It's official, Indian-made stents as good as the best
After much controversy regarding the quality of stents manufactured in India, yet another study comparing an Indian stent with the foremost foreign stent brand has concluded it is just as good. On Monday, the results of a 10-year study comparing clinical outcomes of the Indian stent Yukon Choice PC with those of the market leader, Xience stents from the American company Abbott, showed that they were equally good. A study presented two months back had also concluded that another Indian stent, Supra Flex was as good as Xience.
At the scientific session of the American Heart Association held in Chicago, cardiologists from Germany presented the results of an extended follow up of 2,603 patients who were randomised to treatment with two new generation stents - everolimus eluting Xience and sirolimus eluting Yukon Choice - and a first generation sirolimus eluting Cypher stent. Cypher is not in the market any more. The study published in the journal of the AHA showed there was no difference in outcomes between the two new generation stents.
In February 2017, the government had capped the price of stents + leading to a three-fourths reduction in the prices for drug eluting stents. Several multinational stent companies had threatened to withdraw their stents from India claiming that they were superior to Indian ones and hence deserved a higher price. Several cardiologists too had questioned the quality of Indian stents. However, with studies showing that Indian stents are as good as foreign ones, cardiologists appear to have changed tack.
"These are the kind of studies we need - large, randomised, long-term studies. More Indian companies should do such studies to establish their credibility internationally. Every stent needs to be proven," said Dr Ashok Seth, head of cardiology for the Fortis Group of hospitals. He added that the study also showed there was no difference between stents with biodegradable polymer coating and permanent polymer coating putting paid to the argument that biodegradable polymer coated stents should get a higher price.
Stents cheaper, but not all get benefit
Before price cap, the cost was prohibitive for more than two stents, and so people often opted for open heart as it worked out to be cheaper than angioplasty. But now, multi-stenting is affordable and many patients who would have been forced to go in for an open heart surgery, now opt for stenting.
Dr Upendra Kaul, chairman of Batra Heart Centre, who initiated the earlier one-year study comparing Supraflex to Xience along with Prof Patrick Serruys from the Netherlands, pointed out that even with good newer generation stents, "3% of patients still had heart attacks and needed restenosis each year. “Further research is being done to bring down this 3%," said Dr Kaul.
Yukon stents are made in India from German technology, while Supraflex is a fully indigenous stent, pointed out Dr Kaul. In an editorial in the journal Euro Intervention last year, Dr Kaul had written: "There is a perception in the minds of cardiologists, which gets passed on to the patients, that imported stents are superior." He had added that it was time for Indian companies to prove to cardiologists and patients that their products were as safe and effective as those of multinational companies.
Ban on plastic products
Tamil Nadu government today announced ban on plastic products in the state from next year. Chief minister Edappadi Palaniswami announced this in the state legislative assembly on the occasion of the World Environment Day.
"The ban will be primarily on plastic carry bags, plastic plates, plastic cups, plastic flags, small plastic sachets used in packaging water, among others," Palaniswami said.
"However, a few plastic materials used for packing milk, curd, oil and medicine have been exempted from the ban," he said.
Making a suo motu statement in the Assembly, he sought the cooperation of people and traders in implementing this ban in the state. He said the announcement was based on the recommendations of an expert panel constituted by former Chief Minister Jayalalithaa.
The Chief Minister said the disposal of plastic material affects the flow of waste water and drainage and deeply affects the ground water table.
Pollution from plastic products lead to water stagnation, resulting in spread of malaria and dengue. "Hence to ensure a better pollution-free environment for our next generation, we hereby bans manufacture and use of plastic products from January 1, 2019," Palaniswami announced in the Assembly.
Mother Teresa Life & Living
Nikola Bojaxhiu, a prosperous business man, and a multi-linguist who had widely traveled, was active in politics and the local church in Skopje, Macedonia. He wedded Dranafile Bernai, and soon became the father of three children. Aga, a daughter, Laza, a son, and Agnes Gonxha, a daughter. Agnes was born on 26 August, 1910. Gonxha in Albanian means flower bud.
Nikola passed on to his children a sense of ethnic identity and nationalist pride; however, it was Drana who nurtured the children's spiritual growth.
Agnes Gonxha often accompanied her mother, helping her as she made her way from family to family, offering both spiritual and material comfort. Dranas Christian charity offered a powerful example, helping to mould Agnes Gonxhas spiritual life and to shape her destiny.
In 1919, Agnes Gonxhas father was dead at the age of 45. Nikola Bojaxhius death devastated his wife; Drana fell into deep, prolonged, and often incapacitating grief. Dranas infuence on her children was extraordinary, especially after their fathers death. So powerful was Dranas presence that Agnes Gonxha recalled, Home is where the mother is.
Besides her mother, the Sacred Heart church exercised the most influence on young Gonxha. I was only twelve years old... when I felt the desire to become a nun, Mother Teresa recalled. Father Franjo Jambrekovic, a young Jesuit priest passed on to the members of Sacred Heart Parish the news of the missionary efforts that the Jesuits had undertaken. The missionaries wrote impassioned letters describing the horrible conditions under which the poor and the in lived in India. The zeal with which Father Jambrekovic spoke of the Jesuit missions in India, sparked a renewed sense of devotion in Agnes Gonxha. The more she heard about the missions in India, the more she was drawn to the possibility of working there. Agnes Gonxha had grown into an attractive young woman, a good student, neat and clean in appearance, self-disciplined, and well organized, she had already earned a reputation in the community for her friendliness and willingness to help anyone. But Gonxha was struggling with her decision to become a nun.
Trying to decide the mission of her life, Gonxha turned to Father Jambrekovic for advice. In later years, Mother Teresa acknowledged that there was no doubt in her mind about her decision, stating simply that God had made the choice for her. One day, after returning home from a visit to the shrine of the Madonna, Agnes Gonxha informed her mother that she had made up her mind to become a nun. Because of her interest in missionary work, she intended to apply to the order of the Loreto Sisters, an Irish branch of the Institute of the Blessed Virgin Mary who worked with the Jesuits in Bengal.
Drana gave her daughter her blessing, but also warned her that in choosing to become a nun, she must turn her life over to God without doubt, without fear, without hesitation, and without remorse. The time came for Gonxha to leave Skopje. She was to travel to Paris, where the Mother Superior of the Loreto Sisters was to interview her to determine whether Agnes Gonxha was acceptable to the order. On August 15, 1928, guests came to the Agnes Bojaxhiu home to wish her farewell and her friends gathered to wish the Bojaxhiu woman a safe journey. Finally, on October 8, Agnes Gonxha, accompanied by another young woman, Betika Kanjc, who also hoped to join the Loreto Sisters, boarded the train to Paris. Waving goodbye, Agnes Gonxha bid farewell to her mother, whom she never saw again.
As the train pulled away from the Zagreb station on its way to Paris, Gonxha must have thought about the consequences of her decision. Not only was she leaving her family and friends, she was also leaving the only home she had ever known. If the Loreto Sisters accepted her application, it would mean lifetime separation from her family and her country. She could probably never even visit her homeland again. The chances of her family visiting her were equally remote; travel was expensive and there would be little opportunity for her mother, brother, or sister to come to India. Whether she felt sad and lonely as the train rolled on toward Paris, Gonxha knew that she had made the right choice. Her life belonged to God.
M O T H E R T E R E S A -THE LORETO SISTERS
Beginning in 1834, the Jesuits began arriving in Bengal near Calcutta with a mission to serve the poor. They established St. Xaviers School in which they taught Catholics, Hindus, and Muslims alike. It soon became apparent, though, that the community needed a separate school for the daughters of Irish Catholic military families.
When approached about the possibility of sending nuns to India to staff the girls school, Mother Teresa gently but refused. There were too many children in Ireland in need of assistance. There was also a shortage of nuns. Her German visitor countered that in refusing to send members of her order to India. The case went before the entire community; they would decide whether to accept the mission to India.
In the end, seven sisters decided to go to India, marking the beginning of Loreto missionary work there. On August 23, 1841, the seven, accompanied by two priests and six postulants, or novice nuns, set sail. Almost four months later, they disembarked in Calcutta. disembarked in Calcutta. The little band took possession of the house at 5 Middleton Row, where they were to live and teach. The sisters prepared the once lavishly furnished house into simpler living quarters and classrooms. The 67-foot dining room became the school hall.
The sisters then traveled to the local orphanage near the cathedral of Our Lady of the Rosary to meet the church officials and the children. Finally, on January 10, 1842, the Loreto School opened its doors to boarders and day students.
The initial reports that Mother Teresa received from India were enthusiastic. Streams of volunteers now offered to go to India to aid the Loreto Sisters of Calcutta. In spite of a number of nuns dying of cholera, the flow of volunteers did not stop. It was this pioneering and courageous group of teachers that Gonxha Bojaxhiu soon hoped to join.
On December 1, 1928, the two women Gonxha and Betika set sail for India. Upon their arrival there, the two would begin their novitiate, that is the period of study and prayer which every nun takes before her vows. The sea voyage proved long and arduous, winding its way Suez Canal, then the Red Sea, the Indian Ocean, and the Bay of Bengal. On January 6, 1929, the ship arrived at Calcutta. But at this point, Gonxha had little chance to become acquainted with her surroundings. After just a few days, on January 16, she was sent to the Loreto Novitiate located in Darjeeling, a fashionable hill resort about 400 miles north of Calcutta.
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