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Tuesday, January 19, 2021

Bone Health: This method of weight loss is fatal for bone density, consequences are bad in latter stage of life

 Bone Health: This method of weight loss is fatal for bone density, consequences are bad in latter stage of life

Bone Health: This method of weight loss is fatal for bone density, consequences are bad in latter stage of life

For weight loss, people use special diet, gym training, calorie burning supplements and all medicines. There are some people who have started resorting to weight loss surgery called 'Sleeve Gastrectomy' in the desire of slim-fit body. A new study has revealed the terrible disadvantages of this surgery.

In Sleeve gastrectomy, about 75 percent of the stomach is removed for the human to lose weight. According to a report by Science Daily, between 2005 and 2014, cases of weight loss in teenagers have been increased more than 100 times. Health experts have claimed that this method of weight loss affects the bones (Weak bone).

Miriam A., Professor of Radiology at Harvard Medical School (Boston). Bredella says, "This weight loss bacterial surgery can have a bad effect on human bones for a long time." The body of 52 obese adolescents was examined in this study. Of these, 26 were placed under sleeve gastrectomy.

After monitoring the health of the teenagers for about a year, the researchers showed a decrease of 13 to 28 kg in their weight. Also, more 'Marrow Fat' was found in his bones and the problem of 'loss of bone density' was seen in the lumbar spine.

Dr. Bredella said that there was a possibility of loss of bone density in the bones after the sleeve gastrectomy, because more weight makes the bones stronger. Apart from loss of bone density, it also affects our hormones and nutrients required by the body.

He said, 'We need to find a mechanism that is safe for these bones as well as their bones. Adolescence is an extremely important time for the development of bones and muscles. The wrong experiment with health at this time can give terrible harm in future.

Vitamin D is sufficient to reduce the risk of death from corona virus: study

Vitamin D has potency to reduce the risk of death from corona virus: study

Vitamin D has potency to reduce the risk of death from corona virus

Corona virus patients with a sufficient amount of vitamin D are at a 52 per cent lower risk of death. A new study has found this. This study was conducted by resertures at Boston University in the United States.

Reserchers have come to know that patients with adequate vitamin D content have halved the risk of death after being admitted to the hospital. The risk of falling seriously was also found to be 13 per cent lower due to vitamin D.

During the study, it was revealed that patients with adequate vitamin D were also reduced by 46 per cent in their ventilators. Scientists say that vitamin D has an important role in the immune system of the person, which benefits corona patients. 

On an average, 42 per cent of Americans are found to have vitamin D deficiency. Even in black and elderly people, there is comparatively higher vitamin D deficiency and such people are suffering more from the corona.

Earlier, Boston University's Michael Hollic had discovered in a research that people with sufficient vitamin D are 54 per cent less at risk of being infected with the corona virus.

In the move forward to the previous study, scientists found new information about corona patients and vitamin D relationships. Holic's team had sampled 235 corona patients from a Tehran hospital. In a total of 67 per cent of patients had less than 30 ng/mL.

The expert says that even those suffering from other diseases have low vitamin D content, so it is difficult to say clearly how many lives could have been saved if there was no vitamin D deficiency.

These 7 signs show that your bones are getting weak, carelessness may cause many problems in later life

These 7 signs show that your bones are getting weak, carelessness may cause many problems in later life

Bones, along with maintaining the body's texture, keep the muscles right and also protect many organs. Therefore it is very important to take care of bones. Over time, the strength of bones starts decreasing. After 30 years, the bone mass (density) of most people decreases and bones become weak. Weakening of bones leads to osteoporosis and increases the risk of fracture. Some signs suggest that your bones are weakening and you should not ignore it.

Weakness of gums- 

Due to weakening of bones, gums become troublesome. The jaw bone keeps a grip on the teeth and after an age it becomes weak like other bones. Breaking of the jaw causes teeth to come out of the gum or may even separate. Weakening the jaw can also cause bad teeth.

Weakness of grip  

Many studies have found a correlation between the grip of the hands and the density of the bones of the wrist, spine and hip. In a recent study on postmenopausal women, the strength of the grip of the hands is considered to be the most important physical test to know the density of bones in the whole body.

Weak and Breaking Nails  

If your nails are broken frequently, it may be due to lack of calcium and collagen in your body. Both these nutrients are considered very important for strong bones. Weak nails can be seen as an early sign that your body and bones are in great need of these important nutrients.

Spasms, muscle and bone pain 

Some vitamins and minerals, including vitamin D, calcium, magnesium and potassium, are essential for bone health. Lack of these can cause body cramps, muscle and bone pain. If there is a continuous deficiency of these vitamins and minerals in the body, then it can lead to bone loss.

Body Bend 

Due to fracture of bones, the body starts leaning forward. This may be the initial symptom of weak bones. Without excessive weight, if your spine is bent or due to sitting poorly, the muscles around the spine start to weaken, then it is possible that your bones have started to weaken.

Lack of fitness

If your fitness is declining, it may be that your bone mass (bone density) is decreasing. Studies have shown that weight loss exercises reduce bone loss and they form strong bone through calcium and bone forming cells.

Fast heart beat

The average heart rate is between 60 and 100 beats per minute, but experts say that having a pulse rate of more than 80 beats per minute increases the risk of hip, pelvis and spine fractures. Heart rate indicates your level of fitness.

Wednesday, December 9, 2020

Early gastric and colorectal cancer endoscopic surgery treatment removes off all the cancer cells

Early gastric and colorectal cancer endoscopic surgery treatment removes off only the cancer
30-40% of early gastric cancers have ESD… The stomach can be preserved with no scars remaining...

Early gastric and colorectal cancer endoscopic surgery treatment removes off all the cancer cells
Ewha Womans University Mokdong Hospital Gastroenterology Professor Ji-Taek Hong is performing endoscopic submucosal dissection ESD of a patient diagnosed with gastric cancer

Ewha Womans University Mokdong Hospital Gastroenterology Professor Ji-Taek Hong is performing endoscopic submucosal dissection (ESD) for a patient in her 40s who was diagnosed with gastric cancer. Provided by Ewha Womans University Mokdong Hospital.

Gastric cancer and colon cancer are representative cancers that compete for the 1st and 2nd incidence rates in Korea (as of 2017). Eating habits of enjoying oily and stimulating food and bad lifestyle habits such as smoking and drinking are largely affected. Fortunately, the survival rate is increasing through early detection. According to the central cancer registration statistics, the early detection rate is 61.6% for gastric cancer and 37.7% for colorectal cancer.

This high survival rate is due to the widespread use of gastric and colonoscopy. As the number of people receiving national cancer screenings and health checks increases, the diagnosis and surgery of stomach and colon cancer for the elderly over the age of 80, which were not easy before, are also becoming active. In particular, when gastric and colon cancer is limited to the site of occurrence and does not spread to the surrounding lymph nodes, a treatment has been established to undergo endoscopy without requiring major surgery and at the same time simply remove the cancer lump and pre-cancerous lesions.

30-40% of early gastric cancer, removed only by endoscopy


Endoscopic submucosal dissection (ESD) is generally performed for early gastric cancer (stage 1) where cancer remains in the gastric mucosa and submucosa and there is no lymph node metastasis. The 5-year survival rate of ESD is 93-96%, similar to that of surgery (gastrectomy). Since ESD was selected as a new medical treatment in 2007, it has been established as a curative treatment for relatively large early gastric cancer. According to the 2015 gastric cancer adequacy assessment report by the Health Insurance Review and Assessment Service, 32.6% of the subjects of the assessment received endoscopic treatment. From November 2018, health insurance was applied to ease the burden of expenses. Cancer patients only need to pay 5-10% of the cost, and patients with other procedures such as pre-cancer treatment only need to pay 80%.

If a lesion is found during gastroscopy, it is determined whether it is a target for ESD treatment. If applicable, insert a knife through an endoscope and gently peel off only the area with cancer cells, as if making sashimi. As well as preserving the stomach, it does not leave scars and does not require laparotomy or general anesthesia, enabling rapid recovery.

Since gastrectomy, a standard treatment method, cuts the entire or part of the stomach with cancer, the normal gastric function is lost and the quality of life is inevitably reduced. On the other hand, ESD maintains the above function. Hong Ji-taek, a professor at the Ewha Womans University Mokdong Hospital, said on the 7th, "30-40% of patients with early gastric cancer can be treated with ESD alone."

According to the guidelines for early gastrointestinal cancer, which was distributed this year, in the case of gastric cancer, it is'differentiated adenocarcinoma' (a type that resembles normal cells), and if the cancer is less than 2 cm in diameter, which is not suspicious of invading the lower mucosa when viewed through an endoscope. It becomes an absolute indication. Recently, it has been applied to a wider range. If the biopsy reveals that the cancer is deeper than the submucosal layer of the stomach or if there is a possibility of lymph node metastasis, additional surgery may be required separately from ESD.

The big advantage of ESD is that it is not open surgery, so even the elderly can receive it without burden. As a result of an analysis of the treatment and long-term survival rate of 576 gastric cancer patients aged 65 years or older from 2005 to 2018 by Professor Jeong Hye-kyung of this hospital, the risk of death in the untreated group was 9.4 times higher than that of the treatment group in the case of early gastric cancer where endoscopic resection was possible. Both the elderly and super-aged gastric cancer patients have improved their survival rate and quality of life through active endoscopy treatment. Professor Jeong said, "However, there are cases in which ESD can not be implemented in patients with severe cardiovascular disease, such as patients with poor cooperation, such as insufficient sedation or awakening in the middle as it proceeds with sleep (sedation) endoscopy."

Despite ESD's good performance and many benefits, there are still some things to watch out for. Cancer reoccurs at the site removed by an endoscope (simultaneous gastric cancer) or a new cancer grows elsewhere in the remaining stomach (different gastric cancer). According to an overseas study, 12.9% of concurrent lesions and 2.5% of heterotrophic lesions were found when follow-up of early gastric cancer and pre-gastric cancer (adenoma) after treatment with ESD. In domestic studies, the ratio was higher than this (simultaneous 20.8%, Lee Siseong 20.1%).

Professor Jeong explained, "In the case of endoscopic resection, most of the stomach other than the lesion site is preserved, and the background mucous membrane (chronic gastritis, intestinal epithelial metastasis) that caused cancer remains intact, so there remains a risk of new occurrence." On the other hand, in resection surgery, most of the stomach is cut and the remaining stomach is partially or completely absent, so the rate of recurrence or occurrence of cancer is low.

Gastric cancer is caused by chronic gastritis due to a combination of various environmental factors such as Helicobacter pylori infection, smoking, drinking, and stimulating food, and gradually degenerations such as mucosal atrophy and intestinal epithelial metabolism (gastric mucosa change like intestinal mucosa).

Therefore, even if you have been completely treated with ESD, in order to reduce the risk of further cancer, you should get treatment to get rid of any Helicobacter infections, then quit smoking and abstain from alcohol. You should also be careful about high-risk diets for stomach cancer, such as eating too salty or burning food. Above all, do not neglect regular endoscopic follow-up.

Important for preventive resection in pre-stage colon cancer


Colon cancer is also subject to endoscopic treatment when it is confined to the intestinal mucosa or submucosa like stomach cancer. Among the polyps (polyps) that form lumps on the colon mucosa, the'adenoma', which has a high possibility of cancer, turns into cancer after a long period of time. Therefore, if it is removed at the adenoma stage by colonoscopy, it can prevent colon cancer and lower the mortality rate. There is a study report showing that polypectomy through colonoscopy reduces the risk of colon cancer by 76-90%.

In the case of protruding polyps,'endoscopic mucosal resection (EMR)', which is usually removed by walking with a snare, is performed. For early colorectal cancer, which is difficult to complete resection, ESD is recommended, in which the lesion is cut out using a special endoscopic knife like gastric cancer. If the advanced adenoma is too large to be trapped with a lasso, ESD is needed instead of EMR. Professor Moon Chang-mo of the Department of Gastroenterology said, "Since the survival rate of colorectal cancer decreases sharply if it spreads to other areas, early detection and endoscopic resection are very important."

According to the national cancer screening, colonoscopy is being carried out every year for people over 50 years old, but it is pointed out that this should be accelerated. If you need to take into account the previous colonoscopy results or family history, you should actively receive them from your 30s.

Monday, December 7, 2020

Raising the arm improves rotator cuff movement and improves flexibility

Raising the arm improves rotator cuff movement and improves flexibility

Raising the arm improves rotator cuff movement and improves flexibility

5 minute stretch of spine joint of Stretching to loosen shoulder joints that are stiff in the cold


In winter, many people complain of toxic shoulder pain. When the weather is cold, the muscles around the shoulder joint become tense and the flexibility decreases. In fact, the number of shoulder lesion patients was about 410,000 in November of last year, but increased to 420,000 in December and reached 430,000 in January this year.

The shoulder joint is the only body joint that can rotate 360 ​​degrees. It has a lot of movement and a high degree of freedom. It is also a joint that can be easily injured as it can move freely. For this reason, shoulder disease is the third most common musculoskeletal disease. Also, in winter, more and more people enjoy indoor sports that use a lot of shoulders, such as screen golf, badminton, and swimming. If your shoulder joint is not properly maintained, you may suffer unexpected injuries during exercise.

When there is a problem with the shoulder joint, pain and symptoms of limited function occur, which also limits daily life. In oriental medicine, acupuncture and herbal acupuncture treatments, herbal prescriptions, etc. are used to relieve pain and improve function, and strengthen muscles and ligaments around joints. Recently, a study found that when acupuncture treatment for shoulder joint patients, the surgery rate decreased by about 70% within two years. There are many other treatments available, but the most important thing is to avoid the risk of injury through constant stretching.

The'arm lifting stretch' improves the movement of the rotator cuff (four tendons that cover the shoulder) to increase the mobility and flexibility of the shoulder. It can effectively loosen the hard shoulder joint in winter.

The first movement is lying on the floor and put your arms down next to your hips. Inhale and exhale deeply, extending your arms to the ceiling. At this time, the shoulders should be slightly raised so that they do not touch the floor.

The second movement is to lower the arm in a large circle with the feeling of passing the arm over the head. At that time, your palms face the sky. Repeat this action 10 times.

Lastly, with your palms facing the sky and placed on the side of your hips, make a large circle outward toward the ceiling. Extend both arms to the ceiling and slowly lower them to the floor. This action is also repeated 10 times.

12 Health Benefits of Drinking Baking Soda Water



An inexpensive purchase, baking soda is power-packed with antacid properties and is known to be a great alkalising agent. It is known to have many antiseptic properties along with being an amazing exfoliator.








In this article we learn the amazing benefits of drinking baking soda water.

1. MOUTHWASH



A baking soda mouth rinse may be the next gentle dental remedy. If formulated properly for taste and stability, a mouth rinse with this active ingredient shows great promise for preventing decay and gingivitis as well as helping to keep teeth strong and bright — an all-around great product for dental health!

2. URINARY TRACT INFECTIONS




Drinking a small amount of baking soda, or sodium bicarbonate, mixed with water is a home remedy that some people have tried for UTIs.

Baking soda is said to neutralize the acid in the urine, which allegedly reduces symptoms of a UTI and allows the body to fight the bacteria causing the infection.

People who support this remedy also claim that baking soda can stop the infection from spreading to the kidneys.

3. STOMACH ACHES





You can use it to Calm indigestion: Add 1/4 teaspoon of baking soda to a glass of water to zap acid in your stomach. But acid doesn't cause all kinds of indigestion, so if your symptoms don't improve after 2 weeks, call your doctor. 


4. FLU




Scientific studies have shown that consuming this natural antiseptic at the onset of a bad cold or flu can stop it in its tracks. Drink this concoction on the onset of any colds, coughs and influenza the chances are that within 24-36 hours your symptoms will disappear.

5. GOUT



Baking soda contains properties that work to regulate the pH balance in your body. Since gout is brought on by a build-up of uric acid, the ingredient works wonders to break down and level out the excess.

6. SORE THROATS

On top of drinking a small amount of the mixture, it is also recommended that you gargle with baking soda combined with a pinch of salt. The antiseptic element helps to kill bacteria as it neutralizes.

7. KIDNEY STONES




Multiple factors can contribute to the appearance of painful, unwanted kidney stones, but baking soda can help keep them at bay. When your kidneys become stressed, they have trouble producing sodium bicarbonate, so adding it to your diet may help replenish what you have lost.

8. CONSTIPATION RELIEF:


Consumption of baking soda with water assists you to cure constipation by dragging water inside your digestive tract and facilitating muscle contractions.

Whenever this mixture mixes with stomach acid, it generates gas and makes you to burp, causing relief to constipation.

9. ALKALIZE THE BODY 

Baking soda promotes a more alkaline PH balance in the body and alkaline is of course the opposite of acid. An alkaline PH in the body is healthier than acid although you do need a balance of both because some diseases prefer acidic conditions in which to grow. Certain degenerative diseases, such as osteoporosis, arthritis, and cancer, prefer high acidity levels in the body and so using baking soda can be a help in these circumstances.

10. TREAT MORNING SICKNESS:



The sodium present in baking soda assists to reduce your stomach acid. This way problems caused due to morning sickness are cured as the stomach acid is reduced.

11. REDUCES INFLAMMATION:




Baking soda helps reduce inflammation that further prevents the development of arthritis that affects mostly joints. It is due to the accumulation of uric acid in the joints. Baking soda helps raise the pH levels to alkalise the blood, preventing deposition in joints.

12. IMPROVE KIDNEY FUNCTION:



Bicarbonate of soda can help to detoxify the kidneys, thereby improving their function.

Kidneys are tasked with filtering out waste products inside our bodies, the importance of which should never be underestimated. Kidney disease is extremely common, so a bit of TLC every now and then certainly won't hurt.

The correct way to drink water with baking soda is to drink one tea-spoon of baking soda dissolved inside one glass of water daily, for two times a day, on an empty stomach.

Because baking soda breaks down into sodium ions in the body, taking too much baking soda can disrupt the activity of your muscles, heart and brain.

So its worth speaking to a health care professional if you intend to take baking soda water.

I hope you enjoyed this article on drinking baking soda water.



Chapare Virus: Scientists have discovered a new virus that can spread easily in common masses

Chapare Virus: Scientists have discovered a new virus that can spread easily in populated countries

Chapare Virus: Scientists have discovered a new virus that can spread easily in people


Coronavirus is causing trouble for the world. No one had imagined the virus spread as fast. Now scientists have discovered another virus which can disturb people just like Corona. A virus named chapery has been discovered in the South American country of Bolivia.

The American Center for Disease Control and Prevention has confirmed the virus. According to researchers, this virus has the ability to infect people rapidly. In the grip of this virus, high fever like Ebola virus can occur. Although the Ebola virus was also considered a very dangerous virus initially, but the scientists managed to overcome it.

According to the researchers, in 2004, the virus was first reported in the Chapare area of ​​Bolivia. Because this virus was first seen in the arc, it is named the arc virus.

While scientists from all over the world are looking for ways to prevent coronavirus, researchers from the Center for Disease Control and Prevention are making them aware of the virus. According to researchers, this virus is also as dangerous as corona.

A few days ago, CDC researchers revealed during the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) that they investigated a virus outbreak in Bolivia in 2019 and found that the virus could spread from person to person.

Talking about the symptoms of this virus, people who suffer from it have fever, stomach pain, vomiting, gums bleeding, skin blisters and eye pain.

According to a Live Science report, the CDC said that in 2019, three out of five people who were infected by the infection were health workers, of whom two died. The case of 'chapery virus' infection was revealed in 2019.

According to the researchers, most patients are treated with intravenous fluids due to the lack of specific treatment for the infection.

The Truth about Generic Drugs

It took 10 years to interview more than 240 people and expose the truth behind generic drugs!

The Truth about Generic Drugs

In 2018, with the release of "I'm Not the God of Medicine", many Chinese people were also shocked by the huge price difference between brand-name drugs and generic drugs when they were moved by the moving stories in the movie, which produced a lot of Question, what is a generic drug? Why is there such a big gap between generic drugs and brand-name drugs?

What are generic drugs?

Generic drugs mean that after the patents for certain brand-name drugs expire, other pharmaceutical companies can also produce such drugs. However, the produced drugs must have the same active ingredients, route of administration, dosage form and the same therapeutic effect as the original drugs. This is imitation.

For example, we saw in "I'm Not the God of Medicine" that Chen Yong went to India to buy VEENAT for the treatment of chronic myelogenous leukemia, which is a generic drug of the original drug Gleevec. Because of the high price of Gleevec, many people with poor financial resources choose generic drugs from India.

In fact, whether it was in movies or in real life, because of its low price, the appearance of generic drugs has indeed solved the urgent needs of many families. Its appearance was once considered to be the gospel of patients and is a "21st century public health - The greatest progress in the field".

But in the United States nearly ten years ago, a national public radio host named Joe Gladden continued to complain from many patients. These patients' complaints were all kinds of generic drugs. Many of them have not achieved the expected therapeutic effect after taking generic drugs, some even have other side effects that should not occur, and some drugs can even cause cancer. For a time, generic drugs were pushed to the forefront.

So, Joe Gladden turned to the senior American investigative journalist and writer for Fortune: Ms. Catherine Eban. Because she has been investigating drug and public health issues, after receiving Joe Gleden's request for help. Ms. Catherine Eban immediately launched her investigation of generic drugs, and finally wrote the "The Truth About Generic Drugs" which was called an epic by the New York Times.

For 10 years, Ms. Catherine Eban interviewed more than 240 people, including doctors in various hospitals, patients, employees of some pharmaceutical companies, and some staff of the US Food and Drug Administration. These people provided Catherine Eban with many investigation reports and medication reactions and other information related to generic drugs.

In 2018, a "I'm Not the God of Medicine" was born in mainland China, with a Douban score of 9.0 and a box office of more than 300 million. It caused an upsurge in viewing by the whole people and became a rare word-of-mouth phenomenon with a double harvest at the box office.

The film tells the story of Cheng Yong, the actor starring Xu Zheng, risking his life and legal sanctions to smuggle the generic drug "Glenin" for the treatment of leukemia from India and sell it to patients at an extremely low price. This saved countless families who were on the verge of breaking because they could not afford expensive brand-name drugs.

The contradiction between the high price of the original research drug for the treatment of leukemia in the movie and the struggling of the patient to go bankrupt to treat the disease hits the hearts of the people. The hero's self-sacrificing spirit touched countless people and earned enough tears from the audience.

For a time, India's generic drugs have become synonymous with "good quality and low price", and become a miraculous medicine to save the lives of patients. However, there must be shadows under the sun. Are Indian generic drugs really so magical? The answer is not yes.

(One)

Harry Liver is a 62-year-old cardiologist in the United States. His specialty is the treatment of hypertrophic cardiomyopathy. Many of his patients need diuretics to reduce edema and prevent fluid accumulation. He has prescribed brand-name drugs to patients for several years, and the effects of the drugs have achieved the expected results. However, he recently discovered that a patient had taken a diuretic called "furosemide" imitation by India's Lambeth Company, and it was still difficult to remove body fluids. He replaced the patient with a diuretic produced by another company, and a week later, the patient discharged 15 pounds of body fluids.

Another patient had a similar situation. He took a generic drug called torasemide, but he still had swollen ankles. He could only fall asleep with a pillow to keep his upper body upright. After Liver replaced them with a diuretic produced by another company, the situation improved immediately.

As a result, Liver began to pay attention to the inexplicable symptoms and suspicious drugs that occurred in patients, and more and more discoveries were made.

One of his patients had obstructive cardiomyopathy. He had been taking a brand-name drug called Pravastatin to control cholesterol. Later, he changed to a generic drug called Pravastatin sodium. During the examination, the doctor found that her cholesterol was high. Amazing. And this generic drug also comes from a pharmaceutical company called Glennmark in India.

Many people does not know the difference between generic drugs and original drugs.

The so-called generic drugs are drugs that have the same active ingredients, dosage forms, routes of administration and therapeutic effects as the original drugs. Because it saves expensive research and development costs, the price of generic drugs can also be greatly reduced.

In theory, generic drugs and original drugs should have the same therapeutic effect. But in fact, the situation is not so simple.

For their own interests, the original research drug company with patents will not easily reveal some of the secrets of its production process even after the patent expires. Strict control of the production process is an important way to ensure the quality of drugs.

Therefore, although each generic drug manufacturer knows what the molecular formula of the drug is, how do they synthesize this ingredient? How to ensure its stability and not decompose to produce toxic and harmful impurities during production and storage? How to control the slow-release technology of drugs so that the generic drugs and the original drugs have the same bio equivalence are a series of problems that are insurmountable on the road of generic drug production.

For example: GlaxoSmithKline has a very popular antidepressant Wellbutrin XL. After the patent expired, the Israeli pharmaceutical company Teva launched a generic version of "Budeprion XL". The patient complained of headache, nausea, dizziness, irritability, and sleep and anxiety problems after taking the medicine.

The pharmacologist and medical anthropologist Gladden and his wife took the drug complained by the patient to several independent laboratories for testing, and found that the "Budeprion XL" produced by Teva was suddenly released in the patient's body two hours after taking it. Four times the amount of active ingredients under normal conditions. It's like drinking a glass of wine slowly in two or three hours without feeling drunk, but if you finish drinking it in one breath, you may get drunk.

It can be seen that although various countries and pharmaceutical companies can produce generic drugs after the patent protection period of various original research drugs expires, there are still many problems to be solved, which are not as simple as imagined.

(Two)

At present, there will be more than 150 patents of original research drugs in the world that are about to expire, which means that more countries and pharmaceutical companies will seize this multi-billion dollar market.

However, medicines are different from ordinary commodities after all. It is not just an ordinary workshop that can produce qualified medicines that can treat diseases.

Companies that produce drugs must strictly abide by the requirements of "Good Manufacturing Practices" or GMP.

Any problem in any part of the production process may lead to serious consequences. For example, if the sanitary conditions are not up to standard, then the microbiological limit of the medicine may not pass. Another example is the aging of the gasket in a mixer, and black plastic particles will be mixed into the medicine produced on this assembly line, and once it enters the human body, it may cause unpredictable adverse reactions.

However, driven by huge economic benefits, many companies use forged clinical data, copy and paste the map of branded drugs, or even replace the generic drugs with the original drug to obtain a qualified inspection report when the drug quality is not up to standard., In order to pass the technical review of the US Food and Drug Administration and seize the market for generic drugs.

Indian-American Dinesh Sakur is an information engineer at Bristol-Myers Squibb. This company focuses on the development of new drugs, from Pracos, which treats high cholesterol, to Plavix, which prevents blood clotting. The company’s scientists have won the prestigious Lasker Award and were awarded the National Technology and Innovation Award in the White House in the United States.

Here, Sakur can give full play to his professional strengths and has a boundless future.

However, because of the influence of his old boss Papuhia, he decided to return to India to develop and join the generic drug industry. There is a different culture here, which is also the best medicine, and it should make all patients look up and see the disease.

In India, Lambeth is a legendary enterprise, and its founder, the Singh family, is also known as the royal family in the corporate world.

Sakur came to Lambeth with confidence, ready to use his expertise to bring better development to the company. But soon after, he felt obstructed by all kinds of things.

His first job was to digitize the company's clinical trials records, including informed consent forms, patient cases, and laboratory results.

However, his work was opposed by older employees. The other party even said: "If we do this, how can we back-sign the document?" This is an obvious fraud.

Soon after, his old boss Papuhia suddenly decided to leave Lambeth. He mentioned the "ghost tricks" the company played, many of which were enough to make the company shut down, such as the annual budget.

Sakur clearly remembers that the company has developed about 150 products. Based on the cost of each generic drug of 1.5 million U.S. dollars, Lambeth’s total development budget should also be around 225 million. However, it actually only has About 100 million U.S. dollars, the company made a big discount.

Later, Sakur discovered more evidence of the company's fraud.

Because many Lambeth's production companies are in India. When inspectors from the U.S. Food and Drug Administration come to check on the spot, they must apply for a visa to the customs several months in advance.

This also gives overseas companies more time to prepare, destroy evidence, and falsify data.

As the investigation deepens, Sakur is even more shuddering that this is not just a question of a pharmaceutical factory under the name of the Lambeth Group. It is a practice of the Lambeth Group in global production companies.

Sakur, who had a lot of evidence, resigned from Lambeth.

In order to prevent more patients from becoming victims of this appalling scam, he decided to anonymously report Lambeth’s criminal activities to the U.S. Food and Drug Administration.

However, what he didn't expect was that this eventually turned into a protracted tug of war.

Lambeth is a large multinational company. For Sakur, it is undoubtedly a contest between elephants and ants. The generic drugs exported by Lambeth to the United States not only involve huge economic interests, but also political relations between the United States and India.

What's more frightening is that in India, where the legal consciousness is indifferent, whistle blowers often end up tragically, and may even end up with corpses in the wilderness.

In order to prevent the news from leaking, Sakur had to hide it from his family and daughter. This also caused his marriage to gradually break up.

Sakur is like a weak ant. Can he shake the elephant of Lambeth?

(Three)

The above story comes from the book "The Truth About Generic Drugs". This is the author Catherine Eban's combing and investigation of the global generic drug industry chain over a period of ten years, interviewing whistleblowers, investigators and medical staff. He consulted countless confidential documents in the U.S. Food and Drug Administration, and wrote a documentary that exposed a terrifying scam in the Indian generic drug industry that seriously endangered public health safety.

This book also won the Cornelius Ryan Award for best international non-fiction work.

The New York Times commented on it as "exciting. In addition to the compact rhythm, Eban's narrative structure makes this extremely complex story easy to understand, which gives the book a rough and natural elegance. The significance of this exposure is priceless and it can be called a wonderful epic." This book was also included in the list of 100 notable books in 2019 recommended by the New York Times.

The author of "The Price of America" ​​and Pulitzer Prize winner James Reyson also praised it, "This book will save lives. Catherine Eban asks whether the drugs we take every day will threaten our health. Like Rachel Carson's persistence when he explored environmental crises, "The Truth About Generic Drugs" is a masterpiece of global investigative reporting."

Now, the world's generic drugs account for 90% of the total drugs, but the quality of generic drugs is also uneven. Most medicines of poor quality are sold to backward regions, such as Africa.

The biggest harm of these ineffective generic drugs is that the viruses in those places have developed resistance.

It's like Xiao Yu'er has been soaking in the medicinal wine of the genius doctor of the Evilman Valley since he was a child, thus developing a body that is not invading. In the end, no amount of powerful drugs can kill this virus.

This is also one of the reasons why super viruses are always produced in poor and backward places in Africa and South America.

The emergence of generic drugs is undoubtedly a milestone of great significance in the history of human medicine. However, it is also a double-edged sword. The book "The Truth about Generic Drugs" undoubtedly exposes the shadows behind the sun, allowing more people to look at the same thing from different angles.

It is not only a professional documentary novel, but also a detective novel with ups and downs in plot.

Generic drugs are cheap versions that are legally copied after the patents of brand-name drugs expire. It is said that its ingredients and effects are almost the same as those of brand-name drugs. The widespread application of generic drugs is hailed as "the greatest advancement in the field of public health in the 21st century."

Today, generic drugs account for nearly 90% of the pharmaceutical market. But what is the real state of this industry? Is it flooded with dishonest counterfeiters, or is there no shortage of discounters who ensure quality?

Catherine Eban conducted a decade-long investigation on the global industrial chain of generic drugs, revealing the hidden safety hazards behind it and the terrible risks it brings to global public health. Through interviews with whistleblowers, investigators, and medical staff, and combing through the massive amounts of information contained in thousands of pages of confidential documents from the U.S. Food and Drug Administration, Eban exposed an industry that is rampant in fraud and falsified data. In order to reduce costs and maximize profits, business managers do not hesitate to evade almost every principle of safe production. And patients who take these drugs without knowing it will have unpredictable consequences and sometimes even life-threatening.

All this is not happening in isolation, and the generic drug industry can be described as the ultimate touchstone of globalization. Catherine Eban’s thrilling documentary literature will lead readers to witness how a pioneering work in the field of public health has gradually developed into a terrifying hoax.

Patients often think that the generic drugs they are taking are exactly the same as the brand-name drugs, partly because they imagine a simple and friendly process: after a drug’s patent expires, the brand-name drug company will hand over the formula, and then the generic drug company. The same drug will be produced, but at a fraction of the cost, because it does not have to spend money on research or marketing. But in fact, from the moment they start to develop generic drugs, generic drug companies have begun a battle involving law, science, and regulation, and they often have to fight in the dark. Most of the time, when their products enter the market, they are not helped by brand-name drug companies, but obstructed. Generic drug manufacturers need samples of brand-name drugs in order to conduct research and decomposition, but brand-name drug companies often hold samples and do not sell them. Once a generic drug company locks in a molecule and the company’s scientists have figured out how it works in the human body, the company’s lawyers will begin to investigate the extent to which it is protected by law. The next thing is going on in the laboratory: synthesizing and developing the effective ingredients of the drug. This process alone may take several years of trial and error. Then there is testing. Brand-name drug companies must test new drugs on thousands of patients to prove their safety and efficacy. Generic drug companies only need to prove that their drugs can have similar effects to brand-name drugs in the human body. To this end, they must also test on dozens of healthy volunteers and draw a map of the concentration distribution of the drug in their bodies. After making the active ingredients, selecting additional ingredients, and conducting major laboratory and clinical trials, the formula must be transferred to the production workshop to see if it can be produced on a commercial scale. With the expansion of production scale, the production process has become more difficult to control. As long as any step can go wrong, it will go wrong. Responsible manufacturers will try to prevent old disasters and prevent new ones. But because the production workshop is operated by people, the system will always fail, no matter how well they are designed. To eliminate such variables, the only way is to make the factory strictly abide by good manufacturing practices and record every pharmaceutical step in real time. The data generated from this can be used as a blueprint to find and correct inevitable errors, which is also a process that US Food and Drug Administration investigators will carefully check.

It is not easy to tell an intricate story clearly. Generic drugs have prices in the third world, and there are hidden dangers in the third world, quality control and internal company management issues. Brand-name pharmaceutical companies will not give out formulas even if the patents expire, and the main ingredients are disclosed, but the steps and processes are still confidential, so generic pharmaceutical companies need certain R&D funds and strength. When generic drugs are packaged as charity, it is necessary to expose their fraudulent activities.

The plot is ups and downs, the truth is shocking, the reality is thought-provoking, and the future needs to be changed! This book deserves a more gimmick title "There is no Medicine God in India" for more people to read, because it deeply exposes an important issue that "I am not a medicine god" avoids-driven by profit and lack of effectiveness Regulated generic drugs, because of their cutting corners and low quality, are largely the same as ineffective or even harmful counterfeit drugs. The root cause of this problem is still the "poor disease." Even the U.S. Drug Administration, the world's highest standard (in exchange for the lessons of blood), is forced by the financial pressure of the American people's medical insurance to turn a blind eye to inferior or even killing generic drugs. Close one eye. Of course, the culprit is still India's lustful drug dealers and the national government umbrella behind them. Although the protagonist of this book is India, it is difficult not to think of my country during the reading process. Sure enough, compared with the English version, it was found that the Chinese version had almost deleted every sentence involving my country (I sorted it out and posted it in the discussion area. Is negative information). From this to the present, there can be no falsehoods in every aspect of vaccine development.

About the author ... 

Katherine Eban

Senior investigative journalist, Andrew Carnegie researcher, and Fortune magazine writer, graduated from Brown University and Oxford University. Author of "Dangerous Dose: The True Story of Police, Counterfeiters, and Contamination of the U.S. Drug Supply." Eban's in-depth reports on counterfeit and substandard drugs, CIA torture, and gun trafficking have won numerous awards in the press.

The Truth about Generic Drugs, Are all generic drugs really safe and reliable?

When it comes to generic drugs, what kind of drugs do you think of? 

The Truth about Generic Drugs, Are all generic drugs really safe and reliable?


For me, the first thing that popped out of my mind was not medicine, but a movie-"I am not a god of medicine", and the film showed the generic drug "Glenin India", the sky-high price drug Glenin.

Generic drugs are drugs that have the same active ingredients, the same dosage, the same route of administration, the same dosage form, and the same indications as the original drug (also called a patented drug or brand-name drug). However, they have important economic and social benefits such as reducing medical expenditures, increasing the availability of medicines, and improving the level of medical services. In other words, generic drugs have the same therapeutic effects and the same safety guarantees as the original drugs, but the price is much lower.

The United States is the country with the most developed pharmaceutical industry in the world, and it is also the country with the strongest ability to create pharmaceutical products and the most popular patent protection in the world. However, 40% to 50% of prescription drugs used by Americans are generic drugs, and generic drugs are increasing at a rate of 15% every year.

My country’s neighbor, India, is a large developing country like my country, but the status of generic drugs in the global drug market is increasing. According to Indian customs statistics, most of the drugs exported by India each year are generic drugs.

But are all generic drugs really safe and reliable? Are generic drugs really the same as original drugs? What is the real state of this industry? Is it flooded with dishonest counterfeiters, or is there no shortage of discounters who ensure quality? 

The author of "The Truth about Generic Drugs", Catherine Eban, conducted a decade-long investigation of the global industrial chain of generic drugs, revealing the hidden safety hazards behind it and the terrible risks it brings to global public health.

Through interviews with whistle blowers, investigators, and medical staff, Catherine Eban combed through the massive amounts of information contained in thousands of pages of confidential documents from the U.S. Food and Drug Administration. Eban exposed an industry with rampant fraud and data falsification. In order to reduce costs and maximize profits, business managers do not hesitate to evade almost every principle of safe production. And patients who take these drugs without knowing it will have unpredictable consequences and sometimes even life-threatening.

Why are generic drugs cheap?

In terms of ingredients, generic drugs are almost the same as brand-name drugs, and they are genuine and genuine drugs. Similar to other knockoff products, the biggest advantage of generic drugs over patented drugs is price.

Everyone knows the function of the famous "Viagra" (Viagra), and the price is 128 yuan per tablet. Its generic name is "sildenafil", and its patent expired in May 2014, followed by Baiyunshan Pharmaceutical General Factory in the same year with the approval of a generic drug for "domestic Viagra". In September 2014, Baiyun Mountain’s "Chinese Viagra" Jin Ge was officially unveiled. The price is RMB 48 for one pack, RMB 89 for two packs, RMB 133 for three packs, RMB 178 for four packs, and RMB 345 for 10 packs. In other words, the medicine price of 128 yuan will directly come to 34.5 yuan. The other one approved in the same period was the "Malfele" developed by Jiangsu Yabang Epson Pharmaceutical. The retail price of 10 tablets is also 400 yuan, which is 40 tablets, which is one-third of Pfizer's "Viagra". One. Since then, the 120 million ED patients in China no longer worry about the high price of the “blue pill”.

Why are the original research drugs expensive? 

Because it is a brand-new drug, it can be understood as an invention. The process of discovering a drug requires a lot of money and a lot of money for long-term preclinical safety research and human clinical trials. Evaluate the effectiveness and safety of drugs. The research and development cost of a new drug often reaches US$2 billion, or even US$5 billion. Once a new drug is approved for marketing, the original research drug company will have to promote it, which costs a lot.

In contrast, generic drugs do not need to invest a lot of money in clinical research, and the research and development costs are much lower than the original drugs, which can save huge expenditures for patients and medical insurance. Therefore, some experts believe that the greatest benefit of generic drugs is that they greatly reduce drug prices. If there is a medicine, the inventor will sell it for US$6,000 per ton, and imitate it in India after the protection period, and sell it for only US$60 per ton, which can greatly stimulate consumption.

Are generic drugs really safe?

Medicine is a special commodity, but a pharmaceutical factory is a commercial company after all. In order to continue to develop, it must be profitable. In this book, Catherine Eban’s survey proves that in order to reduce costs and maximize profits, business managers will not hesitate to circumvent almost every principle of safety in production; however, if patients around the world take these without their knowledge Drugs are very likely to have unpredictable consequences, sometimes even life-threatening.

"In the factories I visited in the report, investigators from the Food and Drug Administration rarely visited, and the pressure to make profits was extremely strong. As a result, under the surface of compliance, there was a dark world hidden."

The manufacturer of the original research drug only determined the production method of the drug after many trials. Any change in any step during the period will have a very large impact on the final drug properties. The dosage of each tablet of the original research drug is not determined arbitrarily. It is determined through a large number of experiments and experimental studies to determine a certain dosage. This dosage has the best effect and has the least side effects. Therefore, the single-tablet dose of the original drug should be the best dose.

A pill, when passing through the patient's digestive system, needs to disintegrate and melt at an appropriate time to release the effective ingredients and be absorbed by the gastrointestinal tract. This process is very particular: if it is too fast, it may cause the active ingredient to be absorbed too quickly, the peak serum concentration is too high, causing side effects, and the efficacy is not long enough; if it is too slow, the active ingredient may be discharged before it is completely dissolved. The effect will not play out. This process relies on the excipients and manufacturing processes used by the drugs, which are the core assets of pharmaceutical companies' research and development.

Most of the generic drugs on the market come from India. The book reveals that most Indian pharmaceutical companies have the problem of data fraud in order to make the data look good. The most basic GMP production standards are not complied with. The equipment is old and sometimes drugs are mixed with impurities such as glass slag, metal and dust. And the efficacy of the medicine cannot be guaranteed.

The book also reveals the counterfeiting of the Indian pharmaceutical giant Lambeth and the management omissions of the U.S. Food and Drug Administration (FDA). The real situation of the industry can not help but feel shocking.

Current state of generic drugs in China

My country, like India, is also a big country of generic drugs. There are huge varieties and product specifications of generic drugs, but there is a big gap between the quality of most domestic generic drugs and the original drugs. Some generic drugs in China can only achieve chemical equivalence, but biological equivalence, safety equivalence, and clinical equivalence are still out of reach.

In 2015, the National Food and Drug Administration launched a nationwide evaluation project-generic drug consistency evaluation.

The consistency evaluation of generic drugs refers to the quality consistency evaluation of the generic drugs that have been approved for marketing according to the principle of consistency with the quality and efficacy of the original drug. This means that the quality and efficacy of the generic drug must be comparable to that of the original drug. Consistent level. This evaluation policy is a rigid requirement for the quality of generic drugs.

Carrying out the consistency evaluation of generic drugs can make generic drugs consistent with the original drugs in terms of quality and efficacy, and can replace the original drugs clinically. This not only saves medical costs, but also improves the quality of my country's generic drugs and the overall pharmaceutical industry. The level of development ensures that the patient’s medication is safe and effective.

The generic drug industry is the ultimate touchstone of globalization.

Catherine Eban's "The Truth about Generic Drugs", with its thrilling documentary literature, will lead readers to witness how a pioneering work in the field of public health has gradually developed into a terrifying scam. At the same time, it can also trigger our thinking: while bringing health to patients through the low-cost treatment plan of generic drugs, we should be more alert to the hidden safety hazards behind it.

Wednesday, November 25, 2020

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