Drug watch: Tamiflu

Tamiflu which is the trade name for Oseltamivir is one of the best drugs for seasonal influenza and probabaly also for bird flu. Recently the Japanese government has issued a warning against its use in children between 10 to 20 years. This happened after more than 100 children between 10-19 years showed abnormal behaviors including screaming and attempting to jump off the balcony. Two other anti influenza drugs including Relenza (marketed by Glaxo Smith Kline) and amantidine are also under scrutiny after 13 children who used it developed various neuropsychiatric problems. An efficient system of constant scrutiny, monitoring and reporting of adverse drug reactions will safeguard the medical system of the various iatrogenic illnesses. (Scientific American, 16 May 2007)

For the first time a heart which had been once transplanted was retransplanted into another person in the Cedars Sinai Medical Center in Los Angeles. The second patient was a man with non-compaction of the heart. In this the heart muscle is spongy and the patient was progressively deteriorating on medical therapy. The procedure of retransplantation is challenging for various reasons. The risk of rejection is higher because the heart has been exposed to two different tissues and their antibodies and immune response. It may be technically more challenging because the vessels have been grafted earlier. The third problem is that since the heart muscle has faced two periods of no-flow of blood, the tissue may be more compromised. In this case the patient has completed several weeks post transplant without complications or rejection. (Scientific American, 11 May 2007).

Currently 350-400 hospitals in India are connected by telemedicine. The first telemedicine project was set up by the Apollo Hospitals group in the village of Aragonda in Andhra Pradesh in 1999. The group now has around 150 centers in India, Bangladesh, Maldives, Sri Lanka and Kazakhistan. They plan to have 500 to 700 more locations in the next 18 to 24 months. On the other hand Manipal Hospital’s telemedicine program is 1½-year-old but it already has 15 centers including those in Mauritius and educational links with South Africa. Other cardiac care units like Narayan Hrudayalaya have also done pioneering work in telemedicine. They have 48 remote centers including two each in Malaysia and Pakistan and one in Mauritius. An interesting project has 130 ECG centres used by family physicians who get ECG’s read by specialists at the main hub. Technology is transforming India’s health care industry and the excitement is palpable. (The Economic Times, 26 April 2007)

Gouri Rao Passi,
Consultant,
Department of Pediatrics,
Choithram Hospital & Research Center,
Indore, Madhya Pradesh, India.
E-mail: [email protected]