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ICMR’s GROUNDBREAKING STUDY EVALUATES METFORMIN AND INOSITOL FOR PCOS

by Anshika Mishra October 9, 2024

written by Anshika Mishra

India’s premier health research institution, the Indian Council of Medical Research (ICMR), has announced an ambitious study aimed at evaluating the efficacy of two widely used drugs, Metformin and Inositol, in improving fertility and birth outcomes among women affected by Polycystic Ovarian Syndrome (PCOS). This initiative comes in response to the pressing need for robust clinical evidence on the management of PCOS, particularly in the Indian context.

Understanding Polycystic Ovarian Syndrome (PCOS)

PCOS is a complex endocrine disorder that affects women of reproductive age and is characterized by a range of symptoms that can vary significantly in severity. Some key features of PCOS include:

Irregular Menstrual Cycles (Anovulation): Many women with PCOS experience infrequent or prolonged menstrual periods due to irregular ovulation, which can make conception difficult.
Hyperandrogenism: Elevated levels of male hormones, known as androgens, can lead to physical symptoms such as excessive hair growth (hirsutism), acne, and male-pattern baldness.
Insulin Resistance: Women with PCOS often exhibit insulin resistance, which can lead to higher insulin levels in the blood and increase the risk of developing type 2 diabetes.
Abnormal Gonadotropin Secretion: Hormones that regulate reproductive functions can become unbalanced in women with PCOS.

The prevalence of infertility among women with PCOS is alarmingly high, with estimates suggesting that between 70% to 80% of affected women may face challenges in conceiving. Moreover, these women are at a greater risk for pregnancy complications and less favorable outcomes compared to women without PCOS.

The Need for Effective Treatments

Current treatment options for PCOS often focus on managing symptoms, regulating menstrual cycles, and improving fertility. Among the treatments that have gained traction are Metformin and Inositol.

Metformin: Originally developed to treat type 2 diabetes, Metformin helps lower blood sugar levels and improve insulin sensitivity. It has been found to induce ovulation in women with PCOS, leading to improved fertility rates.
Inositol: This naturally occurring sugar alcohol is often used to improve insulin sensitivity and has gained popularity as a supplement for managing PCOS symptoms, particularly in relation to ovarian function and menstrual regularity.

Despite their widespread use, the ICMR points out that current evidence regarding the efficacy of Metformin and Inositol in improving fertility and pregnancy outcomes is insufficient. This gap in knowledge has prompted the need for a comprehensive evaluation.

The ICMR Study

The ICMR has issued an Expression of Interest (EOI) inviting researchers to participate in a multi-centric randomized controlled trial designed to evaluate the efficacy of Metformin versus Inositol for improving fertility and birth outcomes among women with PCOS. The research aims to answer the critical question:

“Among women with Polycystic Ovary Syndrome (PCOS), how does Inositol in comparison to Metformin work in terms of efficacy and safety on outcomes including pregnancy conception, menstrual cycle regularization, and improvement in endocrinological and metabolic parameters?”

Objectives of the Study

The primary objectives of the study are to:

Evaluate Fertility Outcomes: Assess how each drug influences conception rates among women with PCOS.
Monitor Menstrual Cycle Regularity: Determine the effectiveness of Metformin and Inositol in regulating menstrual cycles, which is crucial for ovulation and fertility.
Assess Endocrinological and Metabolic Parameters: Examine improvements in hormonal balance and metabolic health indicators, including insulin sensitivity.

The Research Context

The significance of this study cannot be overstated. A Finnish study indicated that Metformin could enhance pregnancy rates, live birth rates, and ovulation rates compared to a placebo. However, a Cochrane review that included several smaller studies found only marginal benefits in live birth rates with Metformin. Furthermore, data on Inositol’s effectiveness for women with PCOS remains sparse, particularly regarding birth outcomes and menstrual cycle regulation.

In India, the absence of robust research into the efficacy of these treatments means that healthcare providers often rely on guidelines developed in other countries, which may not be entirely applicable to the Indian population. The ICMR’s call for a multicenter trial aims to fill this knowledge gap and provide evidence-based recommendations for managing PCOS in Indian women.

Collaboration Opportunities

The ICMR is actively seeking partnerships with researchers and institutions interested in developing the multi-center randomized controlled trial. Selected researchers will join the research team to collaborate on the comprehensive research proposal and oversee the project’s execution. This collaborative approach aims to ensure that the study is conducted efficiently and yields meaningful results.

Key Takeaway

The ICMR’s initiative to study the efficacy of Metformin and Inositol for women with PCOS is a significant step toward addressing a major public health concern in India. By generating evidence specific to the Indian context, this research has the potential to inform clinical practices and improve the quality of life for countless women affected by this complex disorder.

As the trial progresses, it is hoped that the findings will contribute to better management strategies for PCOS, leading to improved fertility outcomes and healthier pregnancies for women in India. With 70% to 80% of women with PCOS facing infertility challenges, the importance of this research cannot be overstated—it could change the lives of many women and families across the country.

October 9, 2024 0 comment

Medicine

“ICMR Report Reveals Alarming Rise in Antibiotic Resistance: A Growing Threat to UTIs, Typhoid, and Pneumonia!”

by Dr. Shruthi R October 8, 2024

written by Dr. Shruthi R

The latest ICMR report highlights a troubling increase in antibiotic resistance affecting urinary tract infections, typhoid, and pneumonia in India. This alarming trend poses significant challenges for public health and effective treatment options.

Understanding Antibiotic Resistance: Insights from the ICMR Report

In recent years, the increasing phenomenon of antibiotic resistance has emerged as a significant public health threat globally, affecting various infectious diseases, including urinary tract infections (UTIs), typhoid, and pneumonia. The Indian Council of Medical Research (ICMR) has shed light on this pressing issue through its comprehensive report, highlighting the alarming trends and implications of antibiotic resistance in India. This long description delves into the key findings of the ICMR report, the underlying causes of antibiotic resistance, its impact on public health, and strategies to combat this growing challenge.

The ICMR Report: Key Highlights

The ICMR report offers a detailed analysis of antibiotic resistance patterns in India, with a specific focus on three major infections: UTIs, typhoid, and pneumonia. The report is based on data collected from various hospitals and laboratories across the country, providing valuable insights into the prevalence of antibiotic-resistant bacteria.

1. Urinary Tract Infections (UTIs)

UTIs are among the most common bacterial infections affecting millions of people worldwide, especially women. The ICMR report highlights a concerning rise in antibiotic resistance among the bacteria responsible for UTIs, particularly Escherichia coli (E. coli), which is the leading causative agent.

Rising Resistance Levels: The report indicates that the resistance of E. coli to commonly prescribed antibiotics, such as fluoroquinolones and nitrofurantoin, has increased significantly over the past few years. This trend poses a significant challenge for healthcare providers, making it increasingly difficult to treat UTIs effectively.
Implications for Treatment: The rising resistance rates mean that first-line antibiotic treatments may no longer be effective for many patients. As a result, healthcare providers may need to resort to broader-spectrum antibiotics, which can lead to increased healthcare costs, longer hospital stays, and a higher risk of treatment failure.

2. Typhoid Fever

Typhoid fever, caused by the bacterium Salmonella typhi, remains a major public health concern, particularly in developing countries like India. The ICMR report highlights troubling trends in antibiotic resistance related to typhoid.

Emergence of Multi-Drug Resistant Strains: The report points out the increasing prevalence of multi-drug resistant (MDR) strains of Salmonella typhi. These strains exhibit resistance to multiple antibiotics, including ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole, which have traditionally been used to treat typhoid fever.
Public Health Implications: The rise of MDR typhoid strains complicates treatment options and increases the risk of severe complications, prolonged illness, and mortality. It also emphasizes the need for effective vaccination and public health interventions to control the spread of typhoid in endemic regions.

3. Pneumonia

Pneumonia, a leading cause of morbidity and mortality worldwide, is often caused by bacteria such as Streptococcus pneumoniae and Haemophilus influenzae. The ICMR report underscores the growing threat of antibiotic resistance in pneumonia cases.

Resistance Patterns: The report reveals a concerning increase in resistance rates for key antibiotics used to treat pneumonia, including penicillin and macrolides. This trend raises concerns about the effectiveness of standard treatment protocols and the potential for increased healthcare costs.
Impact on Vulnerable Populations: Children and elderly individuals are particularly vulnerable to pneumonia, and antibiotic resistance can lead to severe complications in these populations. The report highlights the urgent need for better surveillance and targeted interventions to address the issue.

Causes of Antibiotic Resistance

The ICMR report identifies several factors contributing to the rise of antibiotic resistance in India, which are critical to understanding how to combat this growing challenge effectively.

1. Overuse and Misuse of Antibiotics

One of the primary drivers of antibiotic resistance is the overuse and misuse of antibiotics in healthcare and agriculture. Patients often demand antibiotics for viral infections, which are ineffective against bacteria. Additionally, the availability of over-the-counter antibiotics encourages inappropriate use.

2. Inadequate Treatment Practices

Inadequate treatment practices, such as not completing antibiotic courses or using suboptimal dosages, contribute to the development of resistant strains. When antibiotics are not used correctly, bacteria can survive and adapt, leading to resistance.

3. Infection Control Practices

Poor infection control practices in healthcare settings, including inadequate sterilization of equipment and lack of proper hygiene protocols, facilitate the spread of resistant bacteria. Hospitals and clinics must prioritize infection prevention measures to protect patients and reduce the risk of antibiotic resistance.

4. Environmental Factors

Environmental factors, including the presence of antibiotics in wastewater and agricultural runoff, can contribute to the development and spread of antibiotic-resistant bacteria. The use of antibiotics in livestock farming for growth promotion can also play a significant role in environmental contamination.

Impact on Public Health

The rising threat of antibiotic resistance has serious implications for public health in India and globally. The ICMR report highlights several key concerns:

1. Increased Morbidity and Mortality

Antibiotic resistance can lead to higher rates of morbidity and mortality associated with infections that were once easily treatable. Patients may experience prolonged illness, complications, and increased healthcare costs.

2. Healthcare Burden

As antibiotic-resistant infections become more common, the burden on healthcare systems will increase. Hospitals may face higher rates of hospitalizations, longer stays, and the need for more expensive treatments, placing additional strain on already stretched resources.

3. Economic Impact

The economic burden of antibiotic resistance extends beyond healthcare costs. Increased morbidity and mortality can lead to lost productivity, reduced economic output, and higher costs for families and communities.

Strategies to Combat Antibiotic Resistance

To address the growing threat of antibiotic resistance, the ICMR report emphasizes the need for comprehensive strategies at multiple levels:

1. Antibiotic Stewardship Programs

Implementing robust antibiotic stewardship programs in healthcare settings is essential for optimizing antibiotic use. These programs can promote the appropriate prescribing of antibiotics, reduce unnecessary use, and educate healthcare providers and patients about the importance of responsible antibiotic use.

2. Public Awareness Campaigns

Raising public awareness about antibiotic resistance is crucial. Educating patients about the appropriate use of antibiotics and the dangers of misuse can help reduce demand for unnecessary prescriptions. Campaigns should also focus on the importance of vaccination and preventive measures to reduce the risk of infections.

3. Strengthening Infection Prevention and Control

Healthcare facilities must prioritize infection prevention and control measures to limit the spread of resistant bacteria. This includes improving hygiene practices, sterilization of medical equipment, and implementing protocols to reduce hospital-acquired infections.

4. Surveillance and Research

Ongoing surveillance of antibiotic resistance patterns is essential for tracking trends and identifying emerging threats. Research into new antibiotics and alternative treatments is also critical to stay ahead of resistant strains.

5. Regulating Antibiotic Use in Agriculture

Addressing the use of antibiotics in agriculture is vital for reducing environmental contamination and the spread of resistant bacteria. Regulations should be implemented to limit the use of antibiotics for growth promotion in livestock and promote alternative practices.

The ICMR report on antibiotic resistance to UTIs, typhoid, and pneumonia highlights an urgent public health challenge that requires immediate attention. Understanding the factors contributing to antibiotic resistance and its implications for public health is crucial in developing effective strategies to combat this growing threat. Through collaborative efforts involving healthcare providers, policymakers, researchers, and the public, it is possible to reduce the impact of antibiotic resistance and protect future generations from its devastating consequences.

By prioritizing responsible antibiotic use, investing in research and surveillance, and promoting infection prevention practices, we can work towards a healthier future where infections remain treatable and the threat of antibiotic resistance is significantly diminished.

October 8, 2024 0 comment

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ICMR has released book and mobile app to help doctors stay up to date on prevalent illnesses

by Medically Speaking July 13, 2022

written by Medically Speaking

The Indian Council of Medical Research launched a book and a mobile app for physicians on Tuesday to assist them cope with issues such as irrational pharmaceutical usage, over and under diagnosis, and other issues.

The book, Standard Treatment Workflows (STW) volume III, is intended to provide clinicians at all levels of public health care with up-to-date information. With the use of such STW, issues such as illogical medication usage, over and under diagnosis, and improper referral procedures may be handled effectively.

Prof Vinod K. Paul, Member (Health), NITI Aayog, launched the book ICMR Standard Treatment Workflows – Volume III, which covers 54 disorders across 11 specialties, as well as a mobile app. Prof. Balram Bhargava, Secretary, Department of Health Research and Director General, ICMR, and Payden, Deputy Representative to the World Health Organization’s (WHO) Country Office in India, were in attendance.

Prof (Dr) Balram Bhargava, Secretary of DHR and Director General of ICMR, stated on this occasion, “The responsibility of providing healthcare in the periphery lies primarily on primary care physicians, who have done an outstanding job. The Standard Treatment Workflows will assist these clinicians in staying current by providing comprehensive recommendations on how to address common illnesses.”

Also Read: Constant check on Covid-19 is needed as virus is mutating: Expert

According to Prof (Dr) Vinod K. Paul, Member (Health), NITI Aayog, the usage of “Standard Treatment Workflows must be investigated in an operational research manner and at various levels of the public health system. A strong distribution strategy (including worldwide dissemination) involving several stakeholders is required.”

In 2019, the ICMR issued Volume-I, which had 53 conditions, and Volume-II, which contained 18 conditions, in 2019 and 2022, respectively. With new scientific knowledge emerging all the time and healthcare expenditures rising, healthcare practitioners frequently want easy standard treatment recommendations, processes, and reference books. The most recent STWs will aid in its successful implementation at all levels, with an emphasis on excellent health care.

Payden, Deputy Representative to the World Health Organization’s (WHO) Country Office in India, stated that WHO is a proud partner in this endeavour and would assist in disseminating this vital work across multiple nations and platforms. This will also entail the use of WHO field teams to teach healthcare personnel.

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July 13, 2022 0 comment

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ICMR has launched National Registry of Multiple Sclerosis and Related Demyelinating Disorders

by Medically Speaking July 12, 2022

written by Medically Speaking

The Indian Council of Medical Research (ICMR) has established a National Registry of Multiple Sclerosis (MS) and the Indian Multiple Sclerosis and Allied Demyelinating Disorders Registry and Research Network (IMSRN), which will create a systematic system for data collection, storage, retrieval, analysis, management, and outcomes.

It is India’s first countrywide database research network dedicated to MS and related demyelinating illnesses. The IMSRN began in October 2021, with AIIMS New Delhi serving as the national coordinating centre and 24 participant centres located around the country.

Also Read: Research links abnormal heart metabolism to abrupt cardiac mortality in future

“There is a critical need to get an understanding of our patients’ illness profiles and outcomes, as well as to plan research in many domains of pathophysiology, aetiology, therapy, and rehabilitation on these disorders. There are recently licenced drugs known as “disease-modifying treatments” that have been shown to be beneficial, including autologous hematopoietic bone marrow transplantation in the treatment of MS in certain instances “Dr. Balram Bhargava, Secretary of DHR and Director General of ICMR, said.

Multiple Sclerosis illness is a neurological ailment that mainly affects young people between the ages of 20 and 40, although it can also affect children and adolescents. This condition affects females more than males.

MS is expected to impact around 20 people per lakh population, while neuromyelitis optical spectrum disorders (NMOSD) affect approximately 2.7 people per lakh population, albeit this may be an understatement.

“More than 1,000 patients have already been recruited for this register. This will aid in estimating and comprehending our patients’ illness load, disease phenotypes, disease behaviour, treatment effectiveness, side effects, pregnancy outcomes, and long-term disease outcomes. The Registry will open the road for specialists to collaborate and produce ideas and research proposals on disease pathophysiology, aetiology, and imaging “Dr. R S Dhaliwal, ICMR’s Head of the Division of Noncommunicable Diseases, stated.

The registry was inaugurated by Professor Dr Subrata Sinha, Dean Academics of AIIMS, New Delhi, and Dr Satish Chandra, former Director of NIMHANS, Bengaluru. The ceremony was attended by neurologists from throughout the country as well as ICMR executives.

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July 12, 2022 0 comment

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ICMR will undertake study to assess BCG booster doses for children and adolescents

by Medically Speaking July 4, 2022

written by Medically Speaking

Researchers at the ICMR’s National Institute for Research in TB in Chennai intend to launch research on BCG booster doses for children and adolescents who are household contacts of tuberculosis patients. The study’s goal is to determine if a booster BCG injection might prevent TB development among them. Over 9,000 youngsters will be enrolled in this programme across seven venues in India.

The major goal of this research is to evaluate the effectiveness of BCG re-vaccination versus oral chemoprophylaxis in preventing tuberculosis (TB) in household contacts aged 6 to 18 years. Children will be randomly assigned to one of two trial groups: BCG or oral chemoprophylaxis.

The Bacille Calmette Guerin (BCG) vaccine is one of the world’s most extensively used vaccinations for reducing the risk of spontaneous tuberculosis infection. The effectiveness of BCG vaccination in infants is widely recognised, and it has been shown to protect children from meningitis and disseminated tuberculosis.

However, BCG revaccination is fraught with ambiguity. Although it is known that BCG revaccination boosts immunological responses, it has yet to be determined if BCG revaccination can help prevent TB illness in household contacts.

“The study is a multicenter randomised controlled experiment in which two groups of healthy household contacts aged 6-18 years receive either the BCG vaccination or oral chemoprophylaxis.”

The Bacille Calmette Guerin (BCG) vaccine is one of the world’s most extensively used vaccinations for reducing the risk of spontaneous tuberculosis infection.

The effectiveness of BCG vaccination in infants is widely recognised, and it has been shown to protect children from meningitis and disseminated tuberculosis.

Also Read: Health Ministry launches community support strategies for tuberculosis patients

They will be monitored over 24 months to compare the prevalence of tuberculosis in each arm. The purpose of this study is to compare the efficacy of BCG revaccination against oral chemoprophylaxis on the incidence of mycobacterium TB illness in healthy household contacts aged 6-18 years “According to Dr C Padmapriyadarsini, Director of NIRT.

“The ICMR has had one round of discussions with the health ministry, and another meeting is planned for next week.” There is currently no data on how many children in this age group get tuberculosis and how many die as a result of the disease “According to Dr. C Padmapriyadarsini.

“All children will be household contacts of patients with microbiologically proven pulmonary tuberculosis.” The study will also include contacts of people with multidrug-resistant tuberculosis (MDR-TB). Both positive and negative C-Tb skin test children will be included. Likewise, both well-fed and malnourished youngsters will be included. All children will be followed up on for 24 months after enrollment, and the incidence of tuberculosis (all kinds) will be compared across groups. The National Tuberculosis Elimination Program (NTEP) will be used to diagnose TB, and the C-TB skin test findings will be used to determine latent TB infection (LTBI).

While waiting for funding, scientists hope to begin the investigation as soon as feasible. They intend to conclude the study by 2025 in order to meet the health ministry’s TB eradication objective of 2025.

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July 4, 2022 0 comment

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Poor awareness, treatment and control key challenges in diabetes reduction by 2025: ICMR-NCDIR Study

by Medically Speaking Team March 15, 2022

written by Medically Speaking Team

According to researchers at the Indian Council of Medical Research-National Centre for Disease Informatics (ICMR-NCDIR), Bengaluru, the prevalence of diabetes and impaired fasting glucose is high among adults, but awareness, treatment, and control are still low in India, according to a paper published in the international journal Frontiers in Public Health on March 14 that provides a comprehensive picture of diabetes care in India.

The paper, titled ‘Diabetes Care Cascade in India’ provides empirical evidence to strengthen diabetes care in the country and publishes assessment results from the National NCD Monitoring Survey (NNMS) on diabetes prevalence, prevention, and management services available at the public health facility.

As part of this, 9,721 adults aged 18-69 years were surveyed across the country in 2017-18. The survey revealed that diabetes was more prevalent in women and in urban adults. Older age, obesity, raised blood pressure and high cholesterol were all observed to be key risk factors for diabetes. The key findings from the survey include that 9.3% of adults in India were found to be diabetic. Among them, 45.8% were aware of their diabetes status, 36.1% were under treatment and 15.7% had their diabetes under control.

The prevalence of diabetes was two times higher in urban areas (14.3%) than in rural areas (6.9%). However, poor awareness and treatment among rural adults than their urban counterparts is worrisome, Dr Prashant Mathur, Director, ICMR-NCDIR and lead author of the study said.

Women had a higher prevalence of diabetes (10.2%) than males (8.5%), however the majority of women were recently diagnosed (6.0 percent ). Furthermore, diabetes was found in 44.2 percent of individuals with high cholesterol and 16.3 percent of adults with hypertension.

March 15, 2022 0 comment

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Covid will fade by mid-march in most states: Samiran Panda

by Medically Speaking Team February 21, 2022

written by Medically Speaking Team

According to ICMR epidemiology chief Samiran Panda, the third wave of Covid-19, which is driven by the Omicron strain, would fade by mid-March in most states.

“We did an ICMR modeling study led by my team. We constantly make projections based on mathematical modeling exercises. We are projecting that by mid-March, all the states will see infections coming down,” Panda told a newspaper.

He added that some states would see Omicron infection going down earlier, while some states, which saw the entry of Omicron later, will take a little time. “But all the states in India will touch baseline as it was before the third wave by mid-March,” he said, adding that Omicron was found to be the most dominant strain of the Coronavirus.

About Kerala, which continues to report a high number of Covid cases and deaths, Panda said they are tracking the infection very well. “Kerala has a very robust healthcare system. Each state should track its infection epidemiology. Each state differs from the other. But yes, by mid-March, the Covid third wave will wane,” said Panda.

On the Deltacron variant, which has the properties of both the Delta and Omicron variants, and was earlier dismissed as a lab error, Panda said, “Recombination is a known phenomenon in an RNA virus. One must be very careful that the detection system is working fine. Sequencing and contamination of samples have to be eliminated. It should not be a shock or surprise to see that happening. However, one must be sure of laboratory contamination or sequencing techniques used for such announcements.

“Any recombinant might not be fatal or fast-spreading. We need not panic about the detection of a recombinant. We should be looking at it scientifically from a public health perspective whether it is causing any major transmission catastrophe. But this is not the case in India. We need to be vigilant, but not panic,” he said.

February 21, 2022 0 comment

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ICMR DG Balram Bhargava among 32 candidates in race for New AIIMS Director: Report

by Medically Speaking Team February 17, 2022

written by Medically Speaking Team

The incumbent, Randeep Guleria, is set to retire on March 23rd, and 32 candidates are vying for the position of director of the All India Institute of Medical Sciences (AIIMS) in New Delhi.

ICMR Director General Balram Bhargava is one of the candidates.

Twelve doctors from AIIMS have applied for the post. They include Rajesh Malhotra, head of orthopaedics and chief of trauma centre; MV Padma Srivastava, chief of neurosciences centre; Nikhil Tandon, head of department of endocrinology; Sunil Chumber, head of surgery; A K Bishoi, professor of cardiothoracic and vascular surgery (CTVS); and forensic chief Sudhir Gupta.

According to official sources, the date on which the four-member search-cum-selection committee will meet to short-list some names is yet to be decided. The panel comprises Union Health Secretary Rajesh Bhushan, Secretary of Department of Biotechnology Rajesh S Gokhale, Principal Scientific Advisor to the government K Vijay Raghavan, and Delhi University VC Yogesh Singh.

“The members of the search-cum-selection committee will soon meet to finalise some names which then will be sent to the Appointments Committee of the Cabinet (ACC) headed by the prime minister for final approval,” said a source.

February 17, 2022 0 comment

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Molnupiravir approved, but not recommended

by Medically Speaking Team January 7, 2022

written by Medically Speaking Team

Molnupiravir, an antiviral medicine manufactured by US firms Merck and Ridgeback, has been removed off the Indian Council of Medical Research’s recommended treatment plan just a week after it was authorised for early-stage Covid-19 patients (ICMR). The medicine posed “major safety concerns,” according to Dr. Balram Bhargava, the chairman of the ICMR. As a result, an embarrassing scenario has arisen: The substance is legal to take, but it is not advised.

Molnupiravir is a repurposed Covid drug, originally developed to treat influenza. It is meant for mild or moderately ill Covid-19 patients who are at risk of developing serious illness. The pill, if administered during the first five days after contracting the infection, has the potential to prevent serious illnesses.

The pill is among the first few therapeutics now being deployed for treatment of Covid-19. Molnupiravir was first cleared for use in the UK in November, and more recently in the US.

There have been concerns on two counts — low effectiveness, and some potential side-effects. Both were taken into account by drug regulating agencies while approving them.

Molnupiravir was found to be only 30% effective in trials, much lower than earlier indications. Besides, there have been been worries over its mechanism: The drug molecule incorporates itself into the RNA of the virus, inducing mutations with the objective of hampering replication. But this carries the risk of introducing mutations that can make the virus stronger and more dangerous. A bigger worry is the risk of the drug creating mutations in the human DNA itself.

These risks, very low by all accounts, have been considered by the drug regulators while approving the drug, which means that these have not been assessed to be significant enough. The prescribed five-day dosage is not considered large enough to pose any serious health concern.

Also, N K Ganguly, former head of ICMR, pointed out, there are several drugs for other diseases in the market that pose similar risks.

“Those drugs are frequently prescribed in specific situations based on the clinical assessment of the patients, if the benefits from the drugs are considered by the doctor to be outweighing these risks,” he said.

In the case of molnupiravir, it seems, going by the argument of Dr Bhargava, the benefits do not very clearly outweigh the risks, considering the low effectiveness of the drug.

January 7, 2022 0 comment

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As Omicron cases surge, Centre warns of 4th wave across the world

by Medically Speaking Team December 24, 2021

written by Medically Speaking Team

In the light of the rise in Omicron cases, the newest version of SARS-CoV-2, the Union health ministry issued a new warning against the Covid-19 pandemic on Friday. According to health secretary Rajesh Bhushan, during the ministry’s weekly press briefing on Friday, the world recorded over 9 lakh Covid-19 cases on December 23, indicating a new wave of the epidemic.

Here are 10 points the health ministry said:

1. The world is witnessing the 4th surge of the pandemic. On December 23, over 9 lakh Covid cases have been recorded all over the world.

2. Compared with Europe, North America and Africa, Asia is witnessing a decline in the number of fresh cases, but we have to be on guard, Rajesh Bhushan said.

3. India has been recording around 7,000 Covid cases every day. Since the past 4 weeks, India’s daily case tally fell below 10,000

4. India has seen two surges of the pandemic so far: one in September 2020 and the second in May 2021.

5. At present, India’s cases are on the decline: Global case positivity rate is more than 6% while India’s case positivity rate is 5.3%, though there are regional variations.

6. Cause of concern is the case positivity rate in Kerala and Mizoram.

7. Around 20 districts in the country are reporting a weekly positivity between 5 and 10%

8. 108 countries have reported over 1 lakh Omicron cases and there have been 26 deaths. In India, there are 358 Omicron cases in 17 states and UTs. 114 recovery has been reported.

9. Out of 183 cases analysed in India, 121 had foreign travel history, 44 had no foreign travel history but they came in contact with people with foreign travel history. Details of 18 are unknown. Out of these 183 cases, 87 were fully vaccinated, including 3 who received three doses of vaccine. 7 were unvaccinated and 2 were partially vaccinated, the Centre said.

10. Delta continues to be the dominant strain in India, including the recently identified clusters, ICMR DG Dr Balram Bhargava said.

December 24, 2021 0 comment

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