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Thursday, June 19, 2014

Jun 19 2014 : Mirror (Pune)
Snakebite-inundated rural PHCs find new saviour in Ayurveda


As govt struggles with anti-venom supply, Ayurvedic tablet miraculously saves woman in Satara PHC, prompting Health Director to make it available across rural Maharashtra
When a 40-year-old female farmhand from rural Malharpeth in Satara was rushed to the area’s Primary Healthcare Centre (PHC) around one month ago, her chances of survival had already almost completely diminished — having suffered the bite of an extremely venomous Krait while working in a farm, she had been found unconscious and rushed to medical care, but was given only 20 minutes to live by local medical experts. In a last ditch attempt to save her life, an oral ayurvedic tablet — ‘Pinak’ — was administered.Miraculously, the woman began responding within no time, and her life was saved.
The exemplary incident sparked the interest of State Health Director Dr Satish Pawar, who is now involved in a bid to make the life-saving tablet available in the around 1,900 PHCs across Maharashtra. On Wednesday, Pawar confirmed, “We are planning to make this tablet available in all state PHCs in a month or two. After several meetings with Ayurveda experts, we realised that unlike Anti Snake Venom (ASV), which is compulsorily administered by experts or doctors, this tablet can be administered by anybody, like an Auxiliary Nurse Midwife (ANM) — this reduces the usage of and dependency on ASVs, as the tablet is handy and will be soon ubiquitous.” Elaborating on the incident, Malharpeth PHC medical officer Dr Rashmi Kulkarni, told Mirror, “The middle-aged patient was brought to us in an unconscious state and had just about 20 minutes left to live, as the poison had already spread through her system.
Moreover, since ASV injections were unavailable at that time, we were helpless. We had no choice but to call up Ayurveda expert Dr Geeta Pawar who had worked with Sassoon hospital and co-invented Pinak, which we had at the PHC.” She continued, “On her instructions, we immediately kept two tablets under the tongue of the patient — to our absolute surprise, the patient started responding 12 minutes later! We later sent a detailed report to the State Health Director, so that in cases where ASVs — which are often in short supply — are not available, this oral Ayurveda tablet with no side effects can be administered.” Kulkarni added that this is the first time an Ayurveda tablet had been known to replace an ASV.
State Deputy Director of Health Services, Dr Pandurang Pawar, said, “There are several remote areas — including the like of Ambegaon, Khed, Junnar,
Velha, Nandurbar, Gadchiroli, etc. -where snakebites are still frequently reported, and deaths due to delays in reaching hospital are common. ASVs are also often not available, and quite costly too, with each injection priced at around Rs 4-8,000. On the other hand, an Ayurveda tablet costs around Rs 400, and is much more easily available.“Dr Ashok Nandapurkar, a civil surgeon at Aundh Civil Hospital who also heads 21 rural hospitals in the state, told Mirror, “Shortages of ASVs are rampant -annually, we need almost 10,000 vials of ASVs per annum, and since only one pharma company, Haffkine, manufactures them in association with the State, we regularly experience shortages. In cases of snakebite -specially from a snake like the Krait -a neuroparalytic attack is imminent, and death is an almost 100 per cent guarantee; but for an Ayurveda tablet that is easy to administer. Treatment modules for snakebites are also something that are often missing -I myself have administered almost 60 ASV injections to one patient who suffered from a snakebite; in contrast, just giving two oral tablets seems very effective. This will not only save time, but also government expenditure.“
Pinak co-inventor Dr Geeta Pawar said, “Pinak was invented when I was heading the Ayurveda department at Sassoon General Hospital in 2005. It is a curative not only in cases of snakebite victims, but also works on scorpion and honeybee stings. Since it is purely herbal, there are no recorded adverse effects caused by this tablet. The clinical trial of this tablet took place at Sassoon in 20072008, when 30 snakebite victims reacted positively to it, and were literally saved by its administration.“
She added, “The tablet came about when we noticed a severe adverse reaction and worsening of a paralytic attack caused by ASV administration in a patient at a Karad PHC. Thereafter, it was our effort to create a drug that would not only save patients instantly, but would also have no side effects at all.“