Health Ministry Bans 34 Key Antibiotics, Antivirals for Animal Use, See List

New Delhi: Through a recent Gazette notification, the Ministry of Health and Family Welfare has notified a ban on the import, manufacture, sale, and distribution of several classes of antimicrobials for animal use, including 15 antibiotics such as carbapenems, ceftobiprole, ceftaroline, glycopeptides and oxazolidinones, 18 antivirals such as favipiravir, molnupiravir, oseltamivir, ribavirin and zanamivir and others and one antiprotozoal, nitazoxanide.

The decision, published in the Gazette of India (S.O. 4338(E)), was taken under sections 10A and 26A of the Drugs and Cosmetics Act, 1940.

The move follows a draft notification issued on May 22, 2025, which invited objections and suggestions from stakeholders. As no objections were received and safer veterinary alternatives are available, the government finalized the prohibition in consultation with the Drugs Technical Advisory Board.

Also Read: DTAB Recommends Ban on 34 Antimicrobials for Animal Use, Seeks Report on 3 Exceptions

According to Section 10A of the Act, “Power of Central Government to prohibit import of drugs and cosmetics in public interest.— Without prejudice to any other provision contained in this Chapter, if the Central Government is satisfied that the use of any drug or cosmetic is likely to involve any risk to human beings or animals or that any drug does not have the therapeutic value claimed for it or contains ingredients and in such quantity for which there is no therapeutic justification and that in the public interest it is necessary or expedient so to do then, that Government may, by notification in the Official Gazette, prohibit the import of such drug or cosmetic.”

Similarly, Section 26A of the Act states, “Power of Central Government to prohibit manufacture, etc., of drug and cosmetic in public interest.—Without prejudice to any other provision contained in this Chapter, if the Central Government is satisfied, that the use of any drug or cosmetic is likely to involve any risk to human beings or animals or that any drug does not have the therapeutic value claimed or purported to be claimed for it or contains ingredients and in such quantity for which there is no therapeutic justification and that in the public interest it is necessary or expedient so to do, then, that Government may, by notification in the Official Gazette, [regulate, restrict or prohibit] the manufacture, sale or distribution of such drug or cosmetic.”

Relying on these provisions, and noting that “no objections and suggestions were received from the public on the said rules” and “safer alternatives to the said drugs for animal use are available,” the Centre concluded that it was in public interest to prohibit the use of several categories of antimicrobials for animals.

The Gazette notification finally declared:

“The Central Government is satisfied that it is necessary and expedient in the public interest to prohibit the import, manufacture, sale, and distribution of any antimicrobial medicinal products for animal use as specified in this notification;
Now, therefore in exercise of the powers conferred by sections 10A & 26A of the Drugs and Cosmetics Act, 1940 (23 of 1940), after consultation with the Drugs Technical Advisory Board, the Central Government hereby prohibit the import, manufacture, sale and distribution of the following antimicrobials and group of such antimicrobials and their formulations for animal use namely: –
1. Antibiotics
i. Ureidopenicillins
ii. Ceftobiprole
iii. Ceftaroline
iv. Siderophore cephalosporins
v. Carbapenems
vi. Penems
vii. Monobactams
viii. Glycopeptides
ix. Lipopeptides
x. Oxazolidinones
xi. Fidaxomicin
xii. Plazomicin
xiii. Glycylcyclines
xiv. Eravacycline
xv. Omadacycline
2. Antivirals
i. Amantadine
ii. Baloxavir marboxil
iii. Celgosivir
iv. Favipiravir
v. Galidesivir
vi. Lactimidomycin
vii. Laninamivir
viii. Methisazone/ Metisazone
ix. Molnupiravir
x. Nitazoxanide
xi. Oseltamivir
xii. Peramivir
xiii. Ribavirin
xiv. Rimantadine
xv. Tizoxanide
xvi. Triazavirin
xvii. Umifenovir
xviii. Zanamivir
3. Antiprotozoals
Nitazoxanide

To view the official notice, click the link below:

https://medicaldialogues.in/pdf_upload/20250923so-4338e-302594.pdf
Also Read: Health Authorities Crack Down on OTC Sale of Antibiotics, NRx Drugs in Visakhapatnam

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TyG-BMI may predict Adverse Pregnancy Outcomes in IVF, suggests research

Researchers have found in a new study that higher triglyceride-glucose body mass index (TyG-BMI) was associated with increased miscarriage rates in both fresh and frozen embryo transfer (FET) cycles, along with reduced live birth rates in FET and cumulative live birth outcomes. TyG-BMI may serve as a practical marker to identify patients at higher metabolic risk before in vitro fertilization (IVF) treatment.

Assisted reproductive technologies have transformed infertility care, but pregnancy outcomes remain highly variable due to both clinical and metabolic factors. Traditional predictors such as age, ovarian reserve, and body mass index (BMI) provide only partial insight into reproductive prognosis. TyG-BMI, which integrates lipid and glucose metabolism with body mass assessment, has recently emerged as a potential surrogate marker for insulin resistance, a well-known contributor to suboptimal fertility outcomes. In this study, researchers analyzed IVF outcomes across women stratified by TyG-BMI levels. Results showed that patients with higher TyG-BMI not only had a significantly greater risk of miscarriage in both fresh and frozen embryo transfer cycles but also experienced lower rates of live birth in frozen transfers and reduced cumulative live birth rates. These findings highlight the potential of TyG-BMI as a simple, cost-effective, and non-invasive tool to screen for metabolic risk in women undergoing IVF. The study underscores the importance of preconception metabolic assessment in reproductive medicine. By incorporating TyG-BMI into baseline evaluations, clinicians may be able to identify patients at risk for adverse pregnancy outcomes and provide targeted lifestyle, nutritional, or pharmacological interventions to optimize metabolic health before treatment. This could improve overall pregnancy success rates and reduce the emotional and financial burden associated with repeated IVF cycles. However, the authors cautioned that larger multicenter trials are necessary to validate TyG-BMI as a reliable predictive marker across diverse populations. They also noted that future studies should explore whether interventions aimed at lowering TyG-BMI can directly improve reproductive outcomes.

Keywords: TyG-BMI, in vitro fertilization, IVF outcomes, miscarriage risk, frozen embryo transfer, live birth rate, metabolic risk, insulin resistance

Reference:
Zhang X, et al. Association of triglyceride-glucose body mass index with pregnancy outcomes in in vitro fertilization cycles. Fertility and Sterility. 2025. doi:10.1016/j.fertnstert.2025.09.012

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Women’s Childbirth Experiences in the WILL Randomised Trial: A Mixed Methods Analysis

Chronic or gestational hypertension complicates 7% of
pregnancies, half of which will reach 37 weeks’ gestation. Observational data
suggest that early term birth (at 37 to 38 weeks) may reduce maternal
complications (e.g., preeclampsia), Caesareans, stillbirth and costs of
maternal fetal surveillance; however, early term birth may increase neonatal
morbidity. There are no high-quality data on which to base timing of birth for
this high-risk population.

The WILL trial (When to Induce Labour to Limit risk in pregnancy
hypertension) aimed to address the optimal timing of birth for women with
chronic or gestational hypertension at term gestational age, when women remain
well and there is no evidence of pre-eclampsia. WILL was a multicentre
randomised trial of 403 women with chronic or gestational hypertension, who
were randomised at 37+0–6 weeks’ gestational age to either ‘planned early term
birth at 38+0–3 weeks’ gestation’ (N = 201, intervention group) or ‘usual care
at term’ (N = 202, control group); the trial was stopped early by the funder
due to slower-than-anticipated recruitment during the COVID-19 pandemic. The
clinical outcomes and costs favoured the intervention group. While in the
intervention (vs. control) group, there was no difference in the co-primary
outcomes of ‘poor maternal outcome’ (severe hypertension, maternal death, or
maternal morbidity; 27, 13% vs. 24, 12%, respectively) or ‘neonatal unit
admission for ≥4 h’ (14, 7% vs. 14, 7%, respectively), or Caesarean births (58,
29% vs. 72, 36%, respectively), there was a significant reduction in
pre-eclampsia (56, 27.9% vs. 76, 37.6%, respectively) and costs for tests of
maternal or fetal wellbeing (102.84, 95% CI −136.65 to −67.78).

In addition to clinical outcomes and costs, patients’
experiences were evaluated in the WILL trial. As with all health policy, it is
important that timing of birth recommendations be associated with positive
psychosocial outcomes for women, particularly as dissatisfaction with the
childbirth experience has been associated with negative consequences, such as
on breastfeeding, infant bonding and postpartum mental health. In this article,
authors described the experiences of women in the WILL trial, as evaluated by
the Childbirth Experience Questionnaire (CEQ) and their associated free-text
comments.

In intervention (vs. control) groups, the CEQ was completed
by 177/202, 88.1% (vs. 180/202, 89.1%) participants, and 378 free-text comments
were made by 93/177, 52.5% (vs. 98/180, 54.4%) participants. There was no
significant difference in CEQ scores overall (3.1±0.4 vs. 3.1±0.4,
respectively) or by domain (‘Own capacity’ [2.8±0.5 vs. 2.7±0.5, respectively];
‘Professional support’ [3.7±0.5 vs. 3.7±0.6, respectively]; ‘Perceived safety’
[3.2±0.6 vs. 3.1±0.6, respectively]; and ‘Participation’ [2.6±0.7 vs.
2.7±0.6]). Most comments were positive (222/378, 58.7%), and about ‘Relational
care and care interactions’ (CEQ ‘Professional support’). Neither the number
nor positivity of comments appeared to differ between groups.

In this trial of 403 high-risk women with chronic or
gestational hypertension, randomisation to planned early term birth at 38+0–3
weeks (vs. usual care at term) resulted in a similar childbirth experience
overall, by CEQ domain, and whether labour induction or adverse outcomes had
occurred. Just over half of women who responded to the CEQ provided free-text
comments, and most were positive, particularly regarding ‘Relational care and
care interactions’ (CEQ ‘Professional support’ domain). Also, most comments
endorsed the ‘Conceptualising safety’ theme, even when labour induction did not
go as planned. However, it was clear that labour induction was not always
viewed positively, in both arms and across themes of ‘Capacity for autonomy
over care’, ‘Experiences of labour and birth’, and the less frequently-endorsed
themes of ‘Lack of shared decision-making’ and ‘Experience of participating in
research’. Repeatedly, women described logistical issues related to initiation
of labour induction, lack of information, the process not going as they had
expected, uncontrolled pain, and not always being listened to.

For women with chronic or gestational hypertension who
remain well at term gestational age, authors found no difference in childbirth
experience between women randomised to planned early term birth at 38+0–3
weeks’ gestation, compared with usual care at term. This was true regardless of
initiation of birth, mode of birth, or pregnancy outcome, and in directed
content analysis of free-text comments. Based on these findings, shared
decisions about the timing of birth may be more influenced by differences in
clinical outcomes and costs. Additionally, labour induction experiences may be
improved with good information sharing and preparation, to facilitate a sense
of ownership and control of labour.

Source: Sue Tohill, Katie Kirkham,
Eleni Gkini; BJOG: An International Journal of Obstetrics &
Gynaecology, 2025; 0:1–12 https://doi.org/10.1111/1471-0528.18257

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Higher levels of air pollution linked to worsening of sleep apnea: ERS Stu

People who have obstructive sleep apnoea (OSA) may suffer worse symptoms if they live in areas with higher levels of air pollution, according to a multi-national study presented at the European Respiratory Society (ERS) Congress in Amsterdam, the Netherlands .

Patients with OSA often snore loudly, their breathing starts and stops during the night, and they may wake up several times. Not only does this cause excessive sleepiness, but it can also increase the risk of high blood pressure, stroke, heart disease and type 2 diabetes. OSA is very common, but many people do not realise they have the condition.

The research was presented by Martino Pengo, Associate Professor from the University of Milano-Bicocca and clinician at Istituto Auxologico Italiano IRCCS, Milan, Italy. He told the Congress: “We know that OSA is more common in people who are older or overweight, but there’s growing concern that air pollution also might make the condition worse. However, previous studies, mostly focused on just one country, have produced mixed results. We wanted to look at this on a larger scale, across several European cities, to better understand if and how air pollution affects OSA.”

The study included data on 19,325 patients with OSA from 25 different cities in 14 countries [2]. All patients are taking part in a larger research project called the European Sleep Apnoea Database. As well as providing data on their age, sex, BMI and whether they smoke, all patients took part in a sleep study to measure the quality of their sleep and confirm a diagnosis of OSA, including recording pauses in breathing and drops in the level of oxygen in the blood.

Researchers combined this patient data with records of PM10 concentration in the air where each patient lives, taken from the Europe-wide Copernicus Atmosphere Monitoring Service. PM10 concentration is the amount of tiny particles, 10 micrometres or smaller, released into the air by vehicle exhausts and industrial processes, for example.

The analysis revealed that, overall, for every one unit increase in PM10, there was a modest but measurable increase in the patients’ apnoea hypopnea index (AHI). AHI is the number of apnoeas (when breathing stops) and hypopneas (when breathing is reduced) per hour during sleep. For example, among patients with low AHI (less than five) the average PM10 in the area where they live was relatively low (around 16 micrograms per cubic meter of air). In contrast, in patients with high AHI (five or more) the average PM10 was also higher (around 19 micrograms per cubic meter of air).

Researchers also found differences between the strength of the link between air pollution and OSA in different cities around Europe: for instance, in cities like Lisbon (Portugal), Paris (France), and Athens (Greece) the association was particularly strong.

Professor Pengo said: “We confirmed a statistically significant positive association between average long-term exposure to air pollution, specifically fine particles known as PM10, and the severity of obstructive sleep apnoea. Even after we took account for other factors that we know have an effect on OSA, we still found an average increase in the number of respiratory events per hour of sleep of 0.41 for every one unit increase in PM10. This effect may seem small for an individual, but across entire populations it can shift many people into higher-severity categories, making it meaningful from a public health perspective”.

“One of the most interesting findings was that the link between air pollution and OSA severity wasn’t the same in every European location. In some cities, the impact was stronger; in others, it was weaker or even absent. These regional differences might be due to things like local climate, the type of pollution or even how healthcare systems detect OSA.”

The researchers say they want to understand why the effects vary between cities and whether some people are more affected by pollution than others. They also hope to explore whether reducing pollution can improve sleep apnoea symptoms.

Professor Sophia Schiza is Head of the European Respiratory Society’s expert group on sleep disordered breathing, based at the University of Crete, Greece, and was not involved in the research. She said: “Obstructive sleep apnoea is a common condition. People who have OSA may know that they snore or wake up often in the night, and they may also feel sleepy during the day. There are also serious health risks associated with this condition. For people with OSA, especially those living in cities with high levels of air pollution, this study is important as it suggests pollution could be making their condition worse.

“For doctors caring for people with OSA, this research highlights the need to consider environmental factors like air quality alongside other risk factors. This study strengthens the connection between environmental health and sleep medicine. It reminds us that tackling air pollution isn’t just good for the planet, it’s also vital for our lungs and our sleep quality too.”

Reference:

Higher levels of air pollution linked to worsening of sleep apnea European Respiratory Society, Meeting: European Respiratory Society Congress.

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Acupuncture treatment improves disabling effects of chronic low back pain in older adults, claims research

According to a study funded by the National Institutes of Health (NIH), older Americans with chronic low back pain who received acupuncture had greater improvement in physical function and reduced pain than those who received usual medical care only, generally prescribed medications or physical therapy. Chronic low back pain is the leading cause of disability worldwide and affects over one-third of older adults in the United States. Treatment options range from pain-relieving drugs to complementary therapies, including acupuncture. There is an urgent need for safe, effective, and non-addictive pain management approaches.

“Of the different treatments we have for chronic low back pain, most have a somewhat modest effect. They often reduce pain by about a third at best and can help people function better,” said lead author Lynn L. DeBar, Ph.D., Kaiser Permanente distinguished investigator. “Our clinical results suggests that acupuncture is working as well as many things that are more familiar to people. We found that the size of this effect, while modest, was positive and sustained.”

The clinical trial, known as BackInAction, enrolled 800 participants, with results based upon self-reported pain-related disability assessments following treatment that either included or omitted acupuncture. Researchers looked at whether manual acupuncture needling, which is eligible for Medicare coverage, could improve function and reduce pain for older adults who have chronic or persistent low back pain.

Acupuncture, with its origins in traditional East Asian medicine, has gained in popularity in the United States since the 1970s. The manual acupuncture needling technique entails inserting fine needles into the skin at points that follow a prescribed anatomical grid. The practice provides various benefits, including reduced discomfort from back, joint or neck pain. While acupuncture has been found to be safe and effective for chronic low back pain in adults overall, few acupuncture studies have focused on adults 65 years of age and older.

Participants in BackInAction included men and women aged 65 and older with a medical history of low back pain for at least three months. All participants had health coverage and were not restricted from receiving usual medical care for their back pain. A third of those received up to 15 acupuncture treatments over three months (standard acupuncture treatment), and another third received an additional six acupuncture treatments (maintenance sessions) over the following three months.

At three study milestones — after three, six and 12 months from enrollment — participants provided self-assessment of their pain and physical limitations. Their agreement with any of 24 statements that describe everyday activities made difficult because of back pain contributed to the participant’s disability score. The researchers used additional tools for insights into pain levels, degree of physical functioning, depression and anxiety.

At the six-month and 12-month assessment, both groups who received acupuncture had greater reductions in pain disability than those who received usual medical care alone. The acupuncture-treated groups also had reduced pain intensity and greater physical function after six months as compared to participants who did not receive acupuncture. The researchers also reported that acupuncture treatment was associated with fewer anxiety symptoms as compared to usual medical care alone at the six and 12-month assessments.

“What sets the BackInAction study apart is that it focused specifically on adults 65 years of age and older, and it was pragmatically designed,” DeBar said. “We worked hard to involve adults in multiple regions of the country so that participant demographics were consistent with the U.S. census for older adults—and we worked with licensed acupuncturists in the community, who are most likely to deliver these services.”

The study authors suggest that access to acupuncture is important for older adults with chronic back pain and that if acupuncture practitioners could bill Medicare directly it could greatly improve access to such services.

“We saw very little in the way of adverse effects during the clinical trial,” said co-lead researcher Andrea J. Cook, Ph.D., Kaiser Permanente senior biostatistics investigator. “Older adults often are dealing with other medical problems in addition to back pain. Acupuncture offers a less invasive option that has a better safety profile than a lot of the common treatments for back pain in older adults.” 

Reference:

DeBar LL, Wellman RD, Justice M, et al. Acupuncture for Chronic Low Back Pain in Older Adults: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(9):e2531348. doi:10.1001/jamanetworkopen.2025.31348

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RSV vaccines are safe and effective, review finds

A new Cochrane review demonstrates that vaccines for respiratory syncytial virus (RSV) are both safe and effective in protecting vulnerable groups that are most at risk of serious illness, including older adults and infants.

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‘Staggering’ costs of e-scooter injuries are quantified for the first time for hospitals in Ireland

Injuries occurring to people who ride e-scooters cost Irish hospitals an average of €1,726 per patient, and researchers have calculated the total overall cost to one hospital in a single year was €128,650.

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Hypnosis can make ventilation masks more acceptable to patients with breathing problems

Hypnosis can significantly improve patients’ tolerance of masks to help them breathe when they are suffering from acute respiratory failure, according to a pilot study presented at the European Emergency Medicine Congress.

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Higher levels of air pollution linked to worsening of sleep apnea

People who have obstructive sleep apnea (OSA) may suffer worse symptoms if they live in areas with higher levels of air pollution, according to a multi-national study presented at the European Respiratory Society (ERS) Congress in Amsterdam, the Netherlands.

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Unplanned, premature, out-of-hospital births pose challenges for emergency team

The first detailed analysis of unplanned births that occurred outside the hospital setting in Austria has shown that, although such deliveries are rare, they pose challenges for emergency teams that attend, especially if babies are born prematurely.

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