Clinical Establishment Law, 2010 passed in Lok Sabha. vAGAIN NOTHING FOR PHARMACY)

Clinical Establishments Bill, 2010 passed in the Lok Sabha making it mandatory for all clinical establishments in the country to register as per the provisions of the new statute. The Bill, which has been pending for several years, aims to bring in uniformity in the healthcare delivery and prescribes penalty for the defaulting establishments. The legislation is now applicable to clinical establishments under all recognized systems of medicines or treatment under Allopathy and Ayush. It would apply to all the hospitals or clinics including single doctor establishments, with or without beds. The Act includes any laboratory, which offers pathological, bacteriological, genetic, radiological, chemical, biological and other diagnostic or investigative services. The government or a department of the government, a trust (public or private), a corporation (including a cooperative society), a local authority or a single doctor establishment can own the establishments.

A significant aspect of the new legislation is that it makes it obligatory for any doctor in a registered clinic, hospital or other clinical establishment to provide treatment to anyone who is brought in an emergency medical condition. No patient can be sent back on some reasons. The Act mandates every state to set up a multi-member State Council of Clinical Establishments without delay. The new Act requires that creation of a Registering Authority for Clinical Establishments in each state with a multi-member body at district level. The registration would be of two types, provisional and permanent. Permanent Registration would be provided after standards have been notified. There are different standards for different categories of clinical establishments.

It is rather strange that a country like India did not have a law to regulate clinical establishments for such a long time allowing them to operate without any laid down standards or ethics. Most of them have been following no good medical practices on their own and have been indulging in fraud and undesirable activities. One of the main culprits in this area used to be thousands of pathology laboratories spread across the country. Many a time incorrect assessment of the medical condition by these labs has been responsible for wrong prescription of medicines to the patients. Currently, health departments of most of the state governments do not have a system to check or monitor the activities of path labs or any other diagnostic centres.

As public health is largely a state subject, the Central health ministry has been rather passive in a framing a law to regulate these clinics, hospitals and laboratories. All these are going to change now with this new enactment. The legislation is expected to empower the state government or Registering Authority to direct any or all clinical establishments to furnish such returns/statistics or other information whenever required. Now the question is how soon this law is going to be enforced by the state governments. The ball is in their court. To pass on the benefit of the new law to the public, the state governments have to establish the necessary infrastructure and create a team regulatory staff in right earnest.

Why Aspirin (as an antipyratic) is contra-indicated in dengue ???

Dengue fever is transmitted by female Aedes Aegypti mosquitoes which acquire the virus while feeding on the blood of an infected person.Dengue occurs in two forms: Dengue fever and dengue haemorrhagic fever.
Dengue fever is marked by the onset of sudden high fever, severe headache and pain behind the eyes, muscles and joints.According to the World Health Organisation, dengue haemorrhagic fever is a potentially deadly complication that is characterised by high fever, often with enlargement of the liver and, in severe cases, circulatory failure.There is no specific treatment for dengue fever but early recognition and symptomatic treatment can save lives.
Use of aspirin during dengue fever is not recommended owing to increased bleeding tendency.Aspirin has an antiplatelet effect by inhibiting the production of thromboxane, which under normal circumstances binds platelet molecules together to create a patch over damage of the walls within blood vessels.

Difference between diclofenac sod. and potessium salt ......

Dilcofenic is a relatively potent NSAID. It is a phenylacetic or benzeneacetic acid derivative with the chemically designation 2-(2,6-dichlorophenyl)amino phenylacetic acid or benzeneacetic acid, monosodium or monopotassium salt. Diclofenac sodium was first synthesised by Ciba-Geigy of Switzerland in 1965 and was launched as Voltaren in 1988.

The sodium salt and potassium salt of diclofenac used are biologically equivalent, with both being protonated by the acid in the stomach. One difference is that diclofenac potassium is slightly more soluble in water than diclofenac sodium.

source-www.drugs.com, www.assistpainrelief.com

How insulin and proinsulin are safe in lysosomal cavity,where they store normally

Insulin is thought to be chemically stabilized within -granules in the crystal form. The other major products of the -granule, proinsulin and C-peptide, by contrast, are not thought able to crystallize. The physico-chemical properties of peptides in soluble or crystalline form are dramatically different. The ability of insulin to crystallize in the -granule might thus explain why this peptide, but not proinsulin/Cpeptide, remains stable even after its introduction into lysosomes as occurs during granulolysis (crinophagy). We have now studied this by exposing proinsulin or insulin to lysosomal proteases in vitro. 125I-insulin in soluble form was found to be degraded at the same rate as 125I-proinsulin. Strikingly, however, when the labelled insulin was crystallized, its rate of degradation was decreased from 1.9 to 0.2 pmol/min. We take these data as confirmation that the insulin crystal is resistant to degradation, thereby possibly accounting for (a) the presence of insulin immunoreactivity within multigranular bodies, and (b) the unusually slow rate of degradation of insulin within B cells compared with that of other hormones in their cells of origin.

source of information
1.Resistance of the insulin crystal to lysosomal proteases: implications for pancreatic B-cell crinophagy
P. A. Halban, R. Mutkoski, G. Dodson and L. Orci