nimesulide + Serratiopeptidase

* fixed dose combination of Paracetamol + Diclofenac + Famotidine

* fixed dose combination of Nimesulide + Pitofenone + Fenpiverinium + Benzyl Alcohol

* fixed dose combination of Omeprazole + Paracetamol + Diclofenac

* fixed dose combination of Nimesulide + Paracetamol injection

* fixed dose combination of Tamsulosin + Diclofenac

* fixed dose combination of Paracetamol + Phenylephrine + Chlorpheniramine + Dextromethorphan + Caffeine

* fixed dose combination of Diclofenac + Zinc Carnosine

* fixed dose combination of Diclofenac + Paracetamol + Chlorpheniramine Maleate + Magnesium Trisillicate

* fixed dose combination of Paracetamol + Pseudoephedrine + Cetrizine

* fixed dose combination of Phenylbutazone + Sodium Salicylate

* fixed dose combination of Lornoxicam + Paracetamol + Trypsin

* fixed dose combination of Paracetamol + Mefenamic Acid + Ranitidine + Dicyclomine

* fixed dose combination of Nimesulide + Dicyclomine

* fixed dose combination of Heparin + Diclofenac

* fixed dose combination of Glucosamine + Methyl Sulfonyl Methane + Vitamin D3 + Manganese + Boron + Copper + Zinc

* fixed dose combination of Paracetamol + Tapentadol

* fixed dose combination of Tranexamic Acid + Proanthocyanidin

* fixed dose combination of Benzoxonium Chloride + Lidocaine

* fixed dose combination of Lornoxicam + Paracetamol + Tramadol

* fixed dose combination of Lornoxicam + Paracetamol + Serratiopeptidase

* fixed dose combination of Diclofenac + Paracetamol + Magnesium Trisilicate

* fixed dose combination of Paracetamol + Domperidone + Caffeine

* fixed dose combination of Ammonium Chloride + Sodium Citrate + Chlorpheniramine Maleate + Menthol

* fixed dose combination of Paracetamol + Prochlorperazine Maleate

* Combikit of 3 tablets of Serratiopeptidase (enteric coated 20000 units) + Diclofenac Potassium & 2 tablets of Doxycycline

* fixed dose combination of Nimesulide + Paracetamol Suspension

* fixed dose combination of Aceclofenac + Paracetamol + Famotidine

* fixed dose combination of Aceclofenac + Zinc Carnosine

* fixed dose combination of Paracetamol + Disodium Hydrogen Citrate + Caffeine

* fixed dose combination of Paracetamol + DL Methionine

* fixed dose combination of Disodium Hydrogen Citrate + Paracetamol

* fixed dose combination of Paracetamol + Caffeine + Codeine

* fixed dose combination of Aceclofenac (SR) + Paracetamol

* fixed dose combination of Diclofenac + Paracetamol injection

* fixed dose combination of Azithromycin + Cefixime

* fixed dose combination of Amoxicillin + Dicloxacillin

* fixed dose combination of Amoxicillin 250 mg + Potassium Clavulanate Diluted 62.5 mg

* fixed dose combination of Azithromycin + Levofloxacin

* fixed dose combination of Cefixime + Linezolid

* fixed dose combination of Amoxicillin + Cefixime + Potassium Clavulanic Acid

* fixed dose combination of Ofloxacin + Nitazoxanide

* fixed dose combination of Cefpodoxime Proxetil + Levofloxacin * Combikit of Azithromycin, Secnidazole and Fluconazole

* fixed dose combination of Levofloxacin + Ornidazole + Alpha Tocopherol Acetate

* fixed dose combination of Nimorazole + Ofloxacin

* fixed dose combination of Azithromycin + Ofloxacin

* fixed dose combination of Amoxycillin + Tinidazole

* fixed dose combination of Doxycycline + Serratiopeptidase

* fixed dose combination of Cefixime + Levofloxacin

* fixed dose combination of Ofloxacin + Metronidazole + Zinc Acetate

* fixed dose combination of Diphenoxylate + Atropine + Furazolidone * Combikit of Fluconazole Tablet, Azithromycin Tablet and Ornidazole Tablets

* fixed dose combination of Ciprofloxacin + Phenazopyridine

* fixed dose combination of Amoxycillin + Dicloxacillin + Serratiopeptidase * Combikit of Fluconazole Tablet, Azithromycin Tablet and Ornidazole Tablets

* fixed dose combination of Ciprofloxacin + Phenazopyridine

* fixed dose combination of Amoxycillin + Dicloxacillin + Serratiopeptidase

* fixed dose combination of Azithromycin + Cefpodoxime

* fixed dose combination of Lignocaine + Clotrimazole + Ofloxacin + Beclomethasone

* fixed dose combination of Cefuroxime + Linezolid

* fixed dose combination of Ofloxacin + Ornidazole + Zinc Bisglycinate

* fixed dose combination of Metronidazole + Norfloxacin

* fixed dose combination of Amoxicillin + Bromhexine

* fixed dose combination of Ciprofloxacin + Fluticasone + Clotrimazole + Neomycin

* fixed dose combination of Metronidazole + Tetracycline

* fixed dose combination of Cephalexin + Neomycin + Prednisolone

* fixed dose combination of Azithromycin + Ambroxol

* fixed dose combination of Cilnidipine + Metoprolol Succinate + Metoprolol Tartrate

* fixed dose combination of L-Arginine + Sildenafil

* fixed dose combination of Atorvastatin + Vitamin D3 + Folic Acid + Vitamin B12 + Pyridoxine

* fixed dose combination of Metformin + Atorvastatin

* fixed dose combination of Clindamycin + Telmisartan

* fixed dose combination of Olmesartan + Hydrochlorothiazide + Chlorthalidone

* fixed dose combination of L-5-Methyltetrahydrofolate Calcium + Escitalopram i

* fixed dose combination of Pholcodine + Promethazine

* fixed dose combination of Paracetamol + Promethazine

* fixed dose combination of Betahistine + Ginkgo Biloba Extract + Vinpocetine + Piracetam

* fixed dose combination of Cetirizine + Diethyl Carbamazine

* fixed dose combination of Doxylamine + Pyridoxine + Mefenamic Acid + Paracetamol

* fixed dose combination of Drotaverine + Clidinium + Chlordiazepoxide

* fixed dose combination of Imipramine + Diazepam

* fixed dose combination of Flupentixol + Escitalopram

* fixed dose combination of Paracetamol + Prochloperazine

* fixed dose combination of Gabapentin + Mecobalamin + Pyridoxine + Thiamine

* fixed dose combination of Imipramine + Chlordiazepoxide + Trifluoperazine + Trihexyphenidyl

* fixed dose combination of Chlorpromazine + Trihexyphenidyl

* fixed dose combination of Ursodeoxycholic Acid + Silymarin

* fixed dose combination of Metformin 1000/1000/500/500mg + Pioglitazone 7.5/7.5/7.5/7.5mg + Glimepiride 1/2/1/2mg

* fixed dose combination of Gliclazide 80 mg + Metformin 325 mg

* fixed dose combination of Voglibose+ Metformin + Chromium Picolinate

* fixed dose combination of Pioglitazone 7.5/7.5mg + Metformin 500/1000mg

* fixed dose combination of Glimepiride 1mg/2mg/3mg + Pioglitazone 15mg/15mg/15mg + Metformin 1000mg/ 1000mg/1000mg

* fixed dose combination of Glimepiride 1mg/2mg+ Pioglitazone 15mg/15mg + Metformin 850mg/850mg

* fixed dose combination of Metformin 850mg + Pioglitazone 7.5 mg + Glimepiride 2mg

* fixed dose combination of Metformin 850mg + Pioglitazone 7.5 mg + Glimepiride 1mg

* fixed dose combination of Metformin 500mg/500mg+Gliclazide SR 30mg/60mg + Pioglitazone 7.5mg/7.5mg

* fixed dose combination of Voglibose + Pioglitazone + Metformin

* fixed dose combination of Metformin + Bromocriptine

* fixed dose combination of Metformin + Glimepiride + Methylcobalamin

* fixed dose combination of Pioglitazone 30 mg + Metformin 500 mg

* fixed dose combination of Glimepiride + Pioglitazone + Metformin

* fixed dose combination of Glipizide 2.5mg + Metformin 400 mg

* fixed dose combination of Pioglitazone 15mg + Metformin 850 mg

* fixed dose combination of Metformin ER + Gliclazide MR + Voglibose

* fixed dose combination of Chromium Polynicotinate + Metformin

* fixed dose combination of Metformin + Gliclazide + Piogllitazone + Chromium Polynicotinate

* fixed dose combination of Metformin + Gliclazide + Chromium Polynicotinate

* fixed dose combination of Glibenclamide + Metformin (SR)+ Pioglitazone

* fixed dose combination of Metformin (Sustainded Release) 500mg + Pioglitazone 15 mg + Glimepiride 3mg

* fixed dose combination of Metformin (SR) 500mg + Pioglitazone 5mg

* fixed dose combination of Chloramphenicol + Beclomethasone + Clomitrimazole + Lignocaine

* fixed dose combination of Clotrimazole + Ofloxaxin + Lignocaine + Glycerine and Propylene Glycol

* fixed dose combination of Chloramphennicol + Lignocaine + Betamethasone + Clotrimazole + Ofloxacin + Antipyrine

* fixed dose combination of Ofloxacin + Clotrimazole + Betamethasone + Lignocaine

* fixed dose combination of Gentamicin Sulphate + Clotrimazole + Betamethasone + Lignocaine

* fixed dose combination of Clotrimazole + Beclomethasone + Ofloxacin + Lignocaine

* fixed dose combination of Becloemthasone + Clotrimazole + Chloramphenicol + Gentamycin + Lignocaine Ear drops

* fixed dose combination of Flunarizine + Paracetamole + Domperidone

* fixed dose combination of Rabeprazole + Zinc Carnosine

* fixed dose combination of Magaldrate + Famotidine + Simethicone

* fixed dose combination of Cyproheptadine + Thiamine

* fixed dose combination of Magaldrate + Ranitidine + Pancreatin + Domperidone

* fixed dose combination of Ranitidine + Magaldrate + Simethicone

* fixed dose combination of Magaldrate + Papain + Fungul Diastase + Simethicone

* fixed dose combination of Rabeprazole + Zinc + Domperidone

* fixed dose combination of Famotidine + Oxytacaine + Magaldrate

* fixed dose combination of Ranitidine + Domperidone + Simethicone

* fixed dose combination of Alginic Acid + Sodium Bicarbonate + Dried Aluminium Hydroxide + Magnesium Hydroxide

* fixed dose combination of Clidinium + Paracetamol + Dicyclomine + Activated Dimethicone

* fixed dose combination of Furazolidone + Metronidazole + Loperamide

* fixed dose combination of Rabeprazole + Diclofenac + Paracetamol

* fixed dose combination of Ranitidine + Magaldrate

* fixed dose combination of Norfloxacin + Metronidazole + Zinc Acetate

* fixed dose combination of Zinc Carnosine + Oxetacaine

* fixed dose combination of Oxetacaine + Magaldrate + Famotidine

* fixed dose combination of Pantoprazole (as Enteric Coated Tablet) + Zinc Carnosine (as Film Coated Tablets)

* fixed dose combination of Zinc Carnosine + Magnesium Hydroxide + Dried Aluminium Hydroxide + Simethicone

* fixed dose combination of Zinc Carnosine + Sucralfate

* fixed dose combination of Mebeverine & Inner HPMC capsule (Streptococcus Faecalis + Clostridium butyricum + Bacillus mesentricus + Lactic Acid Bacillus)

* fixed dose combination of Clindamycin + Clotrimazole + Lactic Acid Bacillus

* fixed dose combination of Sildenafil + Estradiol Valerate

* fixed dose combination of Clomifene Citrate + Ubidecarenone + Zinc + Folic Acid + Methylcobalamin + Pyridoxine + Lycopene + Selenium + Levocarnitine Tartrate + L-

Arginine

* fixed dose combination of Thyroxine + Pyridoxine + Folic Acid

* fixed dose combination of Gentamycin + Dexamethasone + Chloramphenicol + Tobramycin + Ofloxacin

* fixed dose combination of Dextromethorphan + Levocetirizine + Phenylephrine + Zinc

* fixed dose combination of Nimesulide + Loratadine + Phenylephrine + Ambroxol

* fixed dose combination of Bromhexine + Phenylephrine + Chlorepheniramine Maleate

* fixed dose combination of Dextromethorphan + Bromhexine + Guaiphenesin

* fixed dose combination of Paracetamol + Loratadine + Phenylephrine + Dextromethorphan + Caffeine

* fixed dose combination of Nimesulide + Phenylephrine + Caffeine + Levocetirizine

* fixed dose combination of Azithromycin + Acebrophylline

* fixed dose combination of Diphenhydramine + Terpine + Ammonium Chloride + Sodium Chloride + Menthol

* fixed dose combination of Nimesulide + Paracetamol + Cetirizine + Phenylephrine

* fixed dose combination of Paracetamol + Loratadine + Dextromethophan + Pseudoepheridine + Caffeine

* fixed dose combination of Chlorpheniramine Maleate + Dextromethorphan + Dextromethophan + Guaiphenesin + Ammonium Chloride + Menthol

* fixed dose combination of Chlorpheniramine Maleate + Ammonium Chloride + Sodium Citrate

* fixed dose combination of Cetirizine + Phenylephrine + Paracetamol + Zinc Gluconate

* fixed dose combination of Ambroxol + Guaiphenesin + Ammonium Chloride + Phenylephrine + Chlorpheniramine Maleate + Menthol

* fixed dose combination of Dextromethorphen + Bromhexine + Chlorpheniramine Maleate + Guaiphenesin

* fixed dose combination of Levocetirizine + Ambroxol + Phenylephrine + Guaiphenesin

* fixed dose combination of Dextromethorphan + Chlorpheniramine + Chlorpheniramine Maleate

* fixed dose combination of Cetirizine + Ambroxol + Guaiphenesin + Ammonium Chloride + Phenylephrine + Menthol

* fixed dose combination of Chlorpheniramine + Phenylephrine + Caffeine

* fixed dose combination of Dextromethorphan + Triprolidine + Phenylephrine

* fixed dose combination of Terpinhydrate + Dextromethorphan + Menthol

* fixed dose combination of Dextromethorphan + Phenylephrine + Zinc Gluconate + Menthol

* fixed dose combination of Chlorpheniramine + Codeine + Sodium Citrate + Menthol Syrup

* fixed dose combination of Enrofloxacin + Bromhexin

* fixed dose combination of Bromhexine + Dextromethorphan + Phenylephrine + Menthol

* fixed dose combination of Levofloxacin + Bromhexine

* fixed dose combination of Levocetirizine + Ranitidine

* fixed dose combination of Levocetirizine + Phenylephrine + Ambroxol + Guaiphenesin + Paracetamol

* fixed dose combination of Cetirizine + Dextromethorphan + Phenylephrine + Zinc Gluconate + Paracetamol + Menthol

* fixed dose combination of Paracetamol + Pseudoephedrine + Dextromethorphan + Cetirizine

* fixed dose combination of Diphenhydramine + Guaiphenesin + Ammonium Chloride + Bromhexine

* fixed dose combination of Chlorpheniramine + Dextromethorphan + Phenylephrine + Paracetamol

* fixed dose combination of Dextromethorphen + Promethazine

* fixed dose combination of Diethylcabamazine Citrate + Cetirizine + Guaiphenesin

* fixed dose combination of Pseudoephedrine + Dextromethorphan + Cetirizine

* fixed dose combination of Chlorpheniramine + Phenylephrine + Dextromethophan + Menthol

* fixed dose combination of Ambroxol + Terbutaline + Dextromethorphan

* fixed dose combination of Dextromethorphan + Chlorpheniramine + Guaiphenesin

* fixed dose combination of Terbutaline + Bromhexine + Guaiphenesin + Dextromethorphan

* fixed dose combination of Dextromethorphan + Tripolidine + Phenylephirine

* fixed dose combination of Paracetamol + Dextromethorphan + Chlorpheniramine

* fixed dose combination of Pholcodine + Phenylephrine + Promethazine

* fixed dose combination of Codeine + Levocetirizine + Menthol

* fixed dose combination of Dextromethorphan + Ambroxol + Guaifenesin + Phenylephrine + Chlorpheniramine

* fixed dose combination of Cetirizine + Phenylephrine + Dextromethorphan + Menthol

* fixed dose combination of Roxithromycin + Serratiopeptidase

* fixed dose combination of Paracetamol + Phenylephrine + Triprolidine

* fixed dose combination of Acetaminophen + Loratadine + Ambroxol + Phenylephrine

* fixed dose combination of Cetirizine + Acetaminophen + Dextromethorphan + Phenyephrine + Zinc Gluconate

* fixed dose combination of Diphenhydramine + Guaifenesin + Bromhexine + Ammonium Chloride + Menthol

* fixed dose combination of Chlopheniramine Maleate + Codeine Syrup

* fixed dose combination of Cetirizine + Dextromethorphan + Zinc Gluconate + Menthol

* fixed dose combination of Paracetamol + Phenylephrine + Desloratadine + Zinc Gluconate + Ambroxol

* fixed dose combination of Levocetirizine + Montelukast + Acebrophylline

* fixed dose combination of Dextromethorphan + Phenylephrine + Ammonium Chloride + Menthol

* fixed dose combination of Dextromethorphan + Bromhexine + Guaiphenesin + Menthol

* fixed dose combination of Acrivastine + Paracetamol + Caffeine + Phenylephrine

* fixed dose combination of Naphazoline + Carboxy Methyl Cellulose + Menthol + Camphor + Phenylephrine

* fixed dose combination of Dextromethorphan + Cetirizine

* fixed dose combination of Nimesulide + Paracetamol + Levocetirizine + Phenylephrine + Caffeine

* fixed dose combination of Terbutaline + Ambroxol + Guaiphenesin + Zinc + Menthol

* fixed dose combination of Codeine + Chlorpheniramine + Alcohol Syrup

* fixed dose combination of Dextromethorphan + Phenylephrine + Guaifenesin + Triprolidine

* fixed dose combination of Ammomium Chloride + Bromhexine + Dextromethorphan

* fixed dose combination of Diethylcarbamazine + Cetirizine + Ambroxol

* fixed dose combination of Ethylmorphine + Noscapine + Chlorpheniramine

* fixed dose combination of Cetirizine + Dextromethorphan + Ambroxol

* fixed dose combination of Bromhexine + Dextromethorphan + Ammonium Chloride + Menthol

* fixed dose combination of Ambroxol + Guaifenesin + Phenylephrine + Chlorpheniramine

* fixed dose combination of Paracetamol + Phenylephrine + Chlorpheniramine + Zinc Gluconate

* fixed dose combination of Dextromethorphan + Phenylephrine + Cetirizine + Paracetamol + Caffeine

* fixed dose combination of Dextromethophan + Chlorpheniramine + Guaifenesin + Ammonium Chloride

* fixed dose combination of Levocetirizine + Dextromethorphan + Zinc

* fixed dose combination of Paracetamol + Phenylephrine + Levocetirizine + Caffeine

* fixed dose combination of Chlorphaniramine + Ammonium Chloride + Sodium Chloride

* fixed dose combination of Paracetamol + Dextromethorphan + Bromhexine + Phenylephrine + Diphenhydramine

* fixed dose combination of Salbutamol + Bromhexine + Guaiphenesin + Menthol

* fixed dose combination of Chlorpheniramine + Ammonium Chloride + Noscapine + Sodium Citrate

* fixed dose combination of Cetirizine + Dextromethorphan + Bromhexine + Guaifenesin

* fixed dose combination of Diethyl Carbamazine + Chlorpheniramine + Guaifenesin

* fixed dose combination of Ketotifen + Cetirizine

* fixed dose combination of Terbutaline + Bromhexine + Etofylline

* fixed dose combination of Ketotifen + Theophylline

* fixed dose combination of Ambroxol + Salbutamol + Theophylline

* fixed dose combination of Cetririzine + Nimesulide + Phenylephrine

* fixed dose combination of Chlorpheniramine + Phenylephrine + Paracetamol + Zink Gluconate

* fixed dose combination of Acetaminophen + Guaifenesin + Dextromethorphan + Chlorpheniramine

* fixed dose combination of Cetirizine + Dextromethorphan + Phenylephrine + Tulsi

* fixed dose combination of Cetirizine + Phenylephrine + Paracetamol + Ambroxol + Caffeine

* fixed dose combination of Guaifenesin + Dextromethorphan

* fixed dose combination of Levocetirizine + Paracetamol + Phenylephirine + Caffeine

* fixed dose combination of Caffeine + Paracetamol + Phenylephrine + Chlorpheniramine

* fixed dose combination of Ketotifen + Levocetrizine

* fixed dose combination of Paracetamol + Levocetirizine + Phenylephirine + Zink Gluconate

* fixed dose combination of Paracetamol + Phenylephrine + Triprolidine + Caffeine

* fixed dose combination of Caffeine + Paracetamol + Phenylephrine + Cetirizine

* fixed dose combination of Caffeine + Paracetamol + Chlorpheniramine

* fixed dose combination of Ammonium Chloride + Dextromethorphan + Cetirizine + Menthol

* fixed dose combination of Dextromethorphan + Paracetamol + Cetirizine + Phenylephrine

* fixed dose combination of Chlorpheniramine + Terpin + Antimony Potassium Tartrate + Ammonium Chloride + Sodium Citrate + Menthol

* fixed dose combination of Terbutaline + Etofylline + Ambroxol

* fixed dose combination of Paracetamol + Codeine + Chlorpheniramine

* fixed dose combination of Paracetamol+Pseudoephedrine+Certirizine+Caffeine

* fixed dose combination of Chlorpheniramine+Ammonium Chloride + Menthol

* fixed dose combination of N-Acetyl Cysteine + Ambroxol + Phenylephrine + Levocertirizine

* fixed dose combination of Dextromethorphan + Phenylephrine + Tripolidine + Menthol

* fixed dose combination of Salbutamol + Certirizine + Ambroxol

* fixed dose combination of Dextromethorphan + Phenylephrine + Bromhexine + Guaifenesin + Chlorpheniramine

* fixed dose combination of Nimesulide + Certirizine + Phenylephrine

* fixed dose combination of Naphazoline + Chlorpheniramine + Zinc Sulphate + Boric Acid + Sodium Chloride + Chlorobutol

* fixed dose combination of Paracetamol + Bromhexine + Phenylephrine + Chlorpheniramine + Guaifenesin

* fixed dose combination of Salbutamol + Bromhexine

* fixed dose combination of Dextromethorphan + Phenylephrine + Guaifenesin + Certirizine + Acetaminophen

* fixed dose combination of Guaifenesin + Bromhexine + Chlorpheniramine + Paracetamol

* fixed dose combination of Chlorpheniramine + Ammonium Chloride + Chloroform + Menthol

* fixed dose combination of Salbutamol + Choline Theophylinate + Ambroxol

* fixed dose combination of Chlorpheniramine + Codeine Phosphate + Menthol Syrup

* fixed dose combination of Pseudoephedrine + Bromhexine

* fixed dose combination of Certirizine + Phenylephrine + Paracetamol + Caffeine + Nimesulide

* fixed dose combination of Dextromethorphan + Cetirizine + Guaifenesin + Ammonium Chloride

* fixed dose combination of Ambroxol + Salbutamol + Choline Theophyllinate + Menthol

* fixed dose combination of Paracetamol + Chlorpheniramine + Ambroxol + Guaifenesin + Phenylephrine

* fixed dose combination of Chlorpheniramine + Vasaka + Tolubalsm + Ammonium Chloride + Sodium Citrate + Menthol

* fixed dose combination of Bromhexine + Cetrizine + Phenylephrine IP+Guaifenesin + Menthol

* fixed dose combination of Dextromethorphan + Ambroxol + Ammonium Chloride + Chlorpheniramine + Menthol

* fixed dose combination of Dextromethorphan + Phenylephrine + Cetirizine + Zinc + Menthol

* fixed dose combination of Terbutaline + N-Acetyl L-Cysteine + Guaifenesin

* fixed dose combination of Calcium Gluconate + Levocetirizine

* fixed dose combination of Paracetamol + Levocetirizine + Pseudoephedrine

* fixed dose combination of Salbutamol + Choline Theophylinate + Carbocisteine

* fixed dose combination of Chlorpheniramine + Vitamin C

* fixed dose combination of Calcium Gluconate + Chlorpheniramine + Vitamin C

* fixed dose combination of Chlorpheniramine + Paracetamol + Pseudoephedrine + Caffeine

* fixed dose combination of Guaifenesin + Bromhexine + Chlorpheniramine + Phenylephrine + Paracetamol + Serratiopeptidase (as enteric coated granules) 10000 SP Units

* fixed dose combination of Paracetamol + Pheniramine

* fixed dose combination of Betamethasone + Fusidic Acid + Gentamycin + Tolnaftate + lodochlorhydroxyquinoline (ICHQ)

* fixed dose combination of Clobetasol + Ofloxacin + Miconazole + Zinc Sulphate

* fixed dose combination of Clobetasole + Gentamicin + Miconazole + Zinc Sulphate

* fixed dose combination of Levocetirizine + Ambroxol + Phenylephrine + Paracetamol

* fixed dose combination of Permethrin + Cetrimide + Menthol

* fixed dose combination of Beclomethasone + Clotimazole + Neomycin + lodochlorohydroxyquinone

* fixed dose combination of Neomycin + Doxycycline

* fixed dose combination of Ciprofloxacin + Fluocinolone + Clotrimazole + Neomycin + Chlorocresol

* fixed dose combination of Clobetasol + Ofloxacin + Ketoconazol + Zinc Sulphate

* fixed dose combination of Betamethasone + Gentamicin + Tolnaftate + lodochlorhydroxyquinoline

* fixed dose combination of Clobetasol + Gentamicin + Tolnaftate + lodochlorhydroxyquinone + Ketoconazole

* fixed dose combination of Allantoin + Dimethieone + Urea + Propylene + Glycerin + Liquid Paraffin

* fixed dose combination of Acriflavine + Thymol + Cetrimide

* fixed dose combination of Betamethasone + Neomycin + Tolnaftate + lodochlorohydroxyquinoline + Cholorocresol

* fixed dose combination of Clobetasol + Neomycin + Miconazole + Clotrimazole

* fixed dose combination of Ketoconazole + Tea Tree oil + Allantion + Zinc Oxide + Aloe Vera + Jojoba oil + Lavander oil + Soa noodels

* fixed dose combination of Clobetasol Propionate + Ofloxacin + Ornidazole + Terbinafine

* fixed dose combination of Clobetasol + Neomycin + Miconazole + Zinc Sulphate

* fixed dose combination of Beclomethasone Diproprionate + Neomycin + Tolnaftate + lodochlorhydroxyquinoline + Chlorocresol

* fixed dose combination of Betamethasone + Gentamycin + Zinc Sulphate + Clotrimoazole + Chlorocresol

* fixed dose combination of Borax + Boric Acid + Naphazoline + Menthol + Camphor + Methyl Hydroxy Benzoate

* fixed dose combination of Bromhexine + Dextromethorphan

* fixed dose combination of Dextromethophan + Chlopheniramine + Bromhexine

* fixed dose combination of Menthol + Anesthetic Ether

* fixed dose combination of Dextrometharphan + Chlopheniramine + Ammonium + Sodium Citrate + Menthol

* fixed dose combination of Ergotamine Tartrate + Belladona Dry Extract+Caffeine + Paracetamol

* fixed dose combination of Phenytoin + Phenobarbitone

* fixed dose combination of Gliclazide 40mg + Metformin 400mg

* fixed dose combination of Paracetamol + Ambroxol + Phenylephrine + Chlorpheniramine

* fixed dose combination of Oflaxacin + Ornidazole Suspension

* fixed dose combination of Albuterol + Etofylline + Bromhexine + Menthol

* fixed dose combination of Albuterol + Bromhexine + Theophylline

* fixed dose combination of Salbutamol+Hydroxyethyltheophylline (Etofylline) + Bromhexine

* fixed dose combination of Paracetamol+Phenylephrine+Levocetirizine+Sodium Citrate

* fixed dose combination of Paracetamol + Propyphenazone + Caffeine

* fixed dose combination of Guaifenesin + Diphenhydramine + Bromhexine + Phenylephrine

* fixed dose combination of Dried Alumnium Hydroxie Gel + Prophantheline + Diazepam

* fixed dose combination of Bromhenxine + Phenylephrine + Chlorpheniramine + Paracetamol

* fixed dose combination of Beclomethasone + Clotrimazole + Gentamicin + lodochlorhydroxyquinoline

* fixed dose combination of Telmisartan + Metformin

* fixed dose combination of Ammonium Citrate + Vitamin B 12 + Folic Acid + Zinc Sulphate

* fixed dose combination of Levothyroxine + Phyridoxine + Nicotinamide

* fixed dose combination of Benfotiamine + Metformin

* fixed dose combination of Thyroid + Thiamine + Riboflavin + Phyridoxine + Calcium Pantothenate + Tocopheryl Acetate + Nicotinamide

* fixed dose combination of Ascorbic Acid + Manadione Sodium Bisulphate + Rutin + Dibasic Calcium Phosphate + Adrenochrome mono Semicarbazone

* fixed dose combination of Phenylephrine + Chlorpheniramine + Paracetamol + Bromhexine + Caffeine

* fixed dose combination of Clotrimazole + Beclomethasone + Lignocaine + Ofloxacin + Acetic Aicd + Sodium Methyl Paraben + Propyl Paraben

PrEP could prevent 185,000 new HIV infections

Increasing diagnosis, care and treatment of people living with HIV could lead to a large decrease in HIV incidence, preventing some 168,000 new infections by the year 2020, according to a new US Centers for Disease Control and Prevention (CDC) analysis presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2016) last week in Boston. The impact of pre-exposure prophylaxis (PrEP) would be comparatively modest, but its importance would be greater if more people with HIV are not on treatment with undetectable viral load.

Emine Yaylali of the CDC and colleagues developed a dynamic model of HIV transmission, looking at what would happen if 90% of people living with HIV are diagnosed, 85% are linked to care and 80% start antiretroviral therapy (ART) and achieve viral suppression – key goals in the continuum of care outlined in the US National HIV/AIDS Strategy.

Studies have shown that the risk of HIV transmission is reduced to almost zero when people with HIV are on ART that successfully suppresses viral load, and consistent use of tenofovir/emtricitabine (Truvada) as PrEP has been shown to decrease the likelihood of HIV-negative people acquiring HIV to a similar extent. But the relative contribution of these interventions in controlling local and national HIV epidemics is unknown.

The researchers started with the estimate that 87% of people with HIV were diagnosed, 80% were linked to care and 36% of those diagnosed had achieved viral suppression in 2015.

They then assessed the effect of raising these percentages to the National HIV/AIDS Strategy goals, based on the 96% reduction in the risk of new infections in the HPTN 052 study of serodiscordant heterosexual couples when the partner with HIV was on effective ART.

They also looked at the benefit of PrEP used by 40% of high-risk men who have sex with men (MSM), 10% of people who inject drugs and 10% of high-risk heterosexuals. For efficacy, they used the 73% risk reduction in the iPrEx trial for MSM with detectable tenofovir/emtricitabine drug levels, 75% in the Partners PrEP trial for heterosexual couples, and 49% in the Bangkok Tenofovir Study for people who inject drugs.

The model predicted that increasing the number of people on ART with undetectable viral load would, by itself, prevent more than 168,000 new infections by 2020.

Expanding PrEP would avert approximately 17,000 additional infections over the next five years. Together, expanded treatment and PrEP would prevent 185,000 new infections – a 70% reduction.

However, if diagnosis and treatment rates remained stable at 2015 levels, expanded use of PrEP alone could potentially prevent 48,000 new infections, showing that its impact is greater if more people with HIV remain off treatment with detectable viral load.

“If we expand the use of our current prevention strategies today, we can significantly reduce new HIV infections tomorrow,” Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, stated in a CDC press release. “This study confirms that we have the right tools to dramatically reduce new HIV infections, but we have a long way to go in order to make those reductions a reality.”

“We urgently need to close gaps in HIV care and treatment for people living with HIV,” added Eugene McCray, director of CDC’s Division of HIV/AIDS Prevention. “At the same time, in the short term, we need to rapidly expand access to PrEP and other life-saving prevention tools.”

HIV hides and grows inside the body even when undetectable in blood

HIV can hide and grow in body ‘sanctuaries’ after disappearing from blood, study says

Researchers pinpoint how HIV hides and grows inside the body even when undetectable in blood

HIV continues to replicate in the body even if it’s undetectable in the blood after antiretroviral treatment, scientists have discovered.

It explains how the virus rapidly bounces back – and keeps growing – after a patient stops taking antiretroviral drugs.

Study author Dr Steven Wolinsky, chief of infectious diseases at Northwestern’s Feinberg School of Medicine, said: ‘We now have a path to a cure.

‘The challenge is to deliver drugs at clinically effective concentrations to where the virus continues to replicate within the patient.’

Potent antiretroviral drugs are able to seemingly get rid of HIV from the bloodstream in most patients.

After the treatment, their blood tests may not detect the virus.

However, HIV is still growing in a viral reservoir within the lymphoid tissue in the body at that time.

And, it ‘quickly rebounds’ in the blood after patients stop taking the drugs.

Scientists concluded that latently infected cells or ongoing low levels of HIV replication maintain those viral reservoirs during antiretroviral treatment.

Scientists long believed that the reservoir only contained long-infected cells in a resting place – instead of newly infected cells.

That’s because none of them had seen viruses with new genetic mutations that arise when HIV completes its growth cycles.

Furthermore, most patients don’t develop drug resistant mutations – which would seem likely if HIV was growing in the presence of drugs.

The study analyzed viral sequences in serial samples of lymph node cells.

They also examined blood from three HIV-infected patients.

Each of those patients had no detectable virus in their blood.

The scientists determined that the viral reservoir was constantly replenished by low-level virus replication in the lymphoid tissue.

Infected cells would then move from those ‘protected sanctuaries’ and into the blood, they found.

Therefore, infected cells in drug-sanctuaries within the lymphoid tissue can still produce new viruses.

HOW HIV INFECTS

HIV infects CD4+ T-cells, which play a vital role in the immune system and protect us from diseases. As HIV progresses, it reduces the number of active T-cells in the body until the immune system cannot function correctly, a state known as 'acquired immune deficiency syndrome' or AIDS.

Current World Health Organisation guidelines, which the UK government follows, recommend only beginning HIV treatment when the number of T-cells in the bloodstream falls below a certain level.

However, the new model predicts that treatment should start as soon as possible after infection to prevent AIDS from developing in the long term.

They can also infect new target cells and replenish the viral reservoir.

That’s why drugs have not been able to completely purge the body of latently infected cells – and kill the virus all together.

The scientists utilized a mathematical model to track the amount of the virus and number of infected cells as they grew in the sanctuaries – and as they then moved through the body.

The model showed that HIV grows in areas where antiretroviral drug concentrations are lower than in the blood.

The scientists concluded that it is important to deliver high concentrations of antiretroviral drugs to all locations in the body where HIV may grow and evolve.

As such, drugs that penetrate these ‘newly discovered sanctuaries’ will be required to eliminate the viral reservoir – and may bring the medical community closer to finding a cure.

Co-author Dr Angela McLean, a professor of mathematical biology at Oxford University, said: ‘The study is exciting because it really changes how we think about what is happening in treated patients.

‘It helps explains why some strategies that tried to clear the reservoir have failed.’

The study was published in the journal Nature. 

A new study shows that HIV can still live and grow in the body even after disappearing from the blood following aggressive antiretroviral therapy.

The research, published in the journal Nature on Wednesday, involved looking at samples of cells from the lymph nodes of three patients who appeared to have cleared the virus. The researchers found that cells in the lymph node tissue can still produce new viruses and infect new target cells.

The groundbreaking idea of viral reservoirs of HIV made headlines in July 2014 when a Mississippi girl born with HIV, who was believed to be cured after early treatment, tested positive for the virus after stopping therapy. In her case, doctors think the infection reemerged from a viral reservoir that contained cells in a resting state that were not proliferating.

The latest study, funded by the US National Institutes of Health, appears to show a different type of “sanctuary,” as the researchers called it, that harbours cells with low levels of HIV replication that move into the blood. Researchers used a mathematical model to track the amount of virus and the amount of infected cells as they grew and moved through the body.

This suggests that virus growth could occur in a place where drug concentrations are very low.

“These findings are important as it is critical for the field of HIV cure research to know whether new infectious cycles are indeed continuing in patients on seemingly effective treatment,” said Deborah Persaud, a professor of infectious diseases at Johns Hopkins University School of Medicine.

But Persaud, who was not involved in the lymph node research but was part of a team caring for a baby who had received a treatment similar to the Mississippi child, said the study is limited by its small sample size and the fact that the analyses were done during the first six months of combination treatment “when the infected pools are still very dynamic.” She said a similar study on patients with longer-term treatment may offer more clues about what is going on.

Co-author Steven Wolinsky, chief of infectious diseases at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician, said in a statement that the research indicates that “the challenge is to deliver drugs at clinically effective concentrations to where the virus continues to replicate within the patient.”

Angela McLean, a professor of mathematical biology at Oxford University and who supervised the mathematical modeling, added that the study “really changes how we think about what is happening in treated patients.”

“It helps explain why some strategies that tried to clear the reservoir have failed,” she said.

Putting Household Water Treatment Products to the Test

WHO’s new International Scheme to Evaluate Household Water Treatment (HWT) Technologies ensures that products used to treat water in homes are effective in protecting health.

Globally, an estimated 1.9 billion people rely on water supplies that are contaminated with faeces. This requires many to use household water treatment (HWT) technologies to help prevent disease and make water safe for drinking.

The global market for HWT products has now become flooded with products. From chlorination to filtration systems and solar disinfection, the options for purifying water are endless. Manufacturers claim their products make water safe for drinking, but in low-income countries, where many of these devices are essential, labs lack the capacity to verify these claims.

But, times are changing.

“The primary benefit from household water treatment is protecting health,” says WHO's Dr Batsi Majuru.

Now, the health benefits of HWT are increasingly recognized and the need for independent and rigorous evaluation is essential, adds Dr Majuru.

It is estimated that when used correctly and consistently, HWT and safe storage of water can reduce diarrhoeal diseases by as much as 45%, and save thousands of young children every year.

An international evaluation scheme

The International Scheme to Evaluate Household Water Treatment Technologies was established in 2014 to independently and consistently assess the performance of HWT products against WHO health-based criteria - an evaluation system similar to how pharmaceuticals and insecticide-treated bed nets are pre-qualified.

WHO International Scheme to Evaluate Household Water Treatment Technologies

Under the Scheme, a product can be evaluated if it is low-cost, appropriate for low-income settings, free standing and able to treat enough water to serve a limited number of individuals for a day. Products that meet these requirements are tested to see how well they remove microbiological contaminants, such as bacteria, viruses and protozoa, from drinking water. Product performance is classified based a 3 tiered system and those that achieve the highest removal of pathogens are given a 3-star rating.

Recently, WHO released the first round of results on 10 HWT technologies ranging from ultrafiltration to chemical disinfection and found 8 met performance targets. These products reach an estimated 60 countries and millions of users. Every year, WHO plans to test new technologies and release results to help countries like Ethiopia that are working to scale-up HWTselect the technologies that meet WHO performance criteria.

Improving regulation in Ethiopia

Ethiopia is often affected by droughts and floods, meaning that safe drinking water can be hard to come by and diarrhoeal diseases are common. To address the situation, the Government launched the ‘One WASH Programme’, which aims to achieve universal access to safe water, sanitation and hygiene, and improve safe storage and treatment practices in the household.

Prior to WHO’s scheme, many laboratories tried to evaluate HWT products, but there were no standard protocols or test processes. Now, the Ethiopian Food, Medicine and Health Care Administration Control Authority, which is mandated to test the safety of pharmaceuticals, food and beverages, is also mandated to regulate HWT products.

“Previously, we only conducted document reviews and chemical testing on chlorine-based HWT technologies being used in the country,” says Bikila Bayissa, Deputy Director General of Food & Medicines Quality Assessment, Ethiopian Food, Medicine and Health Care Administration & Control Authority. “Now, through WHO’s Scheme, we are also focusing on the microbiology, which is critical to ensuring drinking water is safe.”

WHO is working with the Government of Ethiopia to train staff from various government laboratories, ministries and regulatory bodies on how to do the microbiological testing to evaluate product performance, as well as implementing WHO Guidelines on Drinking-water Quality.

“Many HWT products are imported from other countries, but no one knows if they are good or bad,” says Dr Almaz Gonfa, coordinator, Food Microbiology and Food Safety Research Lab at Ethiopian Public Health Institute. “The WHO Scheme will help Ethiopians know the products they are using are actually cleaning their water and protecting their health.”

Scaling-up in more countries

Universal access to safe drinking water is called for in the Sustainable Development Goals. By strengthening protection and management of water supplies, including at the household level, WHO and governments are taking steps to achieve this goal.

This year, WHO is working with the Government of Ghana to develop HWT performance standards and a certification and product labeling system to aid users in making informed purchases. Once launched, the certification programme will support the Government’s National Strategy for Household Water Treatment and Safe Storage, aimed at reducing waterborne diseases by 2025.

“WHO’s scheme will help make sure the technologies in Ghana effectively clean water, are appropriate for local households and meet international standards,” says Kweku Quansah, programme officer, Ghanaian Ministry of Local Government & Rural Development.

“Once we pass technologies through the evaluation process, individuals will have the assurance that these technologies are internationally verified,” he adds.

Gliptin New Anti Diabetes Drug Cuts Treatment Cost by 80%

There's a new diabetes drug in the market which apparently cuts cost by 80%. We kid you not. This comes as good news for millions of diabetics tackling the debilitating disease.

By lowering the cost of therapy for patients by 80%, the new drug in the 'gliptin' family has disrupted the anti-diabetes market. With 15 companies offering offering the drugs, cost for a day's treatment is down from Rs 45 to an average daily price of Rs 9. This miracle drug could make life easier for the people tackling with the disease which gradually attacks and weakens all body organs.

The cost of gliptin treatment amounted to Rs 16,200 per year (at Rs 1,350 per month). With the entry of the new molecule and subsequently aggressive pricing by domestic companies over the past six months, the cost of therapy has dropped to approximately Rs 3,285 a year (at Rs 270 a month), translating into national savings of roughly Rs 1,300 crore for patients. The new entrant teneligliptin is also the fastest selling in the Rs 1,430 crore gliptin family which occupies 20% of the total anti-diabetic market.

Diabetics in the country have something to cheer about. A new drug in the 'gliptin' family has disrupted the anti-diabetes market by lowering the cost of therapy for patients by 80%, making it easier for millions of diabetics to tackle the debilitating disease which gradually attacks and weakens all body organs.

With the launch of teneligliptin molecule, the popular gliptin category has witnessed a price erosion of over 80% in the last six months, bringing down the cost from 45 for a day's treatment to an average of 9, with over 15 companies now offering it.

Most gliptins are priced around 45 for a day's therapy, taking the cost of treatment for patients to nearly 16,500 a year ( 1,350 a month).

The entry of the new molecule and subsequent aggressive pricing has led to the cost of therapy coming down to approximately 3,285 a year (or 270 a month), translating into savings of roughly 1,300 crore for patients.

The new entrant teneligliptin is also the fastest selling in the 1,430 crore gliptin family, which occupies 20% of the anti-diabetic market.

Teneligliptin, a third-generation new oral anti-diabetic drug manufactured by Mumbai-based Glenmark, received regulatory approval and was priced aggressively at nearly 20 for a day's therapy when it was first launched in June last year.

The launch of Zita Plus and Ziten (teneligliptin brands) by Glenmark paved the way for the entry of a host of other players to launch the molecule in the oral diabetic market, which is valued around 6,000 crore.

As per AIOCD data (December 2015), there are 16 teneligliptin brands in the market, with total sale of 36 crore.

The economic burden of diabetes is high in India as most patients pay out-of-pocket, and due to lack of medical reimbursement.

Worse, the cost of treatment also includes consultation, investigations, drugs, monitoring, complications, while the complications related to the disease may increase it substantially.

Dr Anoop Misra, chairman Fortis-C-DOC Hospital for Diabetes says, "Low cost medications are surely needed in India, however, all of us look at safety data before prescribing any medication. For teneligliptin, safety data is not long term, and confined to patients from far eastern countries, hence confidence to prescribe this medication viz-a-viz other gliptins is lower."

With the entry of the new molecule, the cost of therapy has dropped to approximatelyRs 3,285 a year (at Rs 270 a month), translating into national savings of roughly Rs 1,300 crore for patients.

Price war breaks out among anti-diabetes drug Gliptin in Market

Teneligliptin, a drug to control diabetes, is in the middle of an intense price war. While Mankind Pharma reduced its price by 50 per cent within 24 hours of a launch, Glenmark is evaluating the option of decreasing the price. A week ago, Zydus Cadila, another prominent player, already launched the lowest-priced Teneligliptin.

India's Gliptin market, estimated at Rs 2,000 crore yearly, is growing at around 60 per cent annually. Of the 68 million diabetics in India, about 1.85 million are on the Gliptin therapy to manage their type-2 diabetes.

According to October data from the All-India Organisation of Chemists and Druggists (AIOCD), the country's anti-diabetic drug market is seeing a growth of 25 per cent at Rs 7,638 crore.

"We are evaluating the option of lowering the price of our two Teneligliptin brands (Ziten and Zita Plus) to get more patients in the advanced Gliptin therapy fold," says Sujesh Vasudevan, president and head of India Business, Glenmark Pharmaceuticals.

Glenmark had launched these two drugs earlier this year at Rs 20 a tablet, half the price of the medicine sold by many multinational drug firms. Last year, anti-diabetes drugs accounted for only Rs 100 crore to Glenmark's overall revenue of Rs 6,600 crore. While it is a dominant player in dermatology, the company is now planning to expand its product portfolio in other therapeutic areas like diabetes.

Mankind Pharma, which launched its own Teneligliptin generic 'Dynaglipt' on November 23 at Rs 20 a tablet, decreased the drug's price a day later to Rs 8.60 a tablet.

"Diabetes is a growing epidemic; to cater to it, we are targeting the middle-class and rural diabetic patients, so that it becomes affordable and more economical. The change in prices will help reduce the cost of medicines by about half," said R C Juneja, chairman & founder, Mankind Pharma. The company is targeting at least Rs 200 crore in annual revenue from this drug.

Zydus Cadila, which launched its own generic drug 'Tenglyn' at Rs 7 a tablet a week ago, has no immediate plans to reduce the price further, according to a senior company executive.

"Considering the incidence of the disease, benefits of the drug, and price, Gliptin could become a large-volume drug and face further price erosion as volumes grow," says D G Shah, secretary-general, Indian Pharmaceutical Alliance (IPA).

The Organisation of Pharmaceutical Producers of India, representing multinational companies, refused to comment on the subject.

INTERPRETER OF REMEDIES

Glenmark to reduce teneligliptin prices (Rs 20 per tablet at present)

Mankind & Zydus Cadila have priced these below Rs 10 a tablet

Teneligliptin is a drug of gliptin category that has shown significant results in controlling blood sugar in type-2 diabetics

India Adds More HIV/AIDS, Cancer Drugs To Essential Medicines List

The government has revised its list of essential medicines to add drugs for diseases ranging from cancer and HIV/AIDS to hepatitis C, in a move aimed at making them more affordable.

The update to the National List of Essential Medicines (NLEM) is just the third since it was compiled in 1996.

It increased the list to 376 medicines from 348 and includes drugs ranging from analgesics and antivirals to contraceptives, cardiovascular and anti-tuberculosis drugs.

Reuters reported in April that more HIV/AIDS and tuberculosis medicines were likely to be added to list, which is posted on the Central Drug Standard Control Organisation's (CDSCO) website.

"The NLEM 2015 has been prepared adhering to the basic principles of efficacy, safety, cost-effectiveness; consideration of diseases as public health problems in India," a notice on the website said.

India had been criticised because the former list left out some life-saving drugs.

The new list takes cues from the World Health Organisation's 2015 list of essential drugs, which the United Nations agency defines as those that satisfy the priority healthcare needs of people and ensure affordability.

The revision comes after months of deliberations by a committee of experts formed by the government last May. Views of the pharmaceutical industry and NGOs were also considered, the CDSCO said.

The committee recommended that the list, which is effective immediately, be revised every three years.

In initial thoughts, industry executives said they were yet to study the list's impact.

"We will be seeking clarification and a better understanding of its implications," said Ranjana Smetacek, director general of the Organisation of Pharmaceutical Producers of India (OPPI) which represents large foreign drugmakers.

The Indian Pharmaceuticals Alliance, which represents large local drugmakers, did not respond to requests for immediate comment.

It is likely that medicines in the new list will be brought under price control, as was done with the previous list, some in the industry said.

Drug pricing is a contentious issue in the country, as nearly 70 percent of the population lives on less than $2 a day and health insurance is inadequate.

India contributes roughly 1 percent of its total gross domestic product to healthcare, among the lowest levels of funding in the world.

Industry executives say drug prices in the country are also among the lowest in the world.

India's drug pricing regulator has struggled in the past year to implement price caps and expand them to cover more drugs.

When it fixed prices of about 100 medicines citing public interest last year, the industry fired back with lawsuits.

The government soon curbed the National Pharmaceutical Pricing Authority's (NPPA) powers, restricting it from fixing the price of medicines not on the essential medicines list.

Price caps cover roughly 30 percent of the drugs sold in the country.

India reports 32 percent declining in HIV/AIDS

India is estimated to have registered a 66 per cent decline in new HIV infections from 2000 and 32 per cent decline from 2007, according to the latest round of HIV sentinel surveillance and estimations conducted by the National AIDS Control Organisation (NACO), released by the Union Health Ministry.

There were around 86,000 new HIV infections in 2015. The report noted that Andhra Pradesh and Telangana, Bihar, Gujarat and Uttar Pradesh currently account for 47 per cent of the number of total new infections among adults with each of these States contributing 7,500 or more new infections in 2015.


West Bengal and Rajasthan registered more than 5,000 new HIV infections, but less than 7,500 new infections, while Maharastra, Odisha and Tamil Nadu have new infections in the range of 3,000-4,000. Chhattisgarh, Delhi, Haryana, Jharkhand, Karnataka, Madhya Pradesh and Punjab have 1,000-2,400 new infections among adults and the rest of the States have less than 1,000 new adult HIV infections in 2015.


New infections among adults have declined by 50 percent or more in the State of Andhra Pradesh and Telangana, Karnataka, Maharashtra, Manipur and Odisha during 2007-2015. Bihar, Jharkhand, Kerala, Mizoram, Nagaland, Rajasthan and Uttarakhand are the states where annual new infections declined by 32-47 percent during the same period.

However a rising trend in new infections among adults during 2007-2015 has been detected in Assam, Chandigarh, Chhattisgarh, Gujarat, Sikkim, Tripura and Uttar Pradesh.

The report further noted that since 2007, the number of AIDS-related deaths declined by 54 percent in 2015 with an estimated 67,600 people dying of AIDS-related causes nationally.

The annual number of AIDS deaths has declined by 70-81 per cent during 2007-2015 in Karnataka, Maharashtra and Tamil Nadu. Annual AIDS related deaths declined by 60-70 percent from baseline values of 2007 in Andhra Pradesh and Telangana, Goa, Himachal Pradesh and Nagaland, while a decline of 40-47 percent was estimated in Chhattisgarh, Gujarat and Punjab.

Injectable HIV Treatment Would Change Lives

This month ViiV Healthcare and Janssen Sciences announced that Phase III trials for a bimonthly HIV treatment injection would begin in mid-2016. This year the two 

companies will be evaluating the commercialization of a long-acting formulation to be used as an injectable maintenance treatment for patients who have achieved viral suppression. 

Injectable treatments have been the buzz in HIV treatment research for a while, but this announcement represents a tangible hope that a new form of treatment is within our grasp. In a few years, many people living with HIV might be able to throw away their pillboxes for good.

The current oral regimen continues to be a reason for poor adherence to HIV treatment. Also, the daily pill can sometimes be viewed as a symbol of second-class status. 

No matter how healthy I am, people still see someone whose health is subpar.

In the U.S., the majority of people living with HIV are not able to stay on treatment and maintain viral suppression. The possibility of a bimonthly injection wouldn’t just improve adherence to medication and reduce transmission, it would revolutionize the lives of HIV-positive people.

If you are not living with HIV, just try to imagine it for a second. Imagine being a young person and being told that you can still live a long and healthy life, but only if you adhere to this daily regimen with few to no mistakes. Sounds simple enough, but factor in trying to carry the enormous weight of HIV stigma and concealing 

your diagnosis to the outside world — as most initially try to do — and you have 365 reasons to fail. For so many, a bottle of pills isn’t just a bottle of pills, but an embarrassing reminder to yourself and others, that you contracted a virus that is avoidable.

That sounds harsh. HIV shouldn’t have to be something people are ashamed of. But what should be does not change the reality of the majority of people with HIV who are utterly mortified and almost paralyzed by the idea of people finding out their status.

Now, imagine being told that all it will take to keep you healthy and living the life you want is six doctor visits a year. Sure, it may not still ideal, but what disease is? It is a hell of a lot better than the alternative. An HIV injectable treatment represents an opportunity to resume life knowing that you are virally 

suppressed even if you are not quite ready or able to take on managing your virus full time.

Today, managing HIV doesn’t just require a daily pill. It requires a person to develop an entirely new state of mind — one that requires strength, an awareness of what it means to be positive today, and the support of friends and loved ones. If that were so easy to come by, HIV wouldn’t still be the problem that it is.

An injectable treatment would remove the daily reminder of a disease that shouldn’t but often does hold people back. It would mean the freedom of waking up and going about your day without a siege of panic because you forgot to take your medication. It would mean the removal of shackles to a pill bottle so sleepovers can be spontaneous and packing for vacations is done sans stress. Frankly, an injectable treatment would simply mean a better life.