New Delhi:

The Surgical Site Infections (SSIs) rate among three major hospitals in India was found to be higher than in many high-income countries, an ICMR study has revealed.

The study was conducted in a cohort of 3,020 patients from three hospitals.

SSIs are among the most prevalent healthcare-associated infections.

Debridement surgery, carried out with either an amputation, open reduction internal fixation surgery (ORIF), or closed reduction internal fixation (CRIF) surgery, had the highest SSI rate of 54.2 per cent.

SSIs cause significant morbidity, leading to excess health expenditures and increased length of hospital stay.

There is a lack of data on post-discharge SSIs from low-and middle-income countries. In India, there exists no surveillance system of SSIs that covers the post-discharge period.

“Therefore, we proposed a multicentric analysis to estimate the proportion and identify the risk factors associated with SSIs occurring during hospital stay and after discharge,” the study said.

A prospective multicentric cohort study was conducted Jai Prakash Narayan Apex Trauma Centre (JPNATC), Kasturba Hospital (KMC) in Manipal, and Tata Memorial Hospital (TMH) in Mumbai.

The study showed the SSI rate to be higher at the three hospitals as compared to many high-income countries, where its varies typically between 1.2 and 5.2 per cent.

“The rate in our study was lower than that reported in Gujarat (8.95 per cent) and higher than the one from Dehradun (5 per cent) in India, as well as Iran (17.4 per cent), Egypt (17 per cent) and Pakistan (7.3 per cent),” one of the researchers said.

The authors claimed their study was India’s first multicentric systematic surveillance effort, which monitored patients for six months after they had undergone various conventional surgical procedures.

A total of 161 out of 3,090 patients acquired SSI, resulting in a 5.2 per cent SSI incidence.

Clean, polluted wound class and surgeries lasting longer than 120 minutes were substantially linked to an increased risk of SSI.

The study revealed that patients who developed SSIs experienced longer hospital stays.

Post-discharge surveillance helped with the detection of 66 per cent of SSI cases.

Combination surgeries were seen to increase the risk of SSIs in patients. So post-discharge surveillance assisted in diagnosing 50 per cent of SSI patients. 

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

New Delhi:

Amid the rising Human Metapneumovirus (HMPV) scare, the top medical body – the Indian Council of Medical Research or ICMR – on Monday alerted that the virus is already in “circulation” globally, including India. However, it noted that India is well-equipped to handle any potential increase in respiratory illnesses.

The ICMR’s statement came as Bengaluru reported two cases of HMPV – a 3-month-old baby who has been discharged and an 8-month-old who is recovering. The health department ruled out exposure from other regions or countries, saying that the infected infants and their families have no recent travel history.

Both cases were identified through routine surveillance for multiple respiratory viral pathogens, it said.

“It is emphasized that HMPV is already in circulation globally, including in India, and cases of respiratory illnesses associated with HMPV have been reported in various countries. Furthermore, based on current data from ICMR and the Integrated Disease Surveillance Programme (IDSP) network, there has been no unusual surge in Influenza-Like Illness (ILI) or Severe Acute Respiratory Illness (SARI) cases in the country,” the ICMR said.

It also noted that while the Union Health Ministry is monitoring the situation through all available surveillance channels, ICMR will continue to track trends in HMPV circulation throughout the year.

Earlier, the Centre had announced that it is monitoring the HMPV and other respiratory viruses following the surge of cases in China. A Joint Monitoring Group (JMG) was held by representatives from the World Health Organisation (WHO), National Centre for Disease Control (NCDC), Indian Council of Medical Research (ICMR), and other health organisations, to evaluate the situation.

The Karnataka and Maharashtra governments have issued guidelines for citizens. Kerala Health Minister Veena George also advised the elderly and pregnant women to wear masks, adding there is no need to panic as of now.

What is HMPV?

HMPV, first discovered in 2001, is a part of the Pneumoviridae family along with the Respiratory syncytial virus (RSV). The symptoms commonly associated with the virus include cough, fever, nasal congestion, and shortness of breath. HMPV can occasionally trigger pneumonia or chronic respiratory conditions.

It can spread from an infected individual to others through coughing, sneezing or personal contact.

Young children, older adults and those with weakened immune systems are at a higher risk of developing severe illness due to HMPV.

Indian Council of Medical Research (ICMR) has announced a new initiative called First in the World Challenge. File
| Photo Credit: AP

Aimed at encouraging Indian scientists to come up with innovative ideas for finding solutions to difficult health problems, the Indian Council of Medical Research (ICMR) has announced a new initiative called “First in the World Challenge”.

The Council, which is the apex body in India for the formulation, coordination and promotion of biomedical research and is one of the oldest medical research bodies in the world, said that the scheme proposes to foster novel, out of the box, futuristic ideas, new knowledge generation, discovery / development of breakthrough health technologies (vaccines, drugs/ therapeutics, diagnostics, interventions etc.), which has never been thought, tested or tried in the world till date.

“The proposal must have bold research ideas with significant wide-ranging impact and if successful should have potential ‘first of its kind’ biomedical and technological innovations for better health outcomes in the global context,’’ said the Council in its order.

It added that proposals aiming for ‘incremental knowledge’ or ‘process innovation’ will not be funded through this scheme.

The announcement adds that this is a high risk, high reward initiative where the odds of success may be variable.

“But ICMR considers it worth taking the risk to achieve something which no one in the world has ever done before. This program believes in taking big chances for big rewards. Every attempt may not work out, but the successes will bring about a huge revolution in biomedical science,’’ it noted.

The proposals can be submitted by an individual or by a team of researchers (either from a single institute or from multiple institutes). The selection committee will be formed by experts of high repute, innovators, policy makers, scientists with outstanding record of conducting and nurturing research and innovation in the biomedical domain.

Students from various organisation protest over the NEET-UG and UGC-NET examinations issue outside Ministry of Education in New Delhi.
| Photo Credit: SHASHI SHEKHAR KASHYAP

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The ICMR said that while it had not funded the Bharat Biotech for Covaxin development, one of its institutes — the ICMR-National Institute of Virology (NIV), Pune — had spent “funds for Covaxin development“. File
| Photo Credit: The Hindu

India’s first indigenously developed coronavirus vaccine, Covaxin, was a joint collaboration between the Indian Council of Medical Research (ICMR) and the Hyderabad-based Bharat Biotech International Limited (BBIL) with intellectual property (IP) rights jointly shared between the two organisations. That is what the public record states. However, filings by the BBIL at patent offices in India, the United States and Europe suggest that only its scientists and personnel are credited as ‘inventors’ of the vaccine with no mention of ICMR scientists.

The Hindu has viewed documents detailing these patent applications. If BBIL personnel, credited in applications as Deepak Kumar and Krishna Murthy Ella — Chairman and Founder, BBIL— are indeed the only inventors, it contradicts a statement by the Union Health Ministry, the nodal Ministry of the ICMR, in the Rajya Sabha, which claimed that the IP rights are “jointly owned”.

In response to a question in the Rajya Sabha on July 2021 by Congress president Mallikarjun Kharge, who demanded details of the agreement between the ICMR and the BBIL for the development of Covaxin, the then Minister of State (Health Ministry) Bharati Pravin Pawar laid out a detailed response.

The Minister’s statement said the ICMR would provide a “well characterised” virus strain for vaccine development, the BBIL would develop the final vaccine formulation and, be given a “non-exclusive” licence granted to commercialise the product within two years. It was explicitly mentioned that the “..intellectual property over the product would be jointly owned by the ICMR and the BBIL.” The ICMR would also receive as royalty 5% of net sales to be remitted half-yearly.

The ICMR said that while it had not funded the BBIL for Covaxin development, one of its institutes — the ICMR-National Institute of Virology (NIV), Pune — had spent “funds for Covaxin development“.

It also funded phase-3 clinical trials of Covaxin at 25 locations, involving 25,800 participants. All in all, the ICMR spent ₹35 crore for developing Covaxin. As of January 2022 — as per an update by the government to the Rajya Sabha — the ICMR received ₹171 crore as royalty for Covaxin.

Ms. Pawar’s response to Parliament, however, did not elaborate on the sharing of patent rights. The BBIL, which has over the years had several research collaborations with public research bodies such as the Council of Scientific and Industrial Research (CSIR) and the ICMR itself, has listed scientists from all institutions as ‘inventors’ in patent applications.

A BBIL spokesperson told The Hindu that the patent filed by Bharat Biotech was only for “process development” and specific to the making of the vaccine. It also covered the use of an adjuvant (an ingredient used in vaccines to elicit a stronger response) that was licensed from the Kansas-based ViroVax and added to Covaxin.

India’s patent laws allow both product and process patents. Product patents grant an inventor a monopoly over, say, a drug. Process patents bar competitors from making a similar drug using the same sequence of steps. “Bharat Biotech is innovator of the process developed after procuring strain from the NIV through an agreed consideration between both the parties. Moreover, the NIV was also responsible for testing for other variants. It is to be noted that while ICMR/NIV owns the animal challenge (clinical trials on animals) studies, Bharat Biotech owns the process development and new adjuvant added to the vaccine.” In the case of the CSIR, product development involved funding from both the CSIR and the BBIL and hence merited co-inventorship during patent applications, the spokesperson’s email suggested. The BBIL did not clarify on who owned the rights to the human clinical trial data — information that is usually not disclosed by pharmaceutical companies.

Close involvement of ICMR

The ICMR’s close involvement in all aspects of Covaxin development is well known, particularly — as former chief Dr. Balram Bhargava has described in his book, Going Viral: The Making of Covaxin, how ICMR scientists isolated the Sars-Cov2 strain from Italian tourists in March 2020, gave it to Bharat Biotech which developed a batch of vaccine candidates by April 30 that were then used to conduct pre-clinical animal studies on rats, hamsters, monkeys and following encouraging results, trials on humans. All of the resulting publications that describe the results of these trials — some published in leading journals such as TheLancet — list both ICMR scientists as well as scientists from the BBIL as co-authors in the study.

An independent expert said collaborating entities usually clearly spell out how IPR and patenting rights from a resulting invention would be shared in a memorandum of understanding (MoU). “There could be multiple kinds of agreements and only a perusal of the MoU can clarify on such matters,” an IPR lawyer, who declined to be identified as he consulted both of these organisations, told The Hindu. The ICMR has previously declined Right to Information requests by activists and media on the terms of this MoU citing “third party confidentiality”.

“This raises some important questions. If intellectual property is jointly owned, then patent applications require that all the inventors be mentioned. In the United States, for instance, not mentioning all inventors can be strong grounds for the rejection of patents,” Dr. Zakir Thomas, who was previously been involved in intellectual property development at the CSIR, told The Hindu. “While intellectual property is a broad term, only one of which is patents, the ICMR should clarify the statement made to Parliament on what it means by co-ownership and whether it collaborated in the development.” The Hindu emailed to Dr. Rajiv Bahl, Director-General, ICMR, but has received no response till going to press. Dr. Bhargava, who has now retired from the ICMR and All India Institute of Medical Sciences, declined comment.

The Indian Council of Medical Research (ICMR) has advised moderation in tea and coffee consumption, the two beloved beverages deeply woven into Indian culture. The medical body recently introduced 17 new dietary guidelines in partnership with the National Institute of Nutrition (NIN), aiming to encourage healthier eating habits across India. These guidelines stress the significance of a varied diet and active lifestyle.  

While recognising their cultural importance, the medical experts also warned against excessive intake of tea and coffee due to potential health concerns.

ICMR researchers explained that tea and coffee “contain caffeine, which stimulates the central nervous system and induces physiological dependence”.

The guidelines also shed light on the caffeine content of popular beverages, noting that a 150ml cup of brewed coffee contains 80 – 120 mg of caffeine, instant coffee has 50 – 65mg, and tea contains 30 – 65mg. 

The ICMR advises a daily intake of just 300mg of caffeine.

The medical body also advised avoiding tea or coffee for at least an hour before and after meals because they contain tannins, which can reduce iron absorption in the body. Tannins tie to iron in the stomach, making it harder for the body to absorb iron properly. This may lead to iron deficiency and health problems like anaemia. Excessive coffee consumption can also cause high blood pressure and cardiac irregularities, it said.

Drinking tea without milk, though, has various benefits such as improved blood circulation and a reduced risk of conditions like coronary artery disease and stomach cancer, the guidelines said. 

They also recommended a diet rich in fruits, vegetables, whole grains, lean meats, and seafood, while limiting oil, sugar, and salt intake. 

New Delhi:

The ICMR’s National Institute of Virology in Pune on Thursday sent its mobile BSL-3 laboratory to Kozhikode in Kerala to test samples for Nipah virus in the district itself after five cases, including two deaths, were reported there.

A team of experts from the Department of Animal Husbandry has also been deployed to assist the state in the surveillance of animals, official sources told PTI. Apparently, samples will be collected from bats to check for the presence of the Nipah virus.

The brain-damaging virus has killed two people and infected three others in Kozhikode district so far. On Wednesday, a 24-year-old health worker became Kerala’s fifth confirmed Nipah case since its recent outbreak.

“The ICMR’s mBSL-3, which is the first biosafety level-3 containment mobile laboratory of South Asia, has been stationed at Kozhikode. It will help in early testing and detection of the infection at the district itself,” an official source said.

So far, the samples were being sent to the National Institute of Virology in Pune.

The mobile laboratory was set up in February last year to investigate newly emerging and reemerging viral infections that are highly infectious and of lethal potential to human beings.

Union Minister of State for Health Bharati Pravin Pawar visited the ICMR’s National Institute of Virology in Pune and held a review meeting in view of the Nipah virus cases reported in Kozhikode.

She said the affected gram panchayats in the Kozhikode district have been declared as quarantine zones.

A five-member central team comprising experts from the National Centre for Disease Control, RML Hospital and NIMHANS has been stationed in Kerala to take stock of the situation and assist the state government in the management of the Nipah virus infection.

The Union Health Ministry and the ICMR-NIV is monitoring the situation on a daily basis and all possible arrangements are being made by the Central government to deal with the viral outbreak, Pawar added.

The Kerala government on Thursday said there was no need to be apprehensive about the Nipah outbreak in Kozhikode district but caution needs to be exercised by people as they go about their daily activities.

The Kerala government on Thursday said the monoclonal antibody required for treatment of those infected by the Nipah virus has arrived in the state. State Health Minister Veena George said a meeting was held between the Principal Secretary of the Health Department and the Union Health Ministry earlier in the day and now the monoclonal antibody has arrived. 

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)