When 28-year-old Sahil Mehra* from Mumbai was at the verge of kidney failure, and running out of option, a new lifeline came to him, in form of a breakthrough medicine.

Mehra was diagnosed with a severe urinary tract infection, caused by Pseudomonas aeruginosa, which is one of the toughest superbugs known to medicine. It has a history of resisting every antibiotic available. Last-resort drugs like colistin and polymyxins also barely held the infection at bay while worsening his kidney function.

Dr Tanu Singhal, a consultant-pediatrics and infectious diseases at Kokilaben Hospital, Mumbai said, "We were running out of time," reports TOI.

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It was the breakthrough of Zaynich, a combination of Cefepime + Zidebactam that the doctors had secured access to. This was India's first new antibiotic in more than three decades. Within four days, Mehra's fever subsided, and his infection markers fell, with his kidneys now stabilized. Soon, he was discharged.

A similar case is of a 36-year-old woman who was battling a malignant ear infection, caused by a multidrug-resistant-organism, that threated to spread to her skull base and brain. Despite eight weeks of antibiotics, there was no improvement. However, after a 10-day regimen of Zaynich, her symptoms eased, and the infection cleared.

Even abroad too, there have been promising results. At St Jude's Hospital in Memphis, USA, a 15-year-old leukemia patient with a life-threatening infection caused by NDM-producing E. coli recovered after 41 days on Zaynich. Before that, the patient witnessed failure of nine other antibiotics. As of now, 51 patients, worldwide, are successfully treated.

What Makes Zaynich So Different?

It is developed by Mumbai-based Wockhardt, and is now hailed as the first-in-class antibiotic. This is the first of its kind globally, in over 30 years.

It is a combination of two medicines, including:

• Cefepime: a fourth-generation cephalosporin that disrupts bacterial cell wall synthesis.
• Zidebactam: a novel β-lactam enhancer that restores and boosts cefepime’s effectiveness.

Together, they disable bacterian defence enzymes while directly targeting critical bacterial protein. There are several studies to that point towards 97% effectives against drug-resistant Gram-negative bacteria. It also includes hospital-acquired pneumonia. In the phase 3 trials, it also outperformed Meropenem, which is a gold standard antibiotic, with a 20% higher cure rate.

Why Is It Essential?

India remains one of the worst-hit countries by antimicrobial resistance, which is spreading like silent pandemic in hospitals, and communities alike.

The main concern that India and the world faces today are carbapenem-resistant Gram-negative bacteria such as E. coli, Klebsiella, Pseudomonas, and Acinetobacter. For For CR Klebsiella and E. coli, there had been some options, however, for Pseudomonas and Acinetobacter, only polymyxins worked, and that too not very effectively. This is what makes Zaynich life-saving.

Wockhardt plans to launch Zaynich in India later this year, pending approval from the Drugs Controller General of India (DCGI).

*Names have been changed to protect the identity.

About 6 million people in India's capital city are living with several vision problems, such as poor distance vision or near vision, according to a recent study by doctors at All India Institute of Medical Sciences (AIIMS), New Delhi.

The study, Dr. Rajendra Prasad Centre for Ophthalmic Sciences at AIIMS, and submitted to the World Health Organization (WHO), also flagged major gaps in eye care services in Delhi, the Times of India reported.

An estimated one-third of the population in the national capital was identified with refractive errors or presbyopia -- conditions that can usually be corrected with a pair of glasses. Globally, 826 million people suffer from presbyopia.

About 70 percent of older adults in the capital city were identified with the problem.

Alarmingly, about 13.1 percent school-going children had refractive errors, Dr. Praveen Vashist, professor and head of community ophthalmology at AIIMS, was quoted as saying.

Gaps In Eye Care

The study showed a lack of access to vision correction. While just 60 percent of people needing distance vision correction could access care, those with near vision correction could access care in over 47 percent of cases.

Further, the doctors found:

• women had the lowest access to spectacles compared to men
• lack of trained eye care workers,
• the affordability of spectacles,
• limited outreach to vulnerable groups -- elderly patients, rural women, and economically weaker populations.

But Dr. Vashisth noted that Delhi currently has only 1,085 ophthalmologists and approximately 489 optometrists.

Further, only 50 community-level vision centers, out of the has 249 eye care institutions in the city were found to be functioning. Moreover, only about 25 percent of children were receiving free spectacles through public health initiatives.

Global Eye Burden

According to the World Health Organization (WHO), at least 2.2 billion people worldwide have near or distance vision impairment. Of these, at least 1 billion cases could be prevented with increased access to eyeglasses and cataract surgeries

The WHO identifies refractive errors and cataracts as the leading causes of vision impairment and blindness.

Vision loss can affect people of all ages; however, most people with vision impairment and blindness are over the age of 50.

Here's how to maintain a healthy vision:

• Eat fruits and veggies, especially leafy greens like spinach, kale, and fish like salmon and tuna, to protect your sight.
• Be physically active, as being overweight or obese can increase risk for diabetes and other conditions that can lead to vision problems.
• If your vision gets blurry, use glasses to help you see better.
• Always wash your hands before putting them close to your eyes, especially if you’re putting in or taking out contact lenses.
• Use protective eyewear while playing a favorite sport or mowing the lawn
• Wear your shades to prevent the sun’s rays from hurting your eyes.
• Give your eyes a break with the 20-20-20 rule: Every 20 minutes, look about 20 feet away for 20 seconds.
• Quit smoking as it can put you at risk of serious eye issues, leading to blindness.

Ibuflam tablets by pharmaceutical manufacturer Zentiva under the brand name Lichtenstein has been recalled. The 600mg tablets of ibuprofen products were recalled due to contamination. As per several media reports, a piece of metal was found in the tablet which triggered the recall. As per the manufacturer, the affected tablet are the 50-tablet packs with the batch number 5R02514.

Zentiva stated that the recall is explicitly directed at wholesalers and pharmacies, as the company confirmed upon request and the recall is not directed on patients. This measure was taken as a precautionary measure and in consultation with the relevant regulatory authorities.

As of now, patients have the option to return packages from the affected batch and receiving a replacement.

How Can You Return And Receive A New Ibuprofen Prescription?

As per Zentiva, the standard procedure of returning packages from the affected batch and receiving a replacement could be availed. For instance, if the package is almost empty, the standard procedure does not need to be followed, as this could potentially be considered a new prescription. However, patients will have the option of returning packages with the batch number.

A Zentiva spokesperson explained, "The possibility of obtaining a replacement through the supplying pharmacy in case of suspected quality defects always exists. Any connection to the recall lies solely in the fact that the suspicion regarding this batch can generally be considered justified."

This is not a case of re-dispensing under the replacement procedure. It is important to note that when a replacement pack is dispensed in response to a quality complaint, the affected medicinal product is not being placed on the market again, but rather a previously prescribed and supposedly defective medicinal product is being replaced.

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What Is Ibuflam Or Ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug or NSAID that is used to relieve pain, fever, and inflammation. Ibuflam is a brand name which is a combination medication containing ibuprofen and paracetamol or acetaminophen, which is also designed for enhanced pain relief.

As per the World Health Organization (WHO), ibuprofen is on the list of essential medication. The medicine is used by mouth as a syrup or tablet, and could also be applied directly to the skin as a mousse, gel, or spray.

The uses include:

• fever
• inflammation
• headache
• menstrual pain
• common cold
• toothache
• back pain
• arthritis
• sprains

The medicine could have some side effects, which could include pain, diarrhea or constipation, nausea and vomiting, dyspepsia, bloating, dizziness, headache, nervousness, skin rash, tinnitus, edema or fluid retention.

Who Should Not Use Ibuprofen?

Anyone with:

• repeated stomach problems like heartburn
• stomach ulcers
• bleeding problems
• high blood pressure
• heart disease
• kidney disease
• age over 60 years

OR

Anyone who:

• has taken a diuretic
• is using other NSAIDs or pain relief medication
• is using anticoagulants
• is receiving treatment for any serious condition
• has chickenpox or shingles
• has Crohn's disease or ulcerative colitis
• has liver problems

The US Food and Drug Administration approved leucovorin, but not for what White House had recommended for in its September briefing. FDA has approved the prescription drug leucovorin for cerebral folate deficiency in the receptor 1 gene, a genetic condition that is estimated to affect only about 1 in 1 million people.

In September, the White House touted leucovorin as a potential treatment for children with autism. Health and Me previously reported on how parents were struggling to find the prescription drug, while not enough scientific evidence was there to support the claim.

What Is Leucovorin?

It is a high-dose B vitamin, which is commonly used as a treatment to counteract the side effects of chemotherapy. It has been approved by the FDA for cerebral folate deficiency in the receptor 1 gene. The disease is rare and fewer than 50 cases have been identified worldwide. FDA Commissioner Dr Marty Makary called this approval "a significant milestone" for patients with the condition.

However, in September last year, Markary and US Health and Human Services Secretary Robert F Kennedy Jr said that the drug could help children with autism. Kennedy, standing next to US President Donald Trump, said, they had "identified an exciting therapy that may benefit large number of children who suffer from autism."

CNN reported that in Austin, Texas, Meagan Johnson, a mother with an autistic son of three years of age, spent four days calling pharmacies across the region searching for leucovorin. She contacted nearly 40 pharmacies around her home in Pflugerville, hoping to locate the medication. Health and Me reported how getting the prescription turned out to be far harder than obtaining it.

This update on leucovorin, notes CNN have hit some families hard, especially the families of children with autism. This is because of the September briefing and when Trump also said that painkiller Tylenol could in fact cause autism. The drug leucovorin was used as something that could give them hope, however, with the update in its label, parents efforts to find the prescription drugs could feel like in vain.

The Rare Condition For Which Drug Got Its Approval

The drug got its approval for folate deficiency in the receptor 1 gene. This is a defect that causes proteins that guide folate into the brain to malfunction. As a result, normal levels of folate is found in the blood, but not in the brain or nervous system, due to which tasks like thinking, speech and movement could not be performed.

In an op/ed published in Politico and reposted on the White House website last fall, Markary said that his agency would "approve prescription leucovorin as a treatment for children with cerebral folate deficiency and autistic symptoms". However, he did not that it cause not a cure for autism, but there have been studies that show that it could help children with folate deficiency and autism to improve speech by roughly 60 per cent. The Trump administration made a bold move to expand the usage of the drug by "opening the door to the first FDA-recognized treatment for autism." wrote Markary and other HHS leaders.