Centre advises against prescribing cough syrups to children below 2 years
New Delhi (PTI): The Centre has issued an advisory to all states and Union Territories, directing that cough and cold medications should not be prescribed to children under the age of two years.
The advisory, issued by the Directorate General of Health Services (DGHS), comes amid reports of child deaths allegedly linked to contaminated cough syrups in Madhya Pradesh.
Meanwhile, the Union Health Ministry noted none of the tested syrup samples in Madhya Pradesh contained Diethylene Glycol (DEG) or Ethylene Glycol (EG) -- contaminants that are known to cause serious kidney injury.
The DGHS, which comes under the health ministry, said in the advisory that cough syrups are generally not recommended for children below five years.
For those older, their use should be based on careful clinical evaluation, close supervision, strict adherence to appropriate dosing, the shortest effective duration, and avoiding multiple drug combinations, it said.
Further, people may also be sensitised regarding adherence to prescriptions by doctors, the advisory issued by Dr Sunita Sharma of the DGHS said. It reiterated judicious and rational prescribing and dispensing of cough syrups for children.
"Most acute cough illnesses in children are self-limiting and often resolve without pharmacological intervention. Non-pharmacological measures, including adequate hydration, rest, and supportive measures, should be the first-line approach," it said.
The advisory asked all healthcare facilities and clinical establishments to ensure the procurement and dispensing of products manufactured under Good Manufacturing Practices and formulated with pharmaceutical-grade excipients.
"Sensitisation of prescribers and dispensers across public and private sectors is essential to uphold these standards of care. It is requested that all state/UT Health Departments, District Health Authorities, and all Clinical Establishments/healthcare facilities under your jurisdiction should implement and disseminate this advisory across government dispensaries, PHCs, CHCs, district hospitals, and medical institutions," the advisory said.
Earlier in the day, the health ministry said a joint team comprising representatives from the National Centre for Disease Control (NCDC), National Institute of Virology (NIV), Central Drugs Standard Control Organisation (CDSCO), among others, visited the site in Madhya Pradesh to collect samples of various cough syrups amid reports linking the recent deaths of children to the consumption of cough syrups.
"According to the test results, none of the samples contained Diethylene Glycol (DEG) or Ethylene Glycol (EG), contaminants that are known to cause serious kidney injury," the ministry said.
The Madhya Pradesh State Food and Drug Administration (SFDA) also tested three samples and confirmed the absence of DEG/EG, it added.
Further, blood/CSF samples were tested by the National Institute of Virology (NIV), Pune, for common pathogens. One case was found positive for Leptospirosis, the ministry said.
Samples of water, entomological vectors, and respiratory specimens are under further investigation by National Environmental Engineering Research Institute (NEERI), NIV Pune, and other laboratories, it said.
A multi-disciplinary team comprising experts from the National Centre for Disease Control (NCDC), NIV, Indian Council of Medical Research (ICMR), AIIMS-Nagpur, and state health authorities is investigating all possible causes behind the reported cases.
On reports of two child deaths in Rajasthan because of contaminated cough syrup consumption, the ministry clarified that the product in question does not contain Propylene Glycol -- a possible source of DEG/EG contamination, it said.
Additionally, the product under reference is a Dextromethorphan-based formulation, which is not recommended for paediatric use, it said.
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A 99-run loss is unacceptable: Hayden blames batting horror
Ahmedabad (PTI): Gujarat Titans' batting coach Matthew Hayden was scathing about their 99-run defeat to Mumbai Indians, blaming a "horror" batting display and poor death bowling for the heavy loss in the IPL.
From being 44/3 in 5.5 overs, MI hammered 73 runs in the last four overs to post a challenging 199/5 here on Monday. In reply, GT were bundled out for 100.
"I expect our margins to be a lot smaller than 100 (99). That is an unacceptable scorecard for our batting unit," the legendary Australian opener told media in the post-match interaction.
"It was just a horrible day for us today. Truth be told, there was nothing good about this day, really, apart from Rabada's performance with the ball. so we've got some work to do, definitely."
GT boast a strong batting line-up in Sai Sudharsan (759 runs), Shubman Gill (717), and Jos Buttler (538). They have also added New Zealand’s explosive Glenn Phillips in the middle order alongside Shahrukh Khan and Rahul Tewatia.
"When you look down at our batting line-up, we've got wonderful players that have to be in a better mindset and better position to take their opportunities. That is our expectations and has been since the conception of this Gujarat Titans franchise...
"So you can't be sitting here and being happy about, a 100-run (99) margin game in a 20-over game. I mean, back in my day, 100 runs was almost a winning total in 50-over cricket!"
The 54-year-old said GT lost the game in the powerplay.
"Well, middle order was undoubtedly exposed today. When they're coming in with six overs, you know that you're in deep trouble. The thing about the power plays is that you can't win it from there, especially in a run chase, but you can definitely lose it, and we lost it in the power play," he said.
Shahrukh (35 off 25 balls) and Tewatia (49 off 42) have not fared well this season and Hayden feels the duo along with Phillips (67 off 54 balls) have been struggling because the top order has been below its best.
"The relevance behind balls faced when you look at, for example, someone like Glenn Phillips -- his record in T20 cricket is an impressive strike rate and you'll take that all day long in the majority of games," Hayden said.
"However, you need an upfront batting effort where you consistently taking the lion's share of the batting. We shouldn't be allowing, Tiwu (Tewatia) or Shahrukh or these guys lots of balls. That's not their role. That's not what they train for."
Hayden said GT has an aggressive and adaptable unit but their execution fell apart on the day.
"We are a very good thinking batting unit. We're not a conservative batting unit. You don't go out and get 200s as often as we do being conservative. But they're an adaptive batting unit. ...they've got their roles and they play them and today they simply didn't.
"So the worry isn't just today about the middle order. It'd be unfair to say that, they were going to go on and score 13 runs an over because by that stage, I felt like as a batting coach, I was on the mast and the boat was sinking."
It was poorly executed bowling effort
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Hayden also pointed to poor execution in the death overs.
"I feel like one-dimensional is very unfair on a world-class bowling attack, but I will take on board it was a poorly executed bowling effort this evening.
"When you look back at those last four overs, that was just a 'horror story' -- 73 off the last four is unacceptable as world-class players. That bowling line-up has to reflect on that performance... It was purely an executional thing."
He added that GT were below par with the ball on a surface that didn’t fully justify the high total.
"We're very average with the ball, firstly, on a wicket that I really felt was probably a 175-type wicket.
"When you look historically at this black soil pitch on No. 5, it's a 200-wicket for the loss of five batters. That's been its winning first-inning score, and today it wasn't that wicket (199/5)... It was visible that it had cracks in it. It was visible that it was up and down.
"So credit also has to go to Tilak Varma, who put in a wonderful performance. It wasn't a cookie-cutter type performance. It was a dominant performance down the ground. He read the play nicely. He was able to pick up and play with power and precision."
Hayden said the chase was still within reach but poor shot selection proved costly.
"And when you reflect on our own batting, we had one side of the ground that was a little more inaccessible than the other, and we lost, what, three wickets into the bigger side of that boundary.
"And it wasn't an impossible total. 200 still is a total that I would back our three world-class players at the top of the order to etch into that a bit more and then allow our more sort of game players. An opportunity to set out their stalls and bat deep into the innings."
