Editor-in-Chief eMediNexus – Dr KK Aggarwal
2nd May 2019
Building consensus on off-label uses of sildenafil

Dr KK Aggarwal, Padma Shri Awardee

We are building consensus on the off-label uses of sildenafil. The current indications approved by DCGI are as follows:

Drug Name


Date of Approval


Sildenafil citrate film coated 25/50/100 mg

By urologist, psychiatrist, endocrinologist in erectile dysfunction in men.


Cardiologists decide about contraindications but cannot prescribe.

Sildenafil Citrate Orally Disintegrating Strips: 25mg / 50mg

Erectile dysfunction.


Quick acting. Does not mention about restrictions of prescribers. 100 mg will be off label use.

Sildenafil Citrate 20mg

Pulmonary arterial hypertension (WHO group I) to improve exercise ability.


Approved only for primary PPH. For others it will be off label use. Does not mention about prescribing restrictions.

Sildenafil Citrate Injection 0.8mg/ml

Pulmonary arterial hypertension (PAH) (WHO Group-1) to improve exercise ability and delay clinical worsening.



(Source: New Drugs Approved by CDSCO at https://cdscoonline.gov.in/CDSCO/Drugs)....read more

US FDA clears heat-not-burn tobacco device for sale

Dr KK Aggarwal, Padma Shri Awardee

The US Food and Drug Administration has cleared a heat-not-burn tobacco device designed as an alternative to conventional cigarettes, for sale in the United States.

The product consists of a tube that gently heats up sticks of tobacco instead of burning them, making what is inhaled less harmful than conventional cigarette smoke.

The FDA said the marketing of the devices is "appropriate" for public health because "the products produce fewer or lower levels of some toxins than combustible cigarettes." The agency also said it has placed stringent marketing restrictions on the products in an effort to prevent minors from using the device......read more

Practice Updates

Environment Ministry Committee to implement the National Clean Air Program

The Union Environment Ministry has constituted a committee to implement the National Clean Air Programme (NCAP), which aims to reduce particulate matter (PM) pollution by 20%-30% in at least 102 cities by 2024. The committee will be chaired by the Secretary, Union Environment Ministry and has among its members the Joint Secretary.... read more

Childhood obesity continues to be high in WHO European region

A new study from WHO/Europe shows that, despite efforts aimed at prevention, parts of the WHO European Region continue to struggle with comparably higher rates of childhood obesity, according to a study released at this year’s European Congress on Obesity in Glasgow, United Kingdom. According to the new WHO study,.... read more

Watchful waiting reasonable for patients with diabetic macular edema and good vision

People with good vision despite having center-involved diabetic macular edema can safely forego immediate treatment of their eye condition as long as they are closely monitored, and treatment begins promptly if vision worsens, according to clinical trial results, as per a study published online.... read more

Pregnant women with congenital heart defects at greater risk of adverse events

Pregnant women with congenital heart defects (CHDs) were more likely to have comorbidities and experience adverse events during delivery including heart failure, arrhythmias, thromboembolic events, pre-eclampsia and placenta previa; hence, require additional monitoring and care.....read more

Secondhand smoke increases risk for hypertension in children

Exposure to tobacco-specific metabolites found in secondhand smoke increased blood pressure, and put children at higher risk for hypertension, as per findings of a new study presented Pediatric Academic Societies annual meeting in Baltimore.....read more

Medical Voice

1.An agreement between the UK government and food manufacturers to reduce the sugar content of high-sugar foods such as sweets, waffles, pancakes, and breakfast cereals could result in large reductions in diabetes and cardiovascular disease cases but only if it has the intended effect. In 2016, the UK government published Childhood Obesity: A Plan for Action, which set a target to reduce the sugar content of high-sugar products by 20% by 2020, through working with food manufacturers..... read more

eMedi Humor
Medicolegal Corner
eMedi Quiz
1. HBsAg positive only.
2. HbsAg and HBeAg positive.
3. HBsAg and HBe antibody positive.
4. HBV DNA positive.
Lifestyle Updates
Inspirational Story 1: Honesty
Inspirational Story 2: Learn and Earn
Infections becoming untreatable as antibiotic resistance rises around the world
About 7 lakh people die every year due to drug-resistant diseases

New Delhi, 1st May 2019: Drug-resistant diseases could cause 10 million deaths each year by 2050, warned the UN Ad Hoc Interagency Coordinating Group on Antimicrobial Resistance in a report released on Monday. It added that by 2030, antimicrobial resistance could force up to 24 million people into extreme poverty. Currently, at least 7,00,000 people die each year due to drug-resistant diseases, including 2,30,000 people who die from multidrug-resistant tuberculosis.

The report has also noted that more and more common diseases, including respiratory tract infections, sexually transmitted infections and urinary tract infections, are becoming untreatable; lifesaving medical procedures are becoming riskier, and food systems are getting increasingly precarious.

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