Fm March 2021 9 pages

₹ 250.00
VOL 7 | ISSUE 11
PAGES 100
March 2021
FUTUREMEDICINEINDIA.COM
VARIANTS
vs VACCINE
THE MUCH ANTICIPATED COVID-19 VACCINES STUMBLE
AS SARS-CoV-2 MUTATES FASTER THAN EXPECTED
IN THE NEWS RESEARCH DRUG DELIVERY COVID-19 UPDATES
‘MIXOPATHY’: IMA
ON THE WARPATH
FIGHTING COVID-19
INTRANASALLY
NANO DRUGS
TO NEURONS
FOUR THERAPEUTICS
ENTER PHASE 2/3

editor’s note
March 2021 / Vol. 7 / Issue 11
Founder & Managing Editor
CH Unnikrishnan
Executive September Editor 2020 / Vol. 7 / Issue 5
S Harachand
Founder & Managing Editor
Science CH August Unnikrishnan
Editor 2020 / Vol. 7 / Issue 4
Dr
Executive
Rajanikant
Founder
AUGUST
&
Editor
Vangala
2018
Managing / Vol:
Editor
Associate S 5 / Issue: 4
CH
Harachand Editor
Unnikrishnan
N S
Science
Arunkumar
Executive Editor Editor
Copy Dr S Rajanikant Editor
HarachandVangala
Sreejiraj Consulting Eluvangal
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editor’s note
Dear Doctor,
editor’s As a matter note of fact, microorganisms such as viruses and bacteria are our
cohabitants
editor’s
on
note
the earth and they too want to survive, like you and me. For us, they
might Dear Doctor, be hostile, but knowingly or unknowingly, we are often their hosts. And, like
us, Dear they Doctor, leave no stone unturned in their quest for survival. So, the fight for survival
My daughter, like every other urban, school-going child, had hardly any time to
between Perhaps us against and them most has of our been expectations, going since we still life find began ourselves on the in earth. the middle Yes, I of am
sit unengaged. Besides endless academic chores, including the hectic homework
talking a raging about pandemic. the SARS- Like everyone CoV-2 variants. else, you We too thought are exhausted the vaccine with all that the we options prepared
and soft skill projects and presentations, she also found time for her painting and
with for disease much effort management and expectations laid out before will end you. the However, pandemic. the fact But is the that genetic symptom mutations
dancing classes. In between all these edu-arta-thons, she would also invariably
of relievers the virus
Dear and are
Doctor proven again and keeping unproven us on immunity our toes. boosters Despite are our the trust only on options building in front herd
squeeze in her favourite sports and workouts with school and building buddies,
immunity of the infected, and mass and that vaccination the pandemic as potential remains strategies as untamed to tackle as ever. the All COVID-19
of whom she has many. But, COVID-19 has put a stop to all that. The lack
hope
of
now
the
pandemic, rests
usual
on
We opportunities
a potential immune vaccine. evading
know you are for busy. action,
But SARS-CoV-2
It is with
how
always classes
close variants are
reassuring confined
we to would that
that to the
panacea presumably
trust internet
really?
and and,
become Not
faith most
very,
of of
a
all,
major to be frank, but not very far either.
the hundreds relentless
challenge
of confinement
to this whole
patients in at your home,
approach.
healing often
Again,
touch leaves
it
keeps her
is a
moody
fight for
you busy and
survival.
in glum—a
Our
Indeed, the latest WHO survey has a list of 165 SAR-CoV-2 vaccine
this
candidates
noble typical
natural
or
psychological
vaccine immunity
under profession. syndrome
is putting
development In the across hectic that
the practice, affects
increased
the
world. At it’s ‘normal’
pressure
least quite 23 natural people
on the
of them that exposed
viral ecosystem,
are you in clinical might to ‘abnormal’
leading
trials miss
to and
situations. the proliferation
six are out in on This
final some pandemic of mutants
stages, of the including latest and developments the with prolonged increased
phase-3 human in lockdown transmission
studies. emerging nothing capability
Eight medicine. less
vaccine candidates In than and immune
this era a very
evasion. ‘abnormal The
are in of various innovation,
situation’ challenge
stages medical
for is not right
of development science
just before her,
is
but us: getting
millions The number
India too. redefined
of children of such
Of these, almost
and mutants
two by
adults
are the already day.
across of SARSin
Old
the
CoV-2 world. is rising fast, as we have already seen in the UK, South Africa, Brazil and now
in phase-1 India. technologies human trials. are being The Oxford-AstraZeneca replaced by the new vaccine, the which blink is of presumably an eye. Robots the
The repercussions Even as laboratory and manifestations studies suggest of this the prolonged possibility abnormality of immune escape in our with
at
front-runner and artificial among intelligence the four global are taking candidates over a in good the part most of advanced the procedures, stages, has
now
social least
while been
life one vary of
genomics allowed
from these
to
person variants,
and be tested
to person. the biggest
molecular in India.
These worry
science The unveil Indian
include for scientists
the manufacturing
anxiety and and depression epidemiologists
mysteries of partner life further. of
as is
that
the
well the
We British
as biological actual number
are vaccine
effects of
fortunate project—Serum
like variants disturbed out
to have such Institute
sleep, in the
breakthroughs of India
appetite world could
— as will
disturbances be far more.
they conduct help specialists the
and Britain,
observerblind,
other which
leads like
emotional the world
you
randomised
difficulties. in surveillance
rise above
controlled
The severity efforts
the expectations
study
may in
to
of
determine
even this extend regard,
today’s informed
the safety
to has mental recently
patient.
and immunogenicity
illness said and that even there are
at
of substance least 4,000
the vaccine misuse. variants
candidate The of young the virus
in about and 1600 the that old, causes
healthy pregnant COVID-19.
human women, volunteers family in the members country. of
However, the No infected doubt,
this
even and is only those in
the
case who second
of have immune
phase died evasion,
of due human to the
trials, infection present
and they
vaccines and will even move
may the to lonely provide a
certain
Phase-3 are Similarly, all vulnerable amount
only
it
when
is of also to protection.
the mental a
company
time health when But
is
the
successful issues India key is caused issue witnessing
in submitting
here by the is revolutionary that pandemic safety
it may
data, and lead growth
evaluated society’s to reduced in
chances by reaction the healthcare Data of to herd it. Safety industry, immunity. Monitoring especially This Board means in (DSMB), the we private must to the sector, re-evaluate CDSCO—the wherein our Indian approaches increasing drugs and
public regulator. One number health of the of strategies most doctors crucial are to areas create taking we new up must multiple methods focus roles on to is deal of the clinician, with psychological the researcher pandemic. impact and This that
situation this These entrepreneur. has on promising now the poses first This advancements response several requires serious teams expansion by questions, like the you scientific of and your not your community focus only colleagues. to around a wider worldwide our The canvas. vaccination long are In hours
strategy, certainly spent this working context, but commendable. also in it potentially on becomes our But, treatment, important dangerous what we prevention seem how and to a unpleasant busy be and losing professional control sight situations, strategies. in like all such you this Preliminary as can are testing the
data very labs, keep real from hospital challenges pace surveillance wards with these and studies risks COVID latest involved suggest ICUs, developments makes in that vaccine at frontline least development. a quick four-fifths health and workers The easy of the development
way. prone currently to such
available of mental a safe health vaccines issues. with typically In proven this a edition, long, efficacy complex we against wanted process the to highlight and original often virus the lasts ground may 10-15 find realities years
difficult
to and on keep this
At involves Future
front up with multiple and
Medicine, the the rapidly elements paramount
which evolving is of conceived
importance research SARS-CoV-2. and and
of development providing
crafted Our cover by
additional
a and team story various of tries mental
senior to levels give health you a
detailed of support public and information private participation. to both the Therefore, care-seeker this rapid as well race as and the the caregiver. shortened
journalists, scientific scientists analysis and doctors, this evolving our aim scenario. is to help you do just that. We
process In Another is certainly highlight not of the this desirable edition is way a report to go on forward, a genetic but study we do on need the a NCD-hit solution
are
addition,
equipped
Dr Rajanikant’s
to bring you
column
the latest
highlights
from the
the
science
possible
of care
preventive
from across
and control
strategies urgently. South Asian That, to population—uncovering help however, thwart doesn’t the major answer impact the the story question of behind any immune of whether first-ever escape such Genome-wide
of a rapidly the virus,
developed Polygenic
the world
Risk solution
in
Score
an
will
interesting
for be coronary 100%
and
safe artery
convenient
and disease efficacious.
way,
on the
supplemented
In this South edition, Asian we
by
population. delve
the best
without going for new lockdowns that the world economy can ill afford. On the Dr
deep V Ramprasad, of into views the and high-wire CEO analyses of MedGenome, acrobatics from the that masters which is COVID-19 initiated each vaccine the field. CAD We development.
PRS present study, you also this
other hand, India’s noted vaccine expert, Dr Suresh Jadhav of Serum Institute talks of
about Also specialised the in this greater edition knowledge impact is a special that vehicle it feature can that make plugs on the India, you latest into scientific Straight the emerging advancements Talk of world this edition. of
India, re-emphasises the power of the vaccine science, which he believes will still
a most care promising seamlessly. cardiovascular Come, let’s treatment join hands involving this information one-time gene journey.
emerge
editing. Our
Wishing as you the an saviour insightful of mankind. reading,
guest on Straight Talk this month is Sameer Sheriff of iPC Health who explains why
Wishing we need CH Unnikrishnan
to get insightful a grip on reading, India’s high levels of medical error deaths urgently.
Wishing editor@futuremedicineindia.com
you an insightful reading,
C H Unnikrishnan
C editor@futuremedicineindia.com
H Unnikrishnan
editor@futuremedicineindia.com
C H Unnikrishnan
editor@futuremedicineindia.com
www.futuremedicineindia.com futuremedicineindia FutureMedIndia
AUGUST 2018/ FUTURE MEDICINE / 3

IN THE NEWS RESEARCH DRUG DELIVERY COVID-19 UPDATES
Vol 7 Issue 11
March 2021
VARIANTS
vs VACCINE
ThE MUch hOPED-FOr cOVID-19 VAccINES STUMBLE
AS SArS-coV-2 MUTATES FASTEr ThAN EXPEcTED
₹ 250.00
VOL 7 | ISSUE 11
PAGES 100
MArch 2021
FUTUrEMEDIcINEINDIA.COM
13
IN THE NEWS
‘MIXOPATHY’:
IMA ON
THE WARPATH
‘MIXOPATHY’: IMA
ON THE WARPATH
FIGHTING COVID-19
INTRANASALLY
NANO DRUGS
TO NEURONS
FOUR THERAPEUTICS
ENTER PHASE 2/3
REGULAR FEATURES
06 Letters
08 News updates
32 Drug approvals
40 Research snippets
58 Drug delivery
62 Drugs
63 Hospital news
64 Clinical trials
66 Devices&gadgets
74 Gynecology &
paediatrics
76 Public health
78 Guidelines
96 Calendar
97 Book review
98 Holy grail
Columns
19 TRIALOMICS
Dr Arun Bhatt
44 THE CELLVIEW
Dr Rajani Kanth Vangala
16
RESEARCH
FIGHTING
COVID-19
INTRANASALLY
Delivery of peptide inhibitors via
intranasal route could help
prevent the spread of SARS-C0V-2
38
STRAIGHT TALK
‘NO NEED TO
WAIT TILL
THE END TO
PROVIDE
THE BENEFITS
OF PALLIATIVE
CARE’
Professor Richard Harding
Herbert Dunhill Chair, Cicely Saunders
Institute of Palliative Care, Policy &
Rehabilitation

46
FM COVID-19 UPDATES
G7 LEADERS
COMMIT
US$ 4.3 BN TO
FINANCE TESTS,
TREATMENT AND
VACCINES IN 2021
64
CLINICAL TRIAL
bNAbs TO
STALL HIV
Clinical studies find
single-agent antibody
fails to cut HIV transmission
The use of
nanoparticles
for delivering
therapeutic
molecules to the
nervous system
has immense
potential for future
clinical strategies.
Dr Sahadev A
Shankarappa
Center for
Nanosciences and
Molecular Medicine
Amrita Institute of
Medical Sciences and
Research Center
Amrita Vishwa
Vidyapeetham
University, Kochi
20
COVER STORY
MUTANTS
CHALLENGE
COVID-19
VACCINES
The much hyped vaccine
strategy seems to be unraveling
quickly as SARS-CoV-2 mutates
faster than expected

IN THE NEWS RESEARCH TECHNOLOGY COVID-19 UPDATES
letters to the editor
DOCS QUESTION
VACCINE SAFETY
GAME-CHANGING
mRNAs
₹ 250.00
VOL 7 | ISSUE 10
PAGES 100
FEbrUAry 2021
FUTUrEMEDICINEINDIA.COM
WELCOME
TO DESI
JABS
INDIA BEGINS MASS IMMUNISATION
AGAINST COVID-19 WITH TWO
INIGENUOSLY MADE VACCINES,
AMID DOUBTS ON THEIR EFFICACY
NANOTECH GETS
A BOOSTER
FROM COVID-19
VAC IMMUNITY TO
LAST FOR A YEAR
Flouting COVID-19
protocols
Hi
While some medical
practitioners are in a debate
over the efficacy of certain
COVID-19 vaccines in India
whilst they receive them,
new cases in the country
have already begun to take
a new course. Recently, the
apprehension was mainly
observed over Bharat Biotech’s
Covaxin, which was granted
emergency approval before the
completion of phase 3 clinical
trials. Also, many doctors had
raised complaints as they
wanted to choose the vaccine
they received, and many chose
Covishield over Covaxin. Such
incidences made many of them
become skeptic and slowed
down vaccination. This also
has been controversial, as in a
country with over 136.64 crores
population the vaccination has
only reached over 1.4 crore
people so far. However, many
people are still not interested
in taking vaccination and are
planning to try and avoid
them and stick on to basic
protocols of wearing mask and
hand washing, while many
doesn’t even care to do that.
The cases across the country
shows a rising trend and as
many got used to the fear of
COVID-19 they tend to give up
by neglecting the protocols.
This has made some state
governments to take critical
actions by implementing
marshals at weddings or
banning interstate travel and
more.
Dr Suhas K Menon
Kochi
Digital doctors
Sir
This is written with reference to
the story on Viveo Health. The
fact that the company seems
to recreate a virtual office for
doctors enabling a centralised
platform to accommodate
remote consultations, emails,
appointments calendar and
electronic medical records
could become a real boon
to upcoming and practising
doctors. Furthermore, allowing
a free usage version of Viveo
could give the physicians a
chance to experience the
application. Hoping such
platforms could create a
positive impact on the medical
field and among patients.
Dr Vivek Kashyap
Bangalore
High value for readers
Hi
We are completely enthusiastic
especially about the printedition
of Future Medicine,
because we have never had
any possibility to see this. A
really nice and interesting
magazine of high value for the
readers, congrats on that!
Dr Barbara Bauder
Vienna
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news updates
EMERGENCY MEDICAL SERVICES
Health ministry to set up
140 skill training centres
Union Ministry of Health & Family Welfare,
under Central Sector Scheme ‘Human
Resource Development for Emergency
Medical Services’, will establish 140 Skill
Centres in government medical colleges
across India to impart skills on life-saving
interventions.
Under the scheme, 17 such skill centres
have been proposed to be set up in Uttar
Pradesh. Of these, nominations for 11 skill
centres by the state government of Uttar
Pradesh have been received so far, stated
the minister of state (Health and Family
Welfare), Ashwini Kumar Choubey in a
written reply in the Lok Sabha, recently.
Maharashtra will have 11 skill centres
established across the state. Other states
which will get a big share of emergency
medical service skill centres are Bihar (10),
West Bengal (9), Madhya Pradesh and Tamil
Nadu (8) each and Rajasthan, Karnataka
and Gujarat will get 7 centres each.
While Telangana, Kerala, Jharkhand
and Assam will keep 4 centres each, the
proposal is to set up 3 skill training units
each in Punjab, Chhattisgarh and Haryana.
This is a central sector scheme
under the ministry of health and the skill
centres are 100% funded by the central
government, according to an official release.
For each skill centre, funds to the tune
of Rs. 2.60 to 2.90 crores (depending on
the location) are released to government
medical colleges/ institutions subject to
their recommendation by the concerned
state government. The funds allocated
are for infrastructure and procurement of
training equipment.
So far, a total of Rs 121 crores have been
granted to 82 medical colleges.
Zydus completes
phase-I trials
of single-dose
malaria drug
Zydus Cadila has announced
that its antimalarial
compound ZY19489
(MMV253) developed in
partnership with Swiss-based
Medicines for Malaria Venture
(MMV) has completed phase I
clinical evaluation.
In the first human study
conducted in Australia,
escalating doses of 25 to
1,500 mg were administered
to healthy human volunteers.
Emerging pharmacokinetic
(PK) and safety data were
evaluated by a safety data
review committee.
In addition, a malaria
challenge trial involving
the P. falciparum volunteer
infection study (VIS) model
was also conducted in
Australia to determine
safety and tolerability and to
characterize the antimalarial
activity of a single-dose oral
administration of ZY-19489
in healthy adult volunteers.
No serious or severe drugrelated
adverse events were
observed.
ZY19489 has the
potential to be a single-dose
cure for P. falciparum and
P. vivax malaria due to its
novel mechanism of action,
rapid parasite killing activity
8 / FUTURE MEDICINE / March 2021

COVID-19 CARE
IMA slams centre’s data
on death of doctors
The Indian Medical Association
(IMA) has recently refuted the
central government’s data showing
that only 162 doctors died due to
COVID-19.
As per the IMA data, as many
as 734 doctors have died due to
COVID-19 till February 3, “of which
431 are general practitioners, who
are the first point of contact for the
people”. Among them, 25 are below
35 years of age.
In response to a question,
the Ministry of Health and Family
Welfare told Rajya Sabha that 162
doctors, 107 nurses, and 44 ASHA
workers have died due to COVID-19
till February 2.
IMA has condemned the
government’s apathy in verifying the
data and delaying the disbursement
of solatium for COVID-19 martyrs’
families.
IMA said it was “shocked”
by the announcement over the
underreporting of data. “We are
writing to you at this juncture to
appropriately endorse the hard work
and contribution by our doctors
in flattening the COVID-19 curve in
India. IMA is constrained to point
out that they would have stayed
back at home during the pandemic
safely and chose to serve the nation
in best traditions of the medical
profession,” the letter stated.
Demanding a thorough study
by a “high-powered committee”
constituted by the government on
the entire data relating to deceased
doctors, the letter said: “It is
unfortunate that in the devastating
pandemic, the frontline warriors of
modern medicine had fought with
altruism and in the bargain lost their
lives, however the roll of honour
or the appropriate data on these
fatalities were documented by the
government of India. Doctors suffer
a higher viral load and case fatality
ratio as a community. We fervently
appeal to you to expedite the
process of giving solatium to families
at the earliest.”
across all intraerythrocytic
malaria stages, low resistance
potential and long half-life.
Artemisinin resistance is
seen as a mounting challenge
to the global fight against
malaria. ZY19489 is being
developed to provide an
effective alternative to
the current front-line
antimalarial drugs for the
treatment of P. falciparum
and P. vivax malaria,
as artemisinin-based
combination therapies (ACTs)
are under threat of resistance.
As per the World Malaria
Report 2020, in 2019 there
were an estimated 229 million
cases of malaria worldwide
and the estimated number
of malaria deaths stood at
409,000.
Prioritise
investments in
testing: WHO
WHO has updated its
essential diagnostics
list (EDL) to include COVID-19
tests.
The latest edition
expands the suite of tests
for vaccine-preventable and
infectious diseases and noncommunicable
diseases (such
as cancer and diabetes)
and introduces a section
on endocrinology, which is
important for reproductive
and women’s health.
For the first time, the list
includes tests that should
not be supplied in countries,
March 2021 / FUTURE MEDICINE / 9